Henry Schein MicroMD PM 11.0 practice management software User’s Reference Manual

MICROMD PM
VERSION 11.0
USER’S REFERENCE MANUAL
TABLE OF CONTENTS
Chapter 1: General Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.1
Starting the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.1
What Does This Do? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2
Tool Tips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2
What’s This? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2
Navigating Through the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2
Title Bar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.3
Main Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.3
Task Pane . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.3
Launch Pane . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.5
Resizing the Launch Pane . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.6
Floating Tool Bar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.6
Searching for Entries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.7
Search Boxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.7
Lookup Fields . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.7
Find Fields . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.7
Wildcard Characters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.7
Global Search . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.8
Selecting Patients in The System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.9
Common Windows Functionality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.9
Browse for a File or Folder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.9
Drag and Drop . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.11
Drop‐Down Lists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.11
Multitasking Ability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.11
Pop‐up Calculators and Calendars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.12
Resize Windows . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.13
Sorting Columns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.13
Printing in the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.13
Select a Printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.13
Using the Print Icon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.14
Batch Basket . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.14
Enhanced Label Printing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.15
E‐Mail and Web Site Address Fields . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.16
Saving Data in a System Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.16
CrossCode Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.16
Chapter 2: Setup and Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.1
Master Table Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.1
Security Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.1
Customize Entries in a Category . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.1
Miscellaneous Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2
Create the List of Degrees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.3
Specify Form Types for Submitting Claims . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.3
Create a List of Personal Titles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.9
Create a List of Search Arguments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.9
Establish a List of Reasons You Recall Patients to Your Office . . . . . . . . . . . . 2.9
System Classes and Categories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.9
Coverage Classes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.10
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Diagnosis Classes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.10
Financial Classes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.11
Insurance Classes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.11
Charge Classes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.11
Patient Categories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.12
Notes Categories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.13
Task Categories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.13
Insurance Categories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.13
System Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.13
Create Locations for Practices in the System . . . . . . . . . . . . . . . . . . . . . . . . . 2.13
Define RVU Multipliers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.14
Establish System‐Wide Defaults . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.14
Enter Custom Text for the Patient Registration Sheet . . . . . . . . . . . . . . . . . . 2.19
Create Quick Text Macros . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.20
Create System‐Wide List of POS Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.20
Create System‐Wide List of TOS Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.20
Establish Sales Tax Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.20
Create a List of Departments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.21
Practice Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.21
Create a List of Procedure Modifiers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.22
Set Up Billing Messages for Statements/Bills . . . . . . . . . . . . . . . . . . . . . . . . . 2.22
Populate the POS Drop‐Down List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.22
Populate the TOS Drop‐Down List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.26
Establish the Practice’s Billing Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.27
Add Optional Modules to the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.31
Prerequisites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.32
Establish Automated HIPAA Alerts and Default Documents . . . . . . . . . . . . . 2.34
Rules Manager . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.34
Creating New Rules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.35
Rule Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.36
Insurance Classes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.41
Insurance Plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.41
Chapter 3: Identity and Access Management . . . . . . . . . . . . . . . . . . . . . . . . 3.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.1
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.1
Establish Security Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.1
Limit Access to Your System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.2
Log User Access . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.3
Viewing the Current Log Files and Archiving Manually . . . . . . . . . . . . . . . . . 3.3
Viewing Archived Logs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.4
Failed Login Attempts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.4
Specify Password Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.5
Reset Passwords . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.6
Users and Groups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.6
About Permissions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.6
Creating User Groups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.8
Creating a New User . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.9
Example of the Versatility of the Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.11
Change Password Utility for User . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.12
Chapter 4: Your Practice in the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.1
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In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.1
Add New Providers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.1
Add a New Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.6
Associate Providers with the Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.9
Associating Locations with a Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.11
Provider/Practice IDs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.12
Practice Insurance ID Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.13
Provider Insurance IDs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.14
Provider Network IDs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.16
Provider Credentials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.16
Chapter 5: Diagnosis and Procedure Codes . . . . . . . . . . . . . . . . . . . . . . . . . . 5.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.1
Diagnosis Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.1
Practice Common List of Existing Diagnosis Codes for ICD‐10 . . . . . . . . . . . . 5.4
CrossCode Messages—Diagnosis with a Procedure . . . . . . . . . . . . . . . . . . . . 5.7
ICD Searching . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.8
ICD‐10 Diagnosis Validation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.8
Procedure Codes—Charge Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.9
Specify Different Codes/Modifiers for Different Plans . . . . . . . . . . . . . . . . . . 5.14
Specify Different Fees for Each Practice in the Database . . . . . . . . . . . . . . . 5.15
Specify Plans for Capitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.17
Allowed Amounts for the Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.17
Sliding Level Overrides for Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.20
CrossCode Messages—Procedure with a Diagnosis . . . . . . . . . . . . . . . . . . . . 5.21
Explosion Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.22
Procedure Codes—System Billing Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.23
Payment and Write‐off Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.23
Adjustment Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.27
Billing Note Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.29
Chapter 6: Insurance Plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.1
Search for a Plan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.1
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.2
Create a New Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.3
Validating Policy Numbers for the Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.8
Enter the Payment Schedule for the Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.10
Specify Capitated Procedures for the Plan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.11
Indicate Procedures Requiring Pre‐Certification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.11
IDs Tab. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.11
Allowed Amounts for the Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.17
Provider Credentials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.19
CrossCode Messages—Combinations Allowed with This Plan . . . . . . . . . . . . . . . . . . . 6.20
Refer Dr. Tab. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.21
Miscellaneous Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.21
Record Additional Contacts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.21
Plan Copy Utility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.22
Deleting Plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.23
The Plan List Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.24
Chapter 7: Other Necessary Data for Setup. . . . . . . . . . . . . . . . . . . . . . . . . . 7.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.1
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Service Facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.1
Enter a Facility’s Insurance ID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.4
Add the List of Care Units to the Facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.5
Record Additional Contact Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.5
Employers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.5
ZIP Codes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.7
Adding ZIP Codes to the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.7
Country Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.7
Deleting ZIP Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.8
Chapter 8: Patient Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.1
Patient Accounts in the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.1
Adding a Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.1
Deleting a Patient Account . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.12
Temporary Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.12
Patient Sub‐Accounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.13
Enter the Patient’s Plan Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.14
About the System’s Default Plan Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.16
Add Plans to a Plan Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.16
Create Additional Plan Sets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.20
Deleting a Plan Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.20
Changing Insurance Plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.20
Deleting Insurance Plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.21
Create Case Information for a Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.21
Case Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.27
Patient Account Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.28
Printing Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.29
Adding a Note to the Task List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.30
Contacts Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.30
Special Behaviors of Emergency and Pharmacy Types . . . . . . . . . . . . . . . . . . 8.31
Phone Number Fields on the Contacts Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.31
Customize Patient Search List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.31
Search for an Existing Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.32
Patient Utilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.33
Copy Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.33
Renumbering Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.34
Exporting Patient Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.35
Patient Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.35
Patient Chart. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.37
Planned Visits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.37
Patient Registration (Information) Sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.39
Print Labels or Document . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.39
Appointment History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.39
Responsible Party. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.39
Billing Inquiry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.39
View a Patient’s Diagnosis History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.40
View a Patient’s Procedure History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.40
Chapter 9: Day Sheets and Charge Slips. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.1
Example Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.1
4
Table of Contents
Creating and Selecting a Day Sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.1
Security Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.1
Creating a Day Sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.2
Selecting a Day Sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.3
Changing a Day Sheet’s Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.4
Setting Up the Day Sheet Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.5
Day Sheet Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.5
Overview of the Day Sheet Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.7
Closing/Erasing the Day Sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.10
Balancing the Day Sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.10
Erasing the Day Sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.10
Retrieving Day Sheet Totals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.11
Activities Available with the Day Sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.11
Charge Slips. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.14
Designing a Charge Slip . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.14
Editing the Charge Slip . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.18
Charge Slip Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.18
Customize Header Block . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.19
Printing Options Available for All Charge Slips . . . . . . . . . . . . . . . . . . . . . . . . 9.20
Default Charge Slips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.21
Associate a Charge Slip with a Provider . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.22
Associate a Charge Slip for an Appointment Class . . . . . . . . . . . . . . . . . . . . . 9.22
Printing Charge Slips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.23
Print Under the Appropriate Day Sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.23
Charge Slip Print Order . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.24
Print Charge Slips for Patients with a Scheduled Appointment . . . . . . . . . . 9.26
Pick and Choose Patients for Whom to Print Charge Slips . . . . . . . . . . . . . . 9.28
Reprinting Charge Slips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.29
Missing Charge Slip Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.30
Deleting Charge Slips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.30
Chapter 10: Appointments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.1
Set up Appointment Module. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.1
Set Up Appointment Classifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.2
Establish Appointment Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.4
Create Day Templates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.6
Create Week Templates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.9
Provider Week Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.10
Default Provider Week . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.11
Copying Appointment Templates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.11
Holiday/Vacation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.12
Appointment Views . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.15
Provider Display Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.16
Customize Day Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.18
Daily View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.19
Weekly View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.21
Provider Day View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.21
Location Day View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.22
Resource Allocation View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.23
Scheduling Appointments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.25
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Table of Contents
Scheduling Existing Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.29
Scheduling a New Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.31
Recurring Appointments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.33
Copy an Appointment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.36
Delete an Appointment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.37
Rescheduling Appointments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.37
Search for Open Slots . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.38
Appointment Inquiry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.40
Appointment Requests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.41
Appointment Clipboard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.41
Security Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.42
Add Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.42
Delete Entries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.43
Filter Entries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.43
Appointment Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.44
Adding a Note to a Log Entry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.44
Printing the Appointment History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.45
Make Changes to the Appointment Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.45
Delete Old Appointments from the Database . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.45
Check‐In/Check‐Out Module. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.46
Checking a Patient “In” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.47
Selecting a Plan Set When Checking “In” . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.47
Checking a Patient “Out” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.48
Checked In/Checked Out Indicator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.48
Display Only Certain Provider/Location Appointments . . . . . . . . . . . . . . . . . 10.49
Checking in a Temporary Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.49
Display Appointment Detail or Patient Detail . . . . . . . . . . . . . . . . . . . . . . . . . 10.49
Print Charge Slip from the Check‐in/Check‐Out Module . . . . . . . . . . . . . . . . 10.50
Waiting List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.50
Add Patients to the Waiting List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.51
Expired Waiting List Entries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.52
Schedule from the Waiting List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.52
Hospital Rounds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.52
Print a List of Hospital Rounds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.55
Export Appointments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.55
Appointment Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.56
Check‐In/Check‐Out Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.56
Classification Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.57
Day of Week Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.58
Hospital Rounds Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.58
Pre‐certification Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.59
Referral Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.60
Appointment Schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.60
Status Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.62
Appointment Mail Merge Documents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.63
Create a Mail Merge Document . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.63
Print an Appointment Document – Individual Patient . . . . . . . . . . . . . . . . . . 10.64
Print an Appointment Document – Multiple Patients . . . . . . . . . . . . . . . . . . 10.64
Chapter 11: Posting Charges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.1
6
Table of Contents
Overview of Charges/Payments Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.1
Overview of Patient Sequences Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.2
Overview of Charges Window. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.4
Overview of the Claim Transactions Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.9
Posting Charges on an Individual Basis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.11
Posting Charges from the Charge Slips List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.15
Batch Charge Posting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.17
Track Charges as You Post . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.17
Posting Charges in a Batch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.19
AutoCharge Posting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.22
Posting Pending Charges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.25
ICD Code Matching of Imported Charges . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.25
Pending Charges List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.25
Review and Modify Pending Charges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.26
Posting From the List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.28
Placing a Pending Charge on Hold . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.28
Pending Charges Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.28
Posting Patient Co‐Pays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.29
How the System Knows the Patient Has a Co‐Pay . . . . . . . . . . . . . . . . . . . . . 11.29
Tracking Co‐Pays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.30
Reset Co‐pay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.32
Posting Explosion Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.32
Posting Taxable Items . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.33
Editing Charges. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.33
Editing Charges on an Existing Sequence . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.33
Entering Sequence Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.34
Correcting Charge Posting Mistakes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.36
Voiding Charges and Sequences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.36
Posting Charge Adjustments Automatically . . . . . . . . . . . . . . . . . . . . . . . . . . 11.37
Posting Adjustments Manually . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.38
Erasing Charge and Adjustment Entries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.39
Modifying the Plan for the Claim . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.40
Changing Responsibility of a Sequence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.41
Change Responsibility from Insurance to Patient . . . . . . . . . . . . . . . . . . . . . . 11.42
Removing the Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.43
Removing the Claim . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.43
Change Responsibility from Patient to Insurance . . . . . . . . . . . . . . . . . . . . . . 11.44
Merging Sequences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.44
Splitting Sequences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.45
How to Split a Sequence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.47
Other Uses of Split Sequences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.48
Reorder Items in a Sequence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.48
Extra Billing Options. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.49
Ambulance Billing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.49
Chiropractic Billing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.51
Claim Attachment Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.52
Additional Forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.53
Keystroke Posting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.54
Chapter 12: Processing Claims . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.1
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How the System Creates Claims . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.1
Claim Forms and ICD‐10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.2
Processing Electronic Claims . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.2
Functional Acknowledgement (997) Reports . . . . . . . . . . . . . . . . . . . . . . . . . 12.5
Processing Secondary Electronic Claims . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.6
Processing Paper Claims . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.6
Adjusting the Printer Margins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.9
Editing Claims . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.10
Editing from the EB Summary Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.10
Editing Plan Only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.11
Editing Claims . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.11
Adding Non‐Charge Line Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.12
Claim Adjustment Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.12
Entering Other Claim Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.17
Placing a Claim on Hold . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.19
Refile Claims . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.19
Filing Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.22
Chapter 13: Posting Payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.1
Overview of the Payment Calculation Windows . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.1
Green Primary Payment Calculation Window . . . . . . . . . . . . . . . . . . . . . . . . . 13.2
Blue Supplemental and Patient Payment Calculation Window . . . . . . . . . . . 13.5
Viewing Payment Details . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.6
Line‐Item Posting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.7
Posting Primary Insurance Payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.7
Partial Claim Payment and Refiling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.9
Posting Patient and Supplemental Insurance Payments . . . . . . . . . . . . . . . . 13.9
Batch Payment Posting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.11
Track Payments as You Post . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.11
Batch Payment Posting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.13
Posting Patient Payments for Entire Account . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.15
Transfer Patient Payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.17
Credit Card Payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.19
Reimbursements with the standard swiper . . . . . . . . . . . . . . . . . . . . . . . . . . 13.24
Reimbursements with the chip‐enabled swiper . . . . . . . . . . . . . . . . . . . . . . . 13.25
Security code for refunds and voids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.26
Payments made before the charge is entered . . . . . . . . . . . . . . . . . . . . . . . . 13.26
Force posting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.27
Credit card payments over the phone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.28
Printing a receipt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.28
Transaction detail . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.29
Day sheet. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.29
Printing Patient Receipts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.30
Correcting Posting Mistakes Made in Payment Module. . . . . . . . . . . . . . . . . . . . . . . . 13.30
Posting Adjustments Automatically . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.31
Posting Payment Adjustments Manually . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.33
Erasing Payments/Write‐offs and Their Adjustments . . . . . . . . . . . . . . . . . . 13.34
Unapplied Payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.35
Using the Payment Calculation Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.35
Using the Payment Details Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.36
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Unapplied Payments Utility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.37
Posting Without Payment Calculation Windows. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.39
Keystroke Posting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.41
Chapter 14: Statements and Bills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.1
Overview of Generating Statements/Bills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.1
Setting Up Statements/Bills Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.2
Additional Setup Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.8
Finance Charges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.8
Create a Finance Charge Adjustment Code . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.8
Set up to Apply Finance Charges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.9
Finance Charge Calculation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.9
Remove Finance Charge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.10
Cycle Billing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.11
Example . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.11
How to Establish Cycle Billing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.12
Generating Statements/Bills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.12
Including Patients with a Newly Patient‐Responsible Balance . . . . . . . . . . . 14.14
Where Does the Patient Send Payment? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.15
Automated Dunning Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.15
Itemized Statements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.15
Itemized Statement Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.15
Printing Itemized Statements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.17
Third‐Party Statements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.18
Entering Third Parties into the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.18
Assigning a Third Party to a Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.18
Generating a Third‐Party Statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.19
Third‐Party Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.21
Explanation of the Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.22
Chapter 15: Billing and Claims Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.1
Billing Inquiry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.1
Top Portion of Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.2
Middle Portion of Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.2
Bottom Portion of Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.2
Filtering the Billing Inquiry Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.3
Forcing a Statement/Bill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.3
Printing Patient Receipts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.3
Editing a Claim . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.3
Viewing Account Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.4
Account Details . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.4
Transaction Details . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.6
Balance Write‐off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.6
Changing Sequence Responsibility in a Batch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.9
Deleting Claims. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.12
Chapter 16: Useful Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.1
Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.1
Instructional Video Snippets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.3
Contact Manager . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.3
9
Table of Contents
Contact List for the Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.3
Phone Number Fields for Contacts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.4
Fee Update Utilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.5
Allowed Amount Update . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.5
Payment Profile Archive . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.6
Payment Profile Copy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.9
Procedure Fee Update . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.10
HIPAA Compliancy Tool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.12
Using the HIPAA Alerts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.15
Creating an Alert at the Patient Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.16
Adding an Alert to Your Task List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.16
Resetting Category Alerts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.16
HIPAA Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.16
Inventory Tracking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.18
Setup and Posting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.18
Inventory Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.18
Practice/System Log. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.19
Information Tracked . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.20
Searching the Logs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.20
Viewing Deleted Transactions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.21
Reconstruct Numbers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.21
Review Most Recent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.22
Scanning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.23
Setting Up Scanning Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.24
Attaching Previously Scanned Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.25
Viewing and Printing Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.25
Insurance Cards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.26
Patient Pictures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.27
OCR Scanning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.27
Switching Databases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.30
Switching Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.30
Switching Users . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.30
Workstation Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.30
Display Properties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.31
Documentation Paths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.32
Third‐Party Applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.32
Version Refresh . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.33
Chapter 17: Collection Module. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.1
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.1
Pre‐Collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.1
Establish Pre‐Collection Note Category . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.2
Automated Billing Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.3
Pre‐Collection Letters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.5
How Patients Progress through Pre‐Collection Letters . . . . . . . . . . . . . . . . . 17.7
Printing Pre‐Collection Letters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.7
Sequence‐Based Collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.10
Create Billing Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.10
Add Collection Agencies and Associate Codes . . . . . . . . . . . . . . . . . . . . . . . . 17.12
Set Up Preferences for Sequence‐Based Collections . . . . . . . . . . . . . . . . . . . 17.13
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Automated Messages and Pre‐Collection Letters . . . . . . . . . . . . . . . . . . . . . . 17.15
Sending Patient Sequences to the Collection Agency . . . . . . . . . . . . . . . . . . 17.15
Overview of Collection Process – Sequence Report . . . . . . . . . . . . . . . . . . . . 17.15
Removing from Sequence‐Based Collections . . . . . . . . . . . . . . . . . . . . . . . . . 17.19
Posting Payments When the Pre‐Collection Letter Is Successful . . . . . . . . . 17.19
Posting Payments When the Collection Agency Is Successful . . . . . . . . . . . . 17.20
Collection Agency Sequence Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.22
Account‐Based Collections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.24
Set Up Preferences for Account‐Based Collections . . . . . . . . . . . . . . . . . . . . 17.24
Turning Patients Over to Collections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.25
When a Patient Settles Their Account . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.28
Patient Collection Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.29
Using Transworld Collections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.31
User Instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.31
Sequence‐based collections with Transworld . . . . . . . . . . . . . . . . . . . . . . . . . 17.35
Chapter 18: Referral Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.1
Referring Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.1
Referring Physician Identification Numbers . . . . . . . . . . . . . . . . . . . . . . . . . . 18.4
Miscellaneous Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.4
Receiving Patients Referred to Your Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.5
Indicating the Physician Who Referred the Patient . . . . . . . . . . . . . . . . . . . . 18.5
Referral History Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.6
Referring Patients Out to Other Physicians – Basic. . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.7
Referring Patient Out to Other Physicians – Enhanced . . . . . . . . . . . . . . . . . . . . . . . . 18.8
Activating the Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.8
Approved Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.8
Specify Approval through the Plan Detail Window . . . . . . . . . . . . . . . . . . . . 18.8
Specify Approval through the Provider’s Referral Detail Window . . . . . . . . 18.9
Creating a New Referral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.9
Referral Tracking Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.12
Mail Merge Fields . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.13
Referral Out History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.13
Chapter 19: Patient Recall Module. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.1
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.1
Create Recall Entry Manually . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.2
Understanding Automatic Recall Prompts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.4
Appointment Class Column . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.4
Recall Activation Sets Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.5
How Recall Entries Get Created . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.5
Setting Up Patient Recall . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.6
Printing Recall Documents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.7
Chapter 20: Mail Merge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.1
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.1
Create and Edit a Mail Merge Document. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.2
Setting a Module’s Default Document . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.6
Storing Mail Merge Documents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.6
Dedicated Server . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.6
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Data Sources Used in Mail Merge. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.7
Exporting and Importing Data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.7
Tips on Working with Merge Documents. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.8
Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.8
Choose Label Templates or Design My Own . . . . . . . . . . . . . . . . . . . . . . . . . . 20.8
Print a Label for more than One Patient on a Sheet of Labels . . . . . . . . . . . . 20.9
Use Data From a Report if Merging Isn’t Available . . . . . . . . . . . . . . . . . . . . . 20.9
Chapter 21: Task Management. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.1
Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.1
Personal Contact List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.2
Internal Messaging System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.2
Create and Send a System Mail Message . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.3
Receiving a Mail Message . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.4
“Sticky” Notes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.4
System Task List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.5
Add an Item to the Task List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.5
Recurring Tasks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.6
Assign Tasks to Other Users . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.7
Completing Tasks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.7
Task Reminders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.8
Chapter 22: Anesthesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.1
Anesthesia Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.1
Anesthesia Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.1
Enter Provider Modifiers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.2
Specify Anesthesia Types . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.2
Establish Billing Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.2
Link CRNA to a Location to Submit the Correct Insurance ID . . . . . . . . . . . . 22.3
Indicate Insurance Classes That Recognize CRNA Services . . . . . . . . . . . . . . 22.4
Specify Billing Preferences Per Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.4
Anesthesia Concurrence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.6
Anesthesia Concurrence Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.7
Anesthesia Concurrence Graph . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.7
Posting Anesthesia Charges and Payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.7
Charges Example: Medicare Primary/Commercial Secondary . . . . . . . . . . . 22.10
Charges Example: Commercial Insurance Primary/Medicare Secondary . . . 22.12
Charges Example: Commercial Insurance Primary/Secondary . . . . . . . . . . . 22.14
Adjusting Anesthesia Claims . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.14
Anesthesia Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.15
Anesthesia History Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.15
Case Summary Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.16
Location Utilization Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.16
Chapter 23: AutoPayment Posting Module . . . . . . . . . . . . . . . . . . . . . . . . . . 23.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.1
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.1
Retrieving and Processing a Remit File. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.2
Retrieving Remittance File . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.3
Processing the File . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.4
Remittance Splitter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.5
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Customize the Module. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.7
Posting Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.11
Institutional AutoPayment Posting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.11
Retrieving Remittance File . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.13
Processing the File . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.14
Chapter 24: Capitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.1
Setting Up a Capitated Plan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.1
Establishing Capitated Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.1
Setting Up a “Dummy” Payment Account . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.2
Capitation Payment and Write‐off Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.3
Capitation Setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.3
Posting Capitated Charges. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.3
Processing Capitated Write‐offs Automatically . . . . . . . . . . . . . . . . . . . . . . . 24.6
Posting Capitated Payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.6
Capitation Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.7
Plan Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.7
Summary Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.8
Deleting Outstanding Claims. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.10
Chapter 25: Dental Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25.1
Set up a Dental Practice. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25.1
Create a Claim Form Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25.2
Configuring Dental Plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25.2
Configuring Patient Records For Dental . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25.3
Deductible Tracking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25.3
Dental Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25.4
Dental Charges Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25.5
Pre‐Estimates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25.6
Toggle Between Medical and Dental Posting . . . . . . . . . . . . . . . . . . . . . . . . . 25.7
Claim Transactions Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25.8
Pre‐Estimate Pending Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25.9
Chapter 26: Code Scrubbing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26.1
Setting Up Code Scrubbing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26.1
Validation Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26.2
Warning and Error Indicator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26.4
Additional Information for Diagnosis Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26.6
Additional Information for Procedure Codes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26.6
Chapter 27: Lab Results. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27.1
Overview of Lab Results Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27.1
How to View Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27.1
Chapter 28: MicroMD ARS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.1
Setting up MicroMD ARS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.1
Create Priority and Status Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.2
Set Up Work Flows . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.2
Set Up Work Lists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.4
Edit Plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.7
Set User Access Security . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.9
Set User Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.10
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Create User Work Lists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.11
Insurance and Appeals Work Lists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.11
Patient Work Lists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.13
Using MicroMD ARS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.14
Overview of the Work Lists Windows . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.14
Working a List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.15
Update Multiple Sequences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.16
Filter Work List Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.17
Refresh the Work List Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.17
Remove Sequences from MicroMD ARS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.18
Reassign Sequences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.20
Global MicroMD ARS Search . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.20
Quick Text in MicroMD ARS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.22
Printing in MicroMD ARS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.22
Sequence Details . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.23
User Work List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.23
Address Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.24
Letters and Mail Merge Documents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.25
Chapter 29: MicroMD ECM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.1
How to Set up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.1
Identify Special Keywords for Claim Status . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.2
ENS and Practice Insight Human‐Readable Reports . . . . . . . . . . . . . . . . . . . . 29.3
Changes from the ediInsight Change Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.3
Set Up Plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.4
Set Up Appointment Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.5
Automatic Patient Eligibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.6
How to Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.7
Check Patient Eligibility—From Green Plan Bars And Plan Sets Tab . . . . . . . 29.8
Check Patient Eligibility—From Appointments . . . . . . . . . . . . . . . . . . . . . . . . 29.8
Claim Status/Tracking/Remit Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.9
Secondary EOB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.10
Chapter 30: MicroMD CHC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.1
Security Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.1
Establishing MicroMD CHC Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.2
Create Write‐Off Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.2
Set Up Procedures in MicroMD CHC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.2
Include Plan Sets in the Sliding Fee Schedule . . . . . . . . . . . . . . . . . . . . . . . . . 30.3
Create Sliding Fee Profiles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.5
Create Sliding Fee Levels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.7
Customize Information Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.9
Enter Clinic Numbers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.9
Set up Specifics for Your Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.9
Create Service Categories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.12
Create Qualification Alerts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.13
Make UDS Fields Required . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.13
Adding Details to Providers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.14
Adding Details to Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.16
Adding Pregnancy Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.18
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CLINICAL QUALITY MEASURES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.20
Posting Charges with MicroMD CHC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.21
Splitting Procedures in MicroMD CHC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.22
MicroMD CHC Wraparound . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.23
What You Need to Set up – First Option . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.24
What You Need to Set up – Second Option . . . . . . . . . . . . . . . . . . . . . . . . . . 30.25
Posting Charges and Processing Claims . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.26
Posting Payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.27
Data Collection Forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.28
Attachment A – Uninsured Children Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.28
Attachment B – Uninsured Pregnant Women . . . . . . . . . . . . . . . . . . . . . . . . 30.29
Uninsured Areas Served by ZIP Code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.30
Uninsured Quarterly And Year‐To‐Date Report . . . . . . . . . . . . . . . . . . . . . . . 30.30
Uninsured Patient Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.31
UDS Reporting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.32
Service Area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.32
UDS Tables 3A and 3B, 4 (Patient Profile) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.33
UDS Table 5 (Staffing and Utilization) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.34
UDS Table 6A (Staffing and Utilization) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.35
UDS Table 6B (Staffing and Utilization) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.36
UDS Table 7 (Health Outcomes and Disparities) . . . . . . . . . . . . . . . . . . . . . . . 30.37
UDS Table 9 (Financial) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.38
CHC Patient Profile Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.38
Print a Mail Merge Document with the Report Data . . . . . . . . . . . . . . . . . . . 30.41
Chapter 31: MicroMD Rx. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31.1
In This Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31.1
Setting Up MicroMD RX. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31.1
Enter Commonly Used Pharmacies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31.1
Enter Drug Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31.2
Enter Drugs into System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31.4
Writing Prescriptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31.6
Creating a Prescription . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31.6
Printing the Prescription . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31.9
Voiding a Prescription . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31.10
Refill a Used Prescription. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31.10
Prescription Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31.11
Chapter 32: MicroMD Custom Reports Viewer . . . . . . . . . . . . . . . . . . . . . . . 32.1
User Instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32.1
Changing MicroMD Custom Reporting Parameters . . . . . . . . . . . . . . . . . . . . 32.2
Ability to drill down in a group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32.6
Drill‐Down window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32.6
Chapter 33: FAQ. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.1
Adjustment Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.1
What are adjustment codes? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.1
How do I fix an incorrect charge or payment that has been posted? . . . . . . 33.1
Fix an Incorrect Charge Entry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.1
Fix an Incorrect Payment Entry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.1
What is the difference between an adjustment and a refund? . . . . . . . . . . 33.2
Aging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.2
How does it work? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.2
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How do I get a list of patients who are over 90 days due? . . . . . . . . . . . . . . 33.2
Billing Corrections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.2
How do I make posting corrections? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.2
How can I add new charges to an existing claim? . . . . . . . . . . . . . . . . . . . . . 33.2
What is a sequence number? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.3
Billing File Note. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.3
How can I create a note in the billing file? . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.3
Does the system keep a filing history for a claim? . . . . . . . . . . . . . . . . . . . . . 33.3
Can I print the billing notes? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.3
Charge Slip . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.3
Can I design a charge slip through a commercial word processor? . . . . . . . 33.3
Claims Processing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.3
How can I print a description for a procedure on an insurance claim? . . . . 33.3
How do I reprint a claim report? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.3
Collection Letter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.4
Can I design a pre‐collection letter using a commercial word processor? . . 33.4
Cutoff Days . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.4
How do I get a zero balance with old dates of service to reappear? . . . . . . 33.4
Day Sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.4
Sometimes the day sheet date flashes in posting. Why? . . . . . . . . . . . . . . . . 33.4
How do I create a new day sheet without erasing the current one? . . . . . . 33.4
How do I select a different day sheet? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.4
How do I find a day sheet that is not in the system? . . . . . . . . . . . . . . . . . . . 33.4
Can I reprint a day sheet after it has been erased? . . . . . . . . . . . . . . . . . . . . 33.4
Can I alter the date of a day sheet after it has been created? . . . . . . . . . . . 33.5
Can I erase a day sheet without printing it? . . . . . . . . . . . . . . . . . . . . . . . . . . 33.5
Deposit Slip . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.5
My day sheet appears to be okay, but my deposit slip does not balance. . . 33.5
Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.5
Can I have multiple descriptions for an ICD code? . . . . . . . . . . . . . . . . . . . . . 33.5
Monthly Organization/Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.5
Do I need to run any month‐end procedures? . . . . . . . . . . . . . . . . . . . . . . . . 33.5
Payment Codes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.5
What are payment codes? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.5
How do I set up to handle returned checks? . . . . . . . . . . . . . . . . . . . . . . . . . 33.5
Posting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.6
How do I post a Physician Organization Management Fee? . . . . . . . . . . . . . 33.6
How do I keep track of post‐op dates? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.6
When posting charges, how do I remind myself of a patient co‐pay? . . . . . 33.6
Quick Text . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.6
Why isn’t my new Quick Text macro in my list for Patient Detail? . . . . . . . . 33.6
Receipts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.6
How can I print/reprint a receipt? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.6
How do I print one receipt for the patient paying for several past visits? . . 33.7
Refunds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.7
I need to refund some money to a patient. How do I go about doing it? . . 33.7
Remarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.7
Are the remarks printed anywhere? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.7
Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.7
How can I print a specific page in a large report, or any report? . . . . . . . . . 33.7
16
Table of Contents
Scheduling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.7
How do I indicate the patients who are not to be scheduled? . . . . . . . . . . . 33.7
Statements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.8
How do I force a statement/bill to be printed for a patient? . . . . . . . . . . . . 33.8
How do I reprint a statement report? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.8
Transaction Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.8
How do I print transaction notes on patient statements? . . . . . . . . . . . . . . . 33.8
Write‐off Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.8
What are write‐off codes? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.8
Year‐end Organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.8
When should it be done? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.8
Chapter 34: Setup Steps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34.1
Chapter 35: Shortcut Keys. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35.1
Function Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35.1
Working with a Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35.1
Common Functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35.2
Chapter 36: List of Operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36.1
Daily Operations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36.1
Weekly Operations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36.1
Monthly Operations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36.1
Yearly Operations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36.1
Chapter 37: Transferring Balances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.1
Posting a Lump Sum. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.1
Creating Sequences to Submit Primary Claims . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.1
Creating Sequences to Submit Supplemental Claims . . . . . . . . . . . . . . . . . . . . . . . . . . 37.1
First Sequence (Transactions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.2
Second Sequence (Adjustments) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.3
17
GENERAL FEATURES
This serves as a general reference section to the program. It introduces you to common features of MicroMD, which you use consistently throughout the program. Until you are comfortable with the program, keep this section within reach for quick reference.
Not only is startup and shutdown a breeze, but there are also several other features built into the program that help you expedite your practice management processes. Icons and shortcut keys allow you to use the mouse and keyboard to navigate through the program quickly and efficiently. Searching is made simple by using wildcards and click‐and‐sort columns. Tool tips and What’s This? help topics give you fingertip comprehension of many different aspects of the program and icons.
MicroMD is a Microsoft® Windows®‐based program. Therefore, if you have ever used a Windows‐based program, you are already on your way to learning this program. In addition, the File, Edit, Window, and Help menu items are done in a standard Microsoft format.
NOTE | For more detailed instructions on using a Windows‐based system, please refer to your Microsoft Windows user’s manual.
IN THIS CHAPTER
In this chapter, we cover how to:
 Launch the system
 Navigate through the system
 Search for data in various windows
 Use some common windows features
 Print in the system
 Use e‐mail and web site address fields
 Save data from a window
 Understand CrossCode Messages
STARTING THE SYSTEM
If you have more than one workstation with MicroMD, you must be sure to start the file server computer FIRST. This is the main computer that enables the database to be loaded. Then the program can run on all your workstations. Accordingly, when closing for the night, you must close down the file server LAST.
Procedure
Details
1. Double‐click the system folder on the desktop.
For legacy systems, the folder name could be Microsys Computing, Inc.
2. Once the folder opens, double‐click the icon to launch the system.
The Login window opens.
In This Chapter 1.1
General Features
3. Type “user” in the Username field, and type “123” in the Password field.
These are defaults for the supervisor. We strongly recommend that practices change these later.
4. Click OK to proceed.
What Does This Do?
Icons, tool tips, and “What’s This?” help topics all expedite both your knowledge of the program and help you use the program efficiently.
Tool Tips
Tool Tips allow you to rest your cursor on an icon to bring up the name of the icon. When this manual describes the function of an icon that doesn’t have static text and calls the icon by name, this is the name that appears in the pop‐up. For instance, if you rest your cursor over the icon that looks like a piece of paper with dual arrows, a pop‐up appears that displays the word “Reset”.
Figure 1‐1 Tool‐tip Pop‐up
What’s This?
The What’s This? pop‐up offers more information about a particular field in the program. If you are unsure, for instance, of what the Category field is on the Patient Detail window, position your cursor over that field and right‐click. The What’s This? prompt appears. Left‐click on the prompt, and a pop‐up appears with a description of that field.
Figure 1‐2 What’s This? prompt
Navigating Through the System
There are various ways to navigate through the system and various ways to find out where you are in the program. These ways include the title bar, the main menu, the Launch Pane and the Task Pane. You can also use the floating toolbar to access different areas of the program.
1.2
Starting the System
General Features
Figure 1‐3 Navigating the System
Title Bar
The Title Bar displays the name of the module in which you are currently working. It is located in the upper left corner of any window.
TIP | Remember that when this manual references a window, it italicizes the name of window, which is the text in the title bar.
Main Menu
The Main Menu contains all of the commands used to navigate the system: File, Edit, Appt, Aux, Billing, Claims, Maint, Misc, Setup, Reports, Utility, Window, and Help. You can access the menu items by clicking on the word. A menu appears, allowing you to access the menu item of your choice. If there is an arrow next to that menu item, there is a submenu connected. Resting your cursor on a menu item with the arrow to the right of it will bring up the submenu. For instance, if you wanted to access the Patient Aging Report, which is located in a submenu for AR, you would go to Reports > AR > Patient Aging.
TIP | Remember that a menu path is listed in bold text throughout the manual.
Task Pane
The Task Pane (i.e., the upper portion of the left side of the screen) appears only when you begin opening windows. This Task Pane varies slightly to the given task and module. The table below details some of the common icons that appear on the Task Pane throughout the program, including, if Starting the System
1.3
General Features
available, a key combination for using the keyboard instead of the mouse.
TIP | Icons referenced throughout the manual are listed with a bold font.
Common Task Bar Icons
Icon
Description
The New icon is used to add a new record in the corresponding module. For example, when in the Diagnosis Module, this icon can be used to add a new diagnosis code in the system. In Posting Module, use it to post new charges.
The Search icon allows you to search for records within specified parameters. For instance, in the Claims Processing Modules, clicking the Search icon returns a list of all claims matching the selected type. In the Guarantor/Patient List window, clicking the Search icon brings up the full list of patients, or typing a partial name or chart number and clicking the Search icon returns listings just with those parameters. The Save icon can be used if you want to save a record but not exit a window.
Ctrl + S
Ctrl + Home
 or
 or 
The First arrow icon takes you to the top of a list. For instance, if you are scrolling through the Guarantor/Patient List window, you can jump to the top of the list by clicking on this icon. It highlights the first entry.
The Prior arrow icon takes you to the listed item directly above the item that is currently highlighted. If SWARTZ, ROBERT is highlighted, clicking Prior moves to ROLAND, MARY. To move further to PORTER, ANNE, simply click Prior again.
The Next arrow icon takes you to the listed item directly below the item that is currently highlighted. If SWARTZ, ROBERT is highlighted, you can move to TANDY, JOSEPH by clicking Next.
The Last arrow icon takes you to the bottom of a list, no matter where you are in the list. By clicking Last, you save time scrolling down to the very last item listed.
Ctrl + End
The Print icon allows you to print reports, patient data, charge slips, etc.
Ctrl + P
The Delete icon can be used to delete a record. A record cannot be deleted from a list window. You must bring up the detail window for the record in order to delete it.
Ctrl + D
1.4
STOP | Once a record is deleted, it cannot be retrieved.
Starting the System
General Features
Esc
Ctrl + X
The Exit icon can be used to exit a window. After you are finished entering information in a window, click Exit or the X in the upper right corner of a window. When prompted to save, click Yes. The system saves your changes, and you automatically exit the window.
Launch Pane
The bottom portion of the Navigation Panel is the Launch Pane. When you click on one of the buttons, the top left side of the window (the Task Pane) changes accordingly.
Customizing the Launch Pane
Each user has the ability to customize the buttons that appear in their Launch Pane. Supervisors can allow users in each security group access to a set list of functions, and then the users can add those functions they use the most to their Launch Pane. (They can still access the various modules from the main menu.) Along the bottom of the Launch Pane, MicroMD PM displays any Launch buttons that do not fit in the expanded area. There is also a tiny arrow on the bottom toolbar. This arrow provides access to customizing your Launch Pane. To customize your Launch Pane, click that arrow. This displays the Launch Pane menu in which you have three options:
 Show More Buttons: This expands one of the items currently displayed along the bottom of the Launch Pane.
 Show Fewer Buttons: This collapses one of the items from the main part of the pane and adds it to the bottom of the pane.
 Launch Pane Options: This choice opens the Launch Pane Options window in which you can specify the buttons you want to appear in the Launch Pane. The choices available to you depend on the set provided by the supervisor user.
Figure 1‐4 Launch Pane Options Window
Place a check mark next to the Launch Button you want to display. If you want to change the order of the buttons in the Launch Pane, highlight the button you want to move and then click the Move Up and Move Down buttons as needed.
If you always want the system to open a specific module, you can highlight the appropriate button in the Launch Button column and click Default. This displays that window when you first log in. For example, if you use the Task Management module and like to check your messages and to‐do list first thing in the morning, make the Task Management module your default.
Starting the System
1.5
General Features
To revert this window back to the default choices and displayed items, simply click Reset. This reverts the window to the choices made by the supervisor for the user on the Configuration tab of the Identity and Access Management Module.
Resizing the Launch Pane
You can resize the Launch Pane vertically if you would like. Click and drag the bar between the Task Pane and the Launch Pane up to expand the Launch Pane or down to collapse the Launch Pane. The system transfers any buttons that do not fit to the bottom of the pane. If you hover over the images, a pop‐up displays the text of the button.
Floating Tool Bar
You have access to the floating tool bar in the Appointments, Billing Inquiry, Patient Detail, Patient Sequences, and Waiting List windows. You must click the arrow to view the bottom row of icons. Figure 1‐5 Floating Task Bar
Icon
Description
Click the Alert Note icon to open the Patient Alert Note window—an editable patient alert window shared between MicroMD PM and MicroMD EMR. Click the Referral icon to open a Referrals window (for the selected patient), which lists the referring doctor, the date the patient was referred, and any notes for each time this patient was referred. Click the Recall icon to open the Patient Recall window (for the selected patient). Click the RX icon to open the Prescription window, which lists the patient’s prescription history. You can print this information, but you cannot edit or delete it. Please refer to that module’s documentation for more in‐depth information.
Click the Pat Export icon to open the Patient Info Export window, which allows you to export patient information to a third‐party software program. You can select the program from the Export Type drop‐down list. Click the Track Code Hist icon to open the Account History ‐‐ Procedure window. This window allows you to track procedure codes included in explosion codes. You can print this information, but you cannot edit or delete it. 1.6
Starting the System
General Features
Click the ICD Hist icon to open the Account History ‐ Diagnosis window, which lists the patient’s diagnosis history. You can print this information, but you cannot edit or delete it. Click the HIPAA icon to open the HIPAA alerts window. Click the Lab Results icon to open the View Lab Results window. Click the CHC Profile icon to open the Patient ‐ CHC UDS Reporting Profile window. This window allows you to include patient‐specific CHC information that is used in UDS reporting. Click the MicroMD DMS Chart icon to open the MicroMD DMS. The program opens to the patient’s chart to make it easy to access the patient’s information. Click the Case Notes icon to open the Case Notes window. This window allows you to enter notes specific to a case on the Patient Detail window. SEARCHING FOR ENTRIES
The system provides various methods throughout the system to find the records you need. With search boxes, lookup fields and find fields, you can type in a patient’s name or account number to locate their records. You can type in a portion of the patient’s name or the description of a procedure code You can also use wildcard characters to help you locate the information you want if you’re not sure of the exact spelling or phrasing.
Search Boxes
Search boxes are normally in the list windows, whereas lookup fields are in detail windows. For example, the Search for field in the Guarantor/Patient List is a search box that allows you to display a list of names that match the text you type.
Lookup Fields
Lookup fields, in general, require an ID but allow you to type in the description in the same field. A lookup field such as ZIP Code in the Patient Detail window allows you to type in either the ZIP code or all/part of the city name.
Find Fields
Find fields are available throughout the program to help make searching for items easier. Find fields are in list windows. To search using the Find field, begin typing the description in the field. With each letter you type, the list displays the items matching the letters typed.
For example, if looking for a diagnosis code, such as Poisoning/Food, in the Diagnosis List window, begin typing the diagnosis in the Find field. Once you type the p, the list automatically scrolls to the diagnoses whose names begin with the letter “p,” and the first alphabetically of those diagnoses is highlighted. Then, when you type the o, the list automatically scrolls to the diagnoses whose names begin with the letters “po,” etc. This is a quick and easy way to navigate a list.
Wildcard Characters
To search for information using wildcards, use the % sign to replace the set of characters you either do not know or do not want to type. You can insert % anywhere in the search field.
Searching for Entries
1.7
General Features
For example, if looking for patients in the Guarantor/Patient List window, typing “SMI%” in the Search for field brings up all patients whose last name starts with “SMI”, including patients listed in sub‐accounts. Typing “%NN” lists all the patients whose last name has “NN” anywhere in it, such as SINNS, KENNEDY, etc.
Figure 1‐6 Using “%” to Search for a Patient
Use the underscore character (_) as a single‐character replacement marker. For example, typing “_K” brings up all patients who have a “K” as the second letter in their last name. If you type “__K” (two underscores and a K), the system lists all patients who have the letter “K” as the third letter in their last name.
Figure 1‐7 Using “_” to Search for a Patient
Global Search
The system allows you to perform a global search to call up patients across practices in a multiple practice database. This feature is available in the Guarantor/Patient List window and on the Charges/
Payments window. If you would like to utilize this feature, you must place a check mark in the Multi‐
Practice box under Setup > System Preferences > System Preferences tab.
NOTE | When activating this feature, you must assign each user in the system the proper access rights. This feature allows users to access another practice’s information. 1.8
Searching for Entries
General Features
When using this function, each patient number is preceded by a number that corresponds to the patient’s default practice (e.g., 1 for the first practice, 2 for the second practice, etc.) and a dash. When you then select the patient, the system automatically toggles to the patient’s practice.
SELECTING PATIENTS IN THE SYSTEM
The system allows you to select patients from various modules in the program, such as claims processing, charge slips, printing statements, etc. This feature makes selecting one or several patients quick and easy.
Click the Select Patients icon, or click the Select Patient button in a window with this button, to bring up the Patient Selection window. (In some modules, this window automatically appears.) Type the Patient Name/No field to bring up the appropriate patient(s). The patient(s) meeting the selected criteria appear in the green box at the bottom of the Patient Selection window. To select patients, you can double‐click on the patient(s) you want to select or drag‐and‐drop the patients into the white area of the window.
Figure 1‐8 Patient Selection Window
COMMON WINDOWS FUNCTIONALITY
This section describes some common windows functions that the system uses to help you work quickly and efficiently. For more information, check your Microsoft Windows user’s manual.
Browse for a File or Folder
When specifying a file path, such as a claim file for electronic billing or a document for mail merge, click the Browse button to navigate through file directories on your computer or network to find a specific folder or file.  When browsing for a folder, the window acts like the Windows Explorer folders view. Click the + or – signs beside the folder names to collapse or expand the directories in the window. Select the folder you want and click OK.
Selecting Patients in The System
1.9
General Features
Figure 1‐9 Browse for Folder
 When browsing for a file, the window acts similar to a typical Windows Save As… dialog box. Navigate to your file and click the action button (Open, Save, Insert, etc.). For example, to select the default word processor application to use for collection letters and charge slips (Utility > Workstation Setup > Documentation Paths), clicking the Browse button opens an Editor View window to allow you to navigate to the file.
Figure 1‐10 Browse for File
1.10
Common Windows Functionality
General Features
Drag and Drop
The drag‐and‐drop capability allows the user to transfer information from one section of a window to another. Left‐click and hold the mouse button on an item in one pane and move (or drag) the item into the other pane. Once the item is in the other pane, release the mouse button to drop the item.
For example, when setting up the To‐Do List, you can customize the window by selecting the columns that appear.
Procedure
Details
1. Using the mouse, click and hold an item in the Available For Selection pane of the window.
2. Drag the mouse and release the item into the Selections Made side.
3. Click Accept.
Drop-Down Lists
Many fields have drop‐down lists, which allow you to select specifications for that field by clicking the arrow to the right or left of the field. Once the list appears, choose your selection by clicking the list item.
Multitasking Ability
The system not only gives you the power to perform various tasks, but it also gives you the power to perform various tasks at the same time. The multitasking feature allows you to open several windows at once and switch back and forth without having to close one window to work in another.
For example, if you are posting charges at the same time a new patient is registering and other patients are calling to make appointments, you do not need to exit the Payment/Charges window, open the Patient Detail to add a new patient, close it, and then open the Appointment window. Instead, you can open all three windows and keep them open until you are ready to close them.
To switch between windows, you have two options. You can:
 Select Window from the main menu. At the bottom of this menu, you see a list of all the windows you have open. Simply select the one you want and that window comes to the foreground.
OR
 Click the Title Bar of the window you want to activate. This window then moves in front of all others. If another window covers the one you want and prevents you from clicking on it, you can click and drag the top window to move it away.
Common Windows Functionality
1.11
General Features
Figure 1‐11 Multitasking Ability
Pop-up Calculators and Calendars
Calculator and calendar pop‐ups appear throughout the system in fields where it is necessary to calculate values or enter dates. A down arrow appears on the right of a field with either of these tools whenever you click or tab a date or calculation field. Click the down arrow to access the calculator or calendar. TIP | You can also type information directly into the field. You do not have to use these tools to enter information.
Users can disable the calculator and calendar pop‐ups:
Procedure
Details
1. Select Utility > Workstation Setup > Display Properties from the main menu.
The Display Properties window opens.
2. Uncheck the DropDown Calendars and DropDown Calculators checkboxes.
To re‐enable these tools, place checkmarks in these fields again.
3. Click Accept.
These pop‐ups are now disabled.
Calculator
Click the keys on the calculator with the mouse just as you would with a handheld calculator.
Calendar
Use the arrows at the top of the pop‐up to select a month and year. Double arrows move to the same month in the previous or next year. The single arrow moves to the previous or next month. Click the date to select it. To close the pop‐up without selecting a date, click anywhere outside of the calendar pop‐up.
1.12
Common Windows Functionality
General Features
Resize Windows
The system allows you to change the size of many windows in the program. This capability is useful for workstations with a high screen resolution or larger screen sizes. It allows you to view several windows on the screen at the same time.
You can resize windows by simply clicking one of the outside edges of the window (the mouse pointer changes to a line with arrows at both ends), holding the mouse button, dragging the window to the desired size, and releasing the mouse button. MicroMD PM remembers this size the next time you open the window.
NOTE | Window settings are specific to the operating‐system user, not the user. If you set the windows in the system to a particular size, any user who logs on to the system under the same operating‐system user will have those settings for their windows.
You can also reset all windows back to their default size:
Procedure
Details
1. Select Utility > Workstation Setup > Display Properties from the main menu.
2. Click the Reset Window Sizing button and click Accept.
Sorting Columns
Clicking a column heading sorts the entries in the list in ascending or descending order according to that column. For example, if you wanted to sort your patient listing by the patients’ last names, click the Last Name column heading once to sort the names from A to Z and click again to sort the names from Z to A. Most columns in the program windows have this feature.
PRINTING IN THE SYSTEM
The system makes it quick and easy to print. You can print to a printer on your network that is different than the default printer. You can also change your Windows default printer to make it easier to do your assigned task.
Select a Printer
If your computer can print to more than one printer, MicroMD PM allows you to select which printer to use to print out charge slips, reports, patient information and other materials you have created within the system. (If your computer only prints to one printer, your materials default to that printer.)
Procedure
Details
Selecting a Specific Printer for a Single Job
1. Select File > Print Setup from the main menu.
Printing in the System
A list of all printers networked to your computer appears.
1.13
General Features
2. Select the appropriate printer, and click OK.
If you would like to change the properties of the printer (tray selection, paper size, etc.), click Setup.
Changing Your Default Printer (in Windows, not the system)
1. On your Windows task bar, select Start >
Settings > Printers and Faxes.
2. Right‐click on the printer icon.
3. Select Set as Default Printer from the context menu.
If there is a little black‐and‐white check mark beside the icon, this printer is already your default printer.
Using the Print Icon
The Print icon appears on almost every screen; however, there are certain windows—list windows especially—that may not be beneficial for you to print. You should be careful to bring up the appropriate window when you print since selecting the wrong window may not print the expected information.
Batch Basket
The Batch Basket is a “holding area” that allows users to print, view or delete all the reports for that day at once, rather than having to process them individually. For example, a user can save all report results to a particular batch basket and send them to the printer at the end of the workday. The system opens the Add To Batch Basket window when you run a report and select File > Batch from the main menu. Figure 1‐12 Add To Batch Basket Window
Once you select the basket name, you have the option to name the file in the Document Name field. Click Accept when you are finished. The system saves the report in the assigned basket.
NOTE | Create a new basket by entering a name in the Basket Name field. Otherwise, you can select the drop‐down to place the file in an established basket.
When it is time to print the documents from the Batch Basket, following these instructions: Procedure
Details
1. Click the Batch Basket icon from the Launch Pane.
The system opens the Batch Basket window.
1.14
Printing in the System
General Features
2. While on the Batch Basket window, place a check mark next to each basket you want to process. 3. Click the Publish drop‐down button.
Figure 1‐13 Batch Basket Printing Window
Enhanced Label Printing
Label printing allows the user to specify the starting position of the first label on the label sheet. For certain labels, a second option provides the user with the ability to print names in First, Middle, Last order on the label. The system pulls the default value for this option from the General Preferences tab on the Practice Preferences window.
Users can print labels from these menu items:
 Appointment Status Report
 Patient Capitation Report
 Claims Processing ‐ Paper
 Patient Detail
and these Reports:
 Miscellaneous > HIPAA Report
 Patient > New Patients
 Patient > Search Argument
Printing in the System
1.15
General Features
 Recall… by Dates > Birthdate Report
 Recall… by Dates > Last Visit Report
 Recall… by Dates > Patient Recall
 Reference Codes Listing > Patient Report
 Reference Codes Listing > Plan Report
 Reference Codes Listing > Referring Doctor Report
 Reference Codes Listing > ZIP Code Report
E-MAIL AND WEB SITE ADDRESS FIELDS
E‐mail and web site address fields are available from many windows throughout the program. When you have entered an e‐mail address or a web site for an insurance company, patient, service facility, etc., you can double‐click that field to access either your e‐mail program or your internet program. SAVING DATA IN A SYSTEM WINDOW
There are going to be times when you may want to save the data on your screen and view that data in a program other than the system (e.g., Microsoft® Excel® or Adobe® Acrobat®). The system makes it simple. Procedure
Details
1. Select File > Save Rows As… from the main menu.
The Save As dialog box appears.
2. Select the type of file you want to create from the Save as type drop‐down.
3. Type a File name for the file.
4. Click Save.
CROSSCODE MESSAGES
CrossCode Messages enable the user to link diagnosis codes with procedure codes and procedure codes with insurance plans. Procedures can be marked as Allowed or Not Allowed for the diagnosis, and diagnoses can be marked as Allowed or Not Allowed for the procedure. The procedure and diagnosis combination can be marked as Allowed or Not Allowed for certain plans.
You can specify this link through the CrossCode Messages tab in the Diagnosis Detail, the Procedure Detail, or the Plan Detail windows. The system generates a list of Allowed or Not Allowed codes from the information on the CrossCode Messages tab in all three areas. The system then checks the validity of a diagnosis or a procedure at the time of posting charges. (Refer to each of the indicated sections of the manual for detailed instructions on creating CrossCode messages.)
 Diagnosis and Procedure CrossCode Messages
If a CrossCode Messages tab on the Diagnosis Detail or Procedure Detail contains a procedure or diagnosis code and message text associated with it, MicroMD PM prompts the user with that message when they attempt to post charges using these codes together. For codes marked as Allowed, users can still use the code, although a warning with the message from the Message field of 1.16
E‐Mail and Web Site Address Fields
General Features
the tab. For diagnoses or procedures marked as Not Allowed, an error message displays with the message from the Message field of the tab, and the system will not accept the code. Any codes not included in this list default to an allowed status with no message.
For example, if a certain procedure requires additional documentation, it may be marked as Allowed with the message, Additional documentation needed.
 Insurance Plan CrossCode Messages
The CrossCode Messages tab on the Plan Detail window works in a similar manner, although it deals with diagnoses and procedures that are Allowed or Not Allowed by a particular insurance plan. If a user posts a diagnosis code with a procedure code for a patient whose primary insurance plan contains these items on its CrossCode Messages tab, the user receives the error or warning message.
You can also use the CrossCode Messages tab to set up the diagnosis, procedure, or plan to include only specific items. The program looks at the items contained on the tab from general to most specific. If the procedure or diagnosis code field is blank, the field defaults to ALL. Therefore, a diagnosis can have ALL procedures set to Not Allowed and two or three procedures set to Allowed. These two or three procedures would be the only valid procedures to use with this diagnosis when posting charges. The system prompts you with the message from the Message field when using these procedures unless no message was set. If the Message field contains no text for a procedure that is Allowed, no warning appears. However, if the Message field contains no text for a procedure that is Not Allowed, the error still appears indicating that the procedure is invalid for unspecified reasons.
CrossCode Messages
1.17
SETUP AND PREFERENCES
Your support team has already set up your system appropriately, probably with your help. The system is a flexible, very customizable system, built on years of experience with users just like you. This chapter outlines general setup and preference options that you can set for your system and for each practice to help you work as efficiently as possible. The options in the Setup Module affect features throughout MicroMD PM. While setting up the features outlined in the other chapters, you will refer to this chapter frequently.
IN THIS CHAPTER
In this chapter, we cover how to:
 Customize certain information in the database
 Modify any miscellaneous preferences
 Create system classes
 Customize the system preferences
 Customize your practice’s preferences
MASTER TABLE SETUP
Supervisors and support personnel have the ability to customize information in certain database tables within the system. This helps those that submit electronic files to a third party that requires the information in the file to appear a certain way. You can also use this to reorder the display of some drop‐
down lists throughout the program to display your most frequently used selections at the beginning of the list.
Only supervisors and support personnel should access this setup feature. We recommend that only supervisors and support personnel access this setup module because of the dangers inherent in modifying the database.
Security Options
Select Setup > Identity and Access Management from the main menu. Highlight the correct user and click the Permissions tab. In the Setup folder, navigate to the Master Table folder. Check the appropriate option to provide the user the indicated action, or remove the check mark to prevent the user from performing the indicated action. You have the following options for each user:
 Add: Allows the user to create new selection entries in the selected drop‐down list.
 Delete: Allows the user to remove existing selection entries in the selected drop‐down list.
 Modify: Allows the user to edit existing selection entries in the selected drop‐down list.
 View: Allows the user to access the Master Table Setup window. You can check only this option to allow the selected user to view the setup window for their reference only.
Customize Entries in a Category
Throughout the manual, there are references to this section. Those references generally contain the Category you need to edit. Be sure you know which item to select from the Category drop‐down list. In This Chapter 2.1
Setup and Preferences
Some categories are system codes that you cannot edit or delete. They are for your reference only. These display with a red indicator next to the Category drop‐down.
Procedure
Details
1. Select Setup > Master Table from the main menu.
The Master Table Setup window opens.
2. From the Category drop‐down, select the list you want to customize for your practice.
3. Click the New icon on the Task Pane.
4. If you know the ANSI value required for the item, enter it in the Ansi column.
5. Edit the information in the Short Description field of the item(s) to alter the text of the item in the drop‐down list.
The Long Description field is not currently used; however, you should enter the same text that you enter in the Short Description field.
Enter 1 in the Display Order column for the item 6. Edit the Display Order column to reorder the 2 for the item to to appear first in a list. Enter appearance of the items in the drop‐down lists.
appear second in a list. And so on. The system will warn you if you try to enter a duplicate number in this column. 7. Click the Save icon on the Task Pane to save your edits.
8. Repeat steps 2 through 7 for each drop‐down list category you want to edit.
When you have finished, be sure to save and exit the window. Verify that the items you entered now appear in the appropriate place in the application.
MISCELLANEOUS PREFERENCES
Miscellaneous preferences (Setup > Miscellaneous Preferences) allow users to create and modify several lists for use in the system. Users also create claim form types in this window. For instance, items entered in the Degree tab appear in a drop‐down list in the Provider Detail and Referral Detail, and items entered in the Title tab appear in a drop‐down list in the Patient Detail window. This section explains each of the tabs and their fields.
2.2
Miscellaneous Preferences
Setup and Preferences
Figure 2‐1 Miscellaneous Preferences Window
Create the List of Degrees
The Degree tab contains a list of the different degrees that can be used in the system. You can find the Degree drop‐down on the Provider Detail (Maint > Provider) and the Referral Detail (Maint > Referring Doctor) windows. A brand‐new system comes with a standard list of degrees already created in the system. To add a new degree, click the New icon and type a Degree Description. Once saved, the system automatically generates the ID.
Specify Form Types for Submitting Claims
In MicroMD PM, there are two important definitions to clarify before we continue. A FORM is the physical claim form you send to the carrier for payment. A TYPE is the way that form is completed. A FORM TYPE is the container for the two. For example, ABC Insurance Group and Medicare both use the CMS 1500 Universal Claim form. However, your ABC Insurance plans require you to enter the leave boxes 4 and 9 blank if the patient is the insured. Medicare uses this same form, but they require you to print the word “SAME” in boxes 4 and 9. The FORM is the same, but the TYPE—the way you complete the form—is different.
In order to submit claims to insurance carriers (both electronically and on paper) that they will accept, you must create Form Types to associate with the plans in the system. Once you create a Form Type, you can then access the Form Type tab (for that entry). You can also then tell MicroMD PM how to complete the form. The Form Type POS, Form Type TOS and Form Options tabs are accessible once you highlight a form type and only apply to that highlighted form type. If you choose another form type, the information on those tabs changes accordingly. After you have fully created the Form Type, you can associate that form type with the appropriate plan(s) on the Plan Detail window.
Enter POS Codes Different from the Standard
Use the Form Type POS tab if an insurance carrier requires you to submit place of service (POS) codes that are different than the standard codes. For example, an insurance carrier could require the code “03” in the POS field for inpatient hospital services, instead of the standard POS of “21.” The system allows you to post the standard codes in the system and just associate those codes with the carrier’s requirement to use when submitting only those claims.
To create that association, click the New icon, select a standard POS code from the Standard POS drop‐down list, and type the code that the carrier requires for that place of service in the Form Type POS column.
Miscellaneous Preferences
2.3
Setup and Preferences
Enter TOS Codes Different from the Standard
Use the Form Type TOS tab if an insurance carrier requires you to submit type of service (TOS) codes that are different than the standard codes. For example, an insurance carrier could require the code “60” in the TOS field for medical services, instead of the standard TOS of “01.” The system allows you to post the standard codes in the system and just associate those codes with the carrier’s requirement to use when submitting only those claims.
To create that association, click the New icon, select a standard TOS code from the Standard TOS drop‐down list, and type the code that the carrier requires for that type of service in the Form Type TOS column.
Establish Specifics for a Form Type
Use the Form Options tab to establish the various options required to submit paper claims correctly and to tell MicroMD PM which electronic billing type to use for plans associated with this Form Type. Completing the selections on this tab correctly makes sure that the paper claims using this form type have all the necessary information in the proper place as required by the carrier receiving the claims.
TIP | Set up your form types as if you were going to submit them on paper, even if you are going to submit them electronically—
just in case you need to drop claims to paper in the event the insurance company’s system is down for an extended period of time.
Figure 2‐2 Form Options Tab
The information displayed on this tab varies depending on the choice you make in the Form drop‐
down list. Since the CMS 1500 claim form is the standard form used by most carriers, the Type drop‐
down is only available with this form.
2.4
Miscellaneous Preferences
Setup and Preferences
TIP | The system provides three options for the CMS 1500 claim form in the Form drop‐down list:
 CMS 1500: Print only the text of the claim on preprinted claim forms loaded into the printer
 CMS 1500 TEXT FILE: Output claim data to a text file
 CMS 1500 w/FORM IMAGE: Print the text of the claim and the claim image on a blank piece of paper loaded into the printer.
For commercial carriers that use the CMS 1500 form, choose Universal 1500 from the Type drop‐
down. The other selections in the Type drop‐down should be used as indicated by the name. For example, use the ALABAMA MEDICAID type when submitting the CMS 1500 claim form to Alabama Medicaid. Each of the types in the list has special coding that handles various behind‐the‐scenes aspects of the claim submission for that carrier.
The CMS 2/12 1500 Claim Form and the ADA Universal Form 2012 have been added to Form Type Options.
TIP | Your support team has documents detailing how each of these CMS 1500 types completes the claim form, as well as the other forms in the Form drop‐down list.
The Print Options section of this window allows you to indicate how each carrier wants the claim form printed. The ID Setup fields allow you to decide what should print on the CMS form in the indicated fields for the carrier.
Fields Available for the CMS 1500 Form:
Field
Description
Print Options
Type of Service
Check this box to print each procedure’s type of service code in box 24C of the CMS form. The system pulls the TOS from the TOS drop‐down on the Procedure Detail window. Uncheck this box to prohibit the TOS from printing on the claim form.
Insurance Address Check this box to print the insurance address in the upper‐right hand corner of the CMS form. Some carriers such as Medicare and Welfare may require the top of the form to be left blank, facilitating optical scanning of the claim form. In these cases, leave the box unchecked.
Miscellaneous Preferences
2.5
Setup and Preferences
Procedure Documentation
The system allows you to enter documentation for each procedure as you post charges (the D column and the red book icon). If there is no documentation under the red book and there is a check mark in the D column, the system prints the procedure’s code description instead.
Check the Procedure Documentation checkbox to print documentation on the CMS form. The documentation for the code prints in boxes 24D/E on the line immediately below the procedure code. The print area on the claim form is limited to 28 characters.
NOTE | You can have MicroMD PM place a check mark in the D column for certain procedures by default. Check the Document Flag checkbox on the Procedure Detail window. When you post that procedure, the D column is already marked and the red book icon activated. Pending Payor
Check this box to print a “P,” an “S,” or a “T” in the upper right‐hand corner of the CMS form to indicate if the claim is primary, secondary, or tertiary.
Clia No
Check this box to print the CLIA number on the claim form in box 23 (if a procedure on the claim has the CLIA Flag box checked on its Procedure Detail window). The system typically looks for the CLIA number in the following order: 1. Maint > Practice (select the appropriate practice) > Location tab
2. Maint > Practice (select the appropriate practice) > Practice tab
3. Maint > Provider (select the appropriate provider) > Provider Detail
Service Date To
Check this box to print the ending service date in box 24A on the CMS form. This is the date from the Date To field on the Charges window.
Diagnosis Description
Check this box to print the description of the diagnosis in box 21 of the CMS form. When this box is not checked, the system only prints the diagnosis code(s) in box 21.
Show Decimal in Fees
Check this box to print decimals points in any dollar amounts appearing on the CMS form. Certain insurance companies reject claims if the decimal is found on the form. This checkbox enables you to remove them for printing purposes.
Group Procedures
Check this box to group multiple lines of procedures into one line on the claim form, increasing the units accordingly. At this time, it is used primarily for home health.
Suppress ‘SAME’ in Boxes 4 and 9
Check this box to print the patient’s information in Box 4 and in Box 9 of the CMS 1500 insurance form, instead of the word “SAME.”
Show ‘Continued’ Label
Check this box to print the word “Continued” on the CMS 1500 form for multi‐
page claims. The word “continued” appears under the words “PLEASE PRINT OR TYPE” on the form.
Show Case No
Practices can print the case number related to the claim on the paper form. Place a check mark in the Show Case No checkbox. The patient’s case number (as listed on the patient’s Cases tab) prints in the upper left of the form, outside the OCR scan area.
2.6
Miscellaneous Preferences
Setup and Preferences
Show 4 Digit Year
Place a check mark in this box to have the four‐digit year (YYYY) print on the claim form instead of the two‐digit year (YY). NDC starting in
In this drop‐down, specify the box on the claim form where the National Drug Code (NDC) should print. You have the following options: 24A
24B
24C
24D
ID Setup
Box 1
Choose the type of claim form you are printing using this form type. The system marks the appropriate choice in box 1 of the CMS 1500 claim form.
Box 24e
If you want MicroMD PM to print the actual diagnosis code in box 24E on the claim form, select Code from this drop‐down list. If you need the diagnosis code reference number (or pointer) to print in this box, select Pointer from the drop‐
down.
Box 24k
For these four boxes on the CMS 1500 claim form, you can specify which ID numbers print in which box, depending on the requirements for claims submitted using this form type. The following list details where the ID is entered in the system.
Box 25
 (None): Select this option to prevent any numbers from printing in the Box 33 PIN
indicated box on the claim form.
Box 33 GRP
 Federal ID: Entered in the Practice Detail window (under Maint > Practice). There are two places to enter this number: a practice‐level number and a provider‐level number. The system checks for data in the Federal ID field on the Provider tab. If there is no number there, it uses the data from the Federal ID field on the Practice tab.
 License Number and National Provider ID (NPI): Entered on the Provider Detail window (under Maint > Provider) in the License No and NPI fields.
 Practice Insurance ID and Provider Insurance ID: You can find these ID fields in the Practice Detail window. They are generally used in a group practice setting where there may be a provider number for the group and individual provider numbers for the individual providers within the group, although solo practitioners may need these fields as well. Practice and provider insurance IDs are established by location and by insurance class.  Plan Practice ID: This field is no longer in use. Procedure Lines Per Page
Indicate the number of lines of procedures MicroMD PM can print on a claim form using this form type. For example, most insurance carriers allow 11 lines on the claim form, but others may only allow six lines. Enter that number here.
Miscellaneous Preferences
2.7
Setup and Preferences
Electronic Billing Info
NOTE | You must click the New icon on the Task Pane to access these fields. Electronic billing and auto payment posting are optional features, and the system prompts you for security key code(s). Please contact your authorized reseller to obtain this key code.
EB Type
Select the appropriate electronic billing type. The four‐letter designator for the billing type appears to the right of the type description in the drop‐down list. This designator becomes the first part of the filename created when batching electronic claims; the filename consists of the four‐letter designator followed by the practice number, period, and the file extension .ANS (e.g., MCOH1.ans).
AutoPost
Check this box to activate the AutoPayment Posting Module for this electronic billing type.
Adding a New Form Type
To set up a new form type for a new carrier or set of carriers, the following steps walk you through this easy process. Your support personnel can provide you with detailed setup guides for the various forms available in the system.
Procedure
Details
1. On the Form Type tab, click the New icon on the Task Pane.
1. Enter a unique identifier in the Type column for this Form Type.
You can enter up to two alphanumeric characters in this field. We recommend using two characters for easier recognition.
2. Type a description for this form type or select one from the drop‐down list.
The system comes loaded with options for most of the common insurance carriers in several states (i.e., Medicare, Medicaid, Blue Cross/Blue Shield).
When you create your form type, you can select any of these built‐in types from the Description drop‐down list and the Form Options tab automatically defaults to the settings required by this carrier for a solo practice. If your carrier is not included in this list, you can enter the Form Options manually.
3. Click the Save icon on the Task Pane to accept your changes and activate the Form Type tabs for this type.
4. Skip the Form Type POS and Form Type TOS tabs unless the carrier(s) using this form type require non‐standard codes for any POS and TOS.
5. Click the Form Options tab.
2.8
Miscellaneous Preferences
Setup and Preferences
6. Set the Print Options and ID Setup for submitting claims with this form type
TIP | If you chose a built‐in description, these options are already set for you based on the carrier’s requirements. If you are setting these options manually, be sure you have a copy of the carrier’s requirements or the appropriate MicroMD PM Form Options document.
7. Click the Save icon on the Task Pane.
Create a List of Personal Titles
The Title tab contains a list of the various titles in the system (e.g., Mr., Mrs., Rev., etc.). These titles are used when entering patient information in the Patient Detail window or physician information in the Provider Detail and Referring Doctor Detail windows. To add a new title to the list, just click the New icon on the Task Pane in this Title tab, enter a description and click the Save icon on the Task Pane.
Create a List of Search Arguments
Search arguments allow you to keep track of unique patient‐related items that the system may not otherwise record. Once you create an argument on this tab, you can assign it to patients on the Misc tab of the Patient Detail window. You can store up to three arguments for each patient using the Search Argument drop‐downs.
For example, the provider may need to keep track of how many patients have been given a pacemaker. In this case, you can create a search argument called Pacemaker. You can use the Search Arguments report (Reports > Patient) to find patients with any of the arguments you created and stored for your patients.
To add a search argument to the system, click the New icon on the Task Pane, type the text in the Argument field and click the Save icon to commit your changes.
Establish a List of Reasons You Recall Patients to Your Office
The system provides practices the flexibility to remind patients that they need to make an appointment for specific reasons. You could have cancer patients that you need to see every six months for a scan. Perhaps you are a general practice that wants to remind patients that they are due for their yearly physical. The Recall Reason tab allows you to create the different reasons you bring patients back to the office (e.g., dialysis, yearly physicals, etc.).
The tab also provides you a location to automate the Recall Module. This means that when you post the procedures and/or diagnosis combinations that you establish here, the system prompts you to create a recall flag for this patient. When the time comes to print recall letters, the patient will already be flagged to receive a letter.
SYSTEM CLASSES AND CATEGORIES
The system uses classes and categories to help group, associate and link information throughout the program. The System Classes/Categories window allows you to create those entries and any additional information needed for that entry. System classes are used in tandem with the Maintenance Module. Select Setup > System Classes/Categories from the main menu to access this window.
System Classes and Categories
2.9
Setup and Preferences
Figure 2‐3 System Classes Window
Coverage Classes
The Coverage Classes tab contains a list of the default coverage classes that can be used to group related procedure codes and the percentage typically paid by carriers on that type of procedure. Once coverage classes are created and you establish your default rate schedule, you can associate the coverage classes within each insurance plan in the system to define the rate it pays on the allowed amount for procedures within that class. MicroMD PM automatically calculates the co‐insurance and payment amounts for procedures based on this percentage once the user (or the system through the AutoPosting Module) enters the allowed amount on the green Payment Calculation – Primary Insurance Plans window when posting primary payments.
For example, a coverage class of MEDICAL may be set at a rate of 80% for Medicare’s plan, indicating that it pays 80% of the allowed amount. In contrast, a commercial plan may pay only 70% of the allowed amount on those same procedures in the MEDICAL coverage class. To add a new coverage class, click the New icon on the Task Pane and type a useful description in the Coverage Description field. In the Coverage % field, enter the percentage at which most plans pay for procedure codes associated with this class. Check the Default field to add this class and its percentage to the Plan Sched. tab for every new plan added to the system. Users can change this per plan if needed.
NOTE | The MISCELLANEOUS COVERAGE CLASS at 100% is a system code that is unchangeable.
Diagnosis Classes
Diagnosis Classes simply help you categorize your diagnosis list for more accurate reporting options. This helps you break down the diagnosis codes as they are listed in the ICD‐9 CM coding books. For example, you can create a class for DIGESTIVE SYSTEM that you then associate with all diagnosis codes related to the digestive system. You can then generate several reports based on the Diagnosis Class so you can have a more quantitative idea about the nature of the symptoms presented by your patients. Other examples of Diagnosis Classes:
 BLOOD DISEASES
 CIRCULATORY SYSTEM
 PREGNANCY
2.10
System Classes and Categories
Setup and Preferences
 INFECTIOUS AND PARASITIC DISEASES
NOTE | The MISCELLANEOUS DIAGNOSIS CLASS is a system code that is unchangeable. To add a Diagnosis Class, click the New icon on the Task Pane, enter a useful description in the Diagnosis Class Description field, and save. The system automatically assigns an internal ID.
Financial Classes
Another way to group procedures in the system for reporting purposes is to assign them to Financial Classes. By establishing financial classes, you can keep track of how much money your practice generates for performing specific services. It also allows you to quickly choose a group of related procedures in the report, instead of scrolling through the list and picking them one by one.
For example, create a Financial Class called LAB and associate that class with all procedures performed in the lab. Then you can generate a report using the LAB financial class (such as the Procedure Transaction History report) to see how much revenue the lab generates. Other examples of Financial Classes:
 ALLERGY CLINIC
 OFFICE VISITS
 SURGERY ROOM
 HOSPITAL
NOTE | The MISCELLANEOUS FINANCIAL CLASS is a system code that is unchangeable.
To add a financial class, click the New icon on the Task Pane, enter a useful description in the Financial Class Description field, and save. The system automatically assigns an internal ID. Insurance Classes
Insurance Classes group related insurance plans together for reporting purposes and, in some cases, for assigning insurance‐related IDs to a practice, as well as to providers. We recommend that you create insurance classes if the plan provides a practice and/or provider an insurance ID. For example, you could create a MEDICARE class that encompasses all of your regular Medicare‐related plans. You could also create a BC/BS class that encompasses all of the plans in your system related to Blue Cross/Blue Shield (e.g., group your Anthem, Highmark, CareFirst, Wellmark and/or any other Blues plans).
NOTE | The MISCELLANEOUS INSURANCE CLASS is a system code that is unchangeable.
To add an insurance class, click the New icon on the Task Pane, enter a useful description in the Insurance Class Description field, and save. The system automatically assigns an internal ID.
Charge Classes
The purpose of a Charge Class is the ability for multiple practices in the system to assign different fees for the same procedure, if they are different than the procedure’s standard fee. For example, you have two practices in your system. One charges $70.00 for an office visit (e.g., 99212), while another charges $80.00, which is the fee established for the procedure by default. Practices in the same database share the list of procedures and the information stored for each one. Creating a Charge Class and associating it with a procedure allows each practice in the same database the flexibility to still charge their own fees. System Classes and Categories
2.11
Setup and Preferences
Procedure
Details
1. Click the New icon on the Task Pane to create a new Charge Class.
1. Enter a useful name for the Charge Class in the This is typically the name of the practice or a useful shortened version of the name.
Description field
In our example, we entered ADVANCED FAMILY for the Charge Class.
2. Click the Save icon on the Task Pane.
The system automatically assigns an internal ID.
3. Repeat steps 1 through 3 for each Charge Class you need.
Patient Categories
This tab contains a list of all the patient categories that you have established in the system. These categories can be used to group patients for use when generating certain reports. For example, you can create a category called AUTO ACCIDENT so the office can keep track of all the auto accident patients. It is strongly recommended that you use the category called COLLECTION to keep track of collection accounts.
To add a patient category, click the New icon on the Task Pane, enter a useful title for the category in the Category Description field, and save. The system automatically assigns an ID. The patient category is assigned to the patient in the Patient Detail window in the Category drop‐down.
Figure 2‐4 Patient Category Tab
To have the categories flash in red to alert the staff that the current patient has that category selected in the Category drop‐down on their Patient Detail window (e.g., COLLECTION), check the appropriate checkbox on the category’s row. Flash Appt displays the red text on the appointment detail window. Flash Bill displays the red text on the Patient Sequences window.
Check the No Appt box to indicate that a user that attempts to schedule an appointment for a patient with this category on their Patient Detail window should receive a message indicating that the user cannot make an appointment for that patient.
2.12
System Classes and Categories
Setup and Preferences
Notes Categories
This tab contains a list of all the note categories that you have established in the system for categorizing patient notes. Users can assign note categories in patient notes and in sequence notes.
To add a note category, click the New icon on the Task Pane, enter the Notes Category Description, and save. The system automatically assigns an ID. Task Categories
The Task Category tab contains a list of user‐defined categories that are available in the Task Management Module. This enables a category to be selected for each message, task or note. For example, if a COLLECTION category is created, users can then assign that category to any collection‐related messages, tasks or notes. The default category is MISCELLANEOUS.
To add a category, click the New icon on the Task Pane, enter the Category Description, and save. The system automatically assigns an ID. Insurance Categories
The Insurance Category tab contains all of the insurance categories in the system. Insurance categories differ from insurance classes in that while insurance classes generally group several plans for the same carrier together (e.g., an BCBS class for all Anthem plans), categories group plans together for unrelated carriers (e.g., an HMO category to group all HMO plans, regardless if it’s a Medicare, Medicaid, or Blues plan). The default insurance category is MISCELLANEOUS.
To add an insurance category, click the New icon, enter a description in the Insurance Category field, and save. The system automatically assigns an ID. On the Plan Detail window, you can associate an insurance category to the plan. Select the appropriate category from the Insurance Category drop‐down list.
SYSTEM PREFERENCES
The System Preferences window allows you to continue creating lists that populate drop‐downs throughout the system (e.g., practice locations, places of service, etc.). You can also indicate defaults for all practices within the database to help manage the consistent use of the system.
Figure 2‐5 System Preferences Window
Create Locations for Practices in the System
The Location tab is where you enter all locations needed for use in the system. In general, these locations represent the physical practice location where the services are provided (not the service facilities like nursing homes or hospitals). For example, your practice has a Youngstown office and a Poland office. Another practice in the system has a Youngstown office and a Canfield office. You would need to enter System Preferences
2.13
Setup and Preferences
three locations on this tab (i.e., YOUNGSTOWN, POLAND and CANFIELD). Once a location has been added to this list, it must be associated to a specific practice through the Location tab of the Practice Detail. To add a location, click the New icon on the Task Pane, enter the Location Description, and save. The system automatically assigns an internal ID.
Define RVU Multipliers
The RVU Mult tab allows you to define RVU multipliers and assign them a value by which to multiply the value entered for the procedure in the RVU field on its Procedure Detail window. These values allow the practice to update the fees for their services based on the complexity and difficulty of the procedure. The RVU multiplier is used in conjunction with the RVU (relative value unit) field on the Procedure Detail window to help practices determine accurate fees. This allows five surgery procedures to have the same “weight” as 50 procedures done by a general practitioner. To add an RVU multiplier to the system, click the New icon on the Task Pane and enter a useful description in the RVU Multiplier Desc field. Assign a Multiplier value to each RVU. Once saved, the system automatically assigns an ID and adds this multiplier to list you see in the RVU Multiplier drop‐
down list on the Procedure Detail window.
Establish System-Wide Defaults
The System Preferences tab contains some of the default values for the entire system, not just a single practice. In order to complete a number of fields on this tab, you must first create system classes (page 9), as well payment and write‐off codes. Generally, users can change any of these defaults on a case‐by‐
case basis. Also included in this tab is a hard‐coded ICD‐10 crossover date.
Figure 2‐6 System Preference Tab
2.14
System Preferences
Setup and Preferences
Choices Available on the System Preferences Tab:
Field
Description
Billing/Claims
Default Payment Code
Assign a default patient payment code if the practice is using line‐item posting. Only payment codes marked with a “patient” TOS on the Procedure Detail window are available in the drop‐down list. When posting patient payments, the code selected here appears in the blue Payment Calculation – Patient and Non‐Primary Insurance window automatically.
For example, if most of your patients pay by writing a check and you have created payment code for checks (e.g., 2 – PAYMENT CHECK), you would select that code from this list.Fmple, if most of your patients pay by writing a check and you have created payment code for checks (e.g., 2 – PAYMENT CHECK), you would select that code from this list.
Misc Deduction
Select the default write‐off code you want to use for miscellaneous deductions in the green Payment Calculation – Primary Insurance Plan window (under the Misc column). Only write‐off codes (those with a “write‐
off” POS on the Procedure Detail window) appear in this drop‐down list.window) appear in this drop-down list.
Deductible Code
Select the default deductible code that appears in the green Payment Calculation – Primary Insurance Plan window when posting primary insurance payments (under the Deduc column). Only procedure note codes (those with a “PN‐Notes” TOS on the Procedure Detail window) appear in this drop‐down list.
When the user applies the payments, MicroMD PM enters the amount posted in the Deduc column to the end of the description line, instead of posting the amount in an Amount field. These notes display on the patient’s statements/bills to help explain why that amount is due from the patient.
Co‐Insurance Code
Select the default co‐insurance code that appears in the green Payment Calculation – Primary Insurance Plan window when posting primary insurance payments (under the Co‐Ins column). Only procedure note codes (those with a “PN‐Notes” TOS on the Procedure Detail window) appear in this drop‐down list. When the user applies the payments, MicroMD PM enters the amount posted in the Co‐Ins column to the end of the description line, instead of posting the amount in an Amount field. These notes display on the patient’s statements/bills to help explain why that amount is due from the patient.
Medicare Ins Class
Blue Shield Ins Class
Medicaid Ins Class
System Preferences
Select the insurance class that you want the system to know specifically contains Medicare plans (Medicare Ins Class drop‐down), Blue Shield plans (Blue Shield Ins Class drop‐down) and Medicaid plans (Medicaid Ins Class drop‐down). When staff members associate the insurance class selected here to a plan, the system knows to treat the plan as Medicare, Blue Shield or Medicaid.he system knows to treat the plan as Medicare, Blue Shield or Medicaid.
2.15
Setup and Preferences
Field
Description
Default Disbursement
When posting payments in the blue Payment Calculation – Patient and Non‐
Primary Insurance window, there is a Disbursement Type field that contains two options: FIFO or Prorate.
 FIFO: The system disburses payment amounts in a first‐in/first‐
out order. The system applies the money to the first line item with the oldest posting date and then the next until the entire amount of the payment has been allocated.
 Prorate: The system distributes a percentage of the money to each charge.
This Default Disbursement option sets the default choice for the Disbursement Type field. Users can change this choice when posting, if needed. Day sheet open days
This field allows you to select how many days a day sheet can remain open in the system (based on the date it was created) before the system prompts users to print and erase the day sheet. If a day sheet still in the system exceeds this time period, users cannot create a new day sheet until the “expired” one is printed and erased.
Charge Estimate
Check this box to display a Charge Estimate window when posting charges to give users an idea of what to expect as a payment for the service(s) rendered and what the patient might be expected to pay if a secondary does not exist. The window displays an estimate of insurance payments for the specified procedures based on that plan’s past payment history, if available.
Pop‐up Plans
Check this box to display a Patient Plans window so users can view the patient’s plans while posting payments.
Payment Calculation
Check this box to display the green Payment Calculation – Primary Insurance Plan window in the Payments Module. This checkbox works in conjunction with the Post Line Item Details checkbox. When you uncheck the Payment Calculation checkbox, MicroMD PM suppresses the initial display of the green Payment Calculation – Primary Insurance Plan window and disables the Post Line Item Details checkbox.
STOP | To realize the full potential of line‐item payment posting in the system, we recommend that you leave this option (and the Post Line Item Details box) checked and use the Payment Calculation windows for posting payments. 2.16
System Preferences
Setup and Preferences
Field
Description
Post Line‐Item Details
Check this box to enable the blue Payment Calculation – Patient and Non‐
Primary Insurance window. This window allows users to post secondary and tertiary insurance payments; patient payments; adjustments; and/or write‐
offs. You must mark the Payment Calculation checkbox to activate this checkbox.
Checking the Post Line Item Details box also allows users to view the details of each transaction in a sequence. Users can do this by double‐clicking the transaction to see all insurance/patient payments, adjustments, and/or write‐offs posted against each procedure code. This is also known as “drilling down” into the sequence. Show Sequence Applied In the Patient Sequences window, MicroMD PM displays a green bar next to Flag
each sequence that contains an unapplied payment amount. This checkbox displays those notifications. Uncheck this box to hide the flags and possibly speed up the system.
Maintenance
Degree
Select the default degree entry you want to use for the Degree drop‐down when a user creates a new provider or a new referring physician in the system. Users can change the Degree drop‐down on the Provider Detail or Referring Doctor Detail if needed.
Diagnosis Class
Select the default for the Diagnosis Class field on the Diagnosis Detail window for a newly entered diagnosis code. Create diagnosis classes under Setup > System Classes/Categories. Diagnosis classes help categorize similar diagnosis codes for reporting purposes. Coverage Class
Select the default for the Coverage Class field on the Procedure Detail window for a newly entered procedure code. Create coverage classes under Setup > System Classes/Categories.
Coverage classes allow you to indicate at what percentage services are being paid. For example, medical services may be paid at 80%, and lab services may be paid at 100%.
Financial Class
Select the default for the Financial Class field on the Procedure Detail window for a newly entered procedure code. Create coverage classes under Setup > System Classes/Categories.
Financial classes allow you to categorize procedures into logical groups that can be used for revenue tracking reports. Form Type
Select the default for the Form Type drop‐down on the Plan Detail window when creating new plans in the system. Create form types under Setup > Miscellaneous Preferences. Users can change this if needed.
For example, most plans created in your system use the CMS 1500 – Universal form type, so it’s easier to set the default to CMS 1500 – Universal and then change it on a case‐by‐case basis.
System Preferences
2.17
Setup and Preferences
Field
Description
Payment Code
Select the default for the Payment Code drop‐down on the Plan Detail window when creating new plans in the system. In general, specify a miscellaneous payment code that users can change for individual insurance plans, when needed.
Write‐off Code
Select the default for the Write‐off Code drop‐down on the Plan Detail window when creating new plans in the system. In general, specify a miscellaneous write‐off code that users can change for individual insurance plans, when needed.
Insurance Class
Select the default for the Insurance Class drop‐down on the Plan Detail window when creating new plans in the system. Users can change this on a case‐by‐case basis when needed. An insurance class allows you to categorize plans into logical groups that can be used to generate reports, as well as to assign insurance‐specific IDs.
Insurance Category
Select the default for the Insurance Category drop‐down on the Plan Detail window when creating new plans in the system. Users can change this on a case‐by‐case basis when needed. Insurance categories allow you to group unrelated plans (e.g., to assign all HMO plans to an HMO insurance category) for reporting purposes.
Default Lab
If the practice uses a specific lab, enter the name of this lab in this field. When a user checks the Lab box on the Plan Detail window, the text in the Default Lab field appears in the Lab Name field of the Plan Detail window and prints on the patient’s charge slip. Change Resp and
# of Days
Choose the default value for the Change Resp checkbox on the Plan Detail window for a new plan created in the system. Once you check the Change Resp box, the system displays the # of Days field. The # of Days field here is also a default for the # of Days field on the Plan Detail window. Users can change the selections per plan if needed. This checkbox indicates that any claims submitted to the insurance company but have not been paid in the number of days listed should appear in the Batch Responsibility Change utility. This utility allows practices to change the responsibility of the claim to the patient so the patient receives a bill for the unpaid amount. Compute Write‐off
Choose the default value for the Compute Write‐off checkbox on the Plan Detail window for a new plan created in the system.
This box controls whether the system automatically calculates the insurance write‐offs when posting payments using the green Payment Calculation – Primary Insurance Plan window. Generate Sec Claim
2.18
Choose the default value for the Generate Sec Claim checkbox on the Plan Detail window for a new plan created in the system. This box on the Plan Detail window controls what the system should do with the secondary claims in the AutoPosting Module. System Preferences
Setup and Preferences
Field
Description
Miscellaneous
To‐Do List Category
Select the default category for new items users create in the Task Management Module. Task categories help better define items in the task list, “sticky” notes, and messaging. For example, users may use their task lists for patient‐related maintenance, so they created a task called PATIENT and selected it as their default. Create task categories under Setup > System Classes/Categories.
Charge Slip Type
From this drop‐down list, your support team chooses the type of charge slip you want to create when you first purchase the system. This sets the default on a brand‐new system.
Printer Type
Select the type of printer you use to print from MicroMD PM. When a Select Printer dialog box appears, the system activates the button for this type of printer by default.
Use CheckIn For Missed Check this box to include the Missed Appointment Report as an option when Appts
closing the day sheet. The Missed Appointment Report lists all of the patients who had an appointment scheduled on that day sheet date but were not checked in using the Check‐In/Check‐Out Module.
Check‐In/Check‐Out Posting Toggle
Check this box to include the Missed Appointment Report as an option when closing the day sheet. The Missed Appointment Report lists all of the patients who had an appointment scheduled on that day sheet date but were not checked in using the Check‐In/Check‐Out Module.
Multi‐Practice
Check this box to use the global search feature in a multiple‐practice database. STOP | Only the user with supervisor security access can edit this choice.
Print Cover Sheet
Choose the default value for the Cover checkbox on every report options window in the Reporting Module. Check this box to print a cover sheet with every report generated in the system, detailing the options chosen to generate the report. Users can remove the check mark on a case‐by‐case basis. Users can also check this box on a case‐by‐case basis if the default value is to have the box unchecked.
Enter Custom Text for the Patient Registration Sheet
When new patients arrive for their first appointment, most offices have some documents for the patient to sign. The system creates a Patient Info form that lists all of the patient demographic information that users can print. The text on the Registration Text tab prints at the bottom of this form. The registration text usually states that the patient allows the office to bill the insurance company and that the patient is responsible for any fees associated with the services rendered by the provider. There is pre‐loaded registration text already in MicroMD PM. You can edit this text in any way you want. If you do not want this text to print on the Patient Info form, just highlight the text and delete it.
System Preferences
2.19
Setup and Preferences
Create Quick Text Macros
This tab allows you to create macro shortcuts called Quick Text. These shortcut phrases automatically insert the defined sentence or longer phrase. Users can access the Quick Text macros throughout the system (e.g., patient Remarks field, Notes fields, etc.). Users right‐click the text field, select Quick Text from the menu that appears and then choose the appropriate keyword. The full text appears in the text field, speeding up your notations and keeping wording consistent throughout the system.
To create a quick text macro, click the New icon on the Task Pane, type a meaningful Keyword that users quickly recognize, and then enter the full Message. The Keyword appears in the quick text list when users right‐click in a field. The Message is the full text that appears in the field.
TIP | To see your new macro(s) immediately, close out of the system and log back in. This refreshes the lists throughout the program.
Create System-Wide List of POS Codes
This tab contains a list of the CMS‐approved place of service codes. This list, in turn, populates the drop‐
down on the Place of Service tab under Setup > Practice Preferences where practices can choose the ones they use most.
To add a place of service code to the list, click the New icon on the Task Pane, enter a POS, type a description in the Desc field, and save.
Create System-Wide List of TOS Codes
This tab contains a list of CMS‐approved type of service codes. This list, in turn, populates the drop‐down on the Type of Service tab under Setup > Practice Preferences where practices can choose the ones they use most.
To add a type of service code to the list, click the New icon on the Task Pane, enter a TOS, type a description in the Desc field, and save.
Establish Sales Tax Requirements
For those practices that have taxable items, the Sales Tax tab controls the tax applied to procedures at each location. When a user posts a procedure with the Taxable box checked on the Procedure Detail window, MicroMD PM multiplies the charge for that item by the percentage listed on this tab. When the user saves the sequence, the system posts a line item with the code listed in the Procedure column for the tax amount. To add a new entry, click the New icon on the Task Pane, enter the appropriate information, and save.
Field
Description
Location
Select the practice location for which this sales tax entry applies. If the sales tax applies to all practices, leave the choice at (ALL). If the location on a sequence matches one on this tab and the sequence contains a taxable procedure, MicroMD PM applies the appropriate tax. Otherwise, the system uses the tax information from the (ALL) entry.
2.20
System Preferences
Setup and Preferences
Date From
Enter the effective starting date of this sales tax entry. If the user posts a taxable procedure against a day sheet whose date is before the date listed here, the system does not apply the sales tax.
TIP | You can have a new tax entry for each new tax year if necessary. Just change the Date From accordingly.
Procedure
Enter the procedure code the system should use when posting the sales tax transaction.
TIP | If you want the sales tax line item included on the claim or in the claim file, leave the Patient Resp checkbox on the sales tax procedure UNCHECKED. Now when someone posts a taxable code, the system automatically posts the sales tax code, but it posts the code as an insurance‐responsible amount (i.e., Y – Ins. Billing/Pat. Resp.) and prints the line item on the claim or includes it in the claim file.
Description
The Description field completes automatically based on the procedure chosen.
Tax Rate
Enter the tax rate percentage the system should use when calculating the sales tax. For example, if the tax rate is 6.5%, simply type 6.5 in this column.
Create a List of Departments
This tab allows practices to create and maintain a list of department descriptions and attach those to providers. This Department association is for reporting purposes only. Those reports include (but are not limited to) Applied Payments, Procedure History, Plan Procedure History, Revenue, Provider Utilization – Sequence Summary, and Provider Utilization – Day Sheet Summary.
To create a department, click the New icon on the Task Pane, type a description and save change. The system creates an ID for the entry automatically.
PRACTICE PREFERENCES
Practice preferences (under Setup > Practice Preferences) provides a location where each practice in the database can customize their default settings, including their posting and billing needs, and enter information that is unique to their practice. For example, Practice 1 purchased the MicroMD RX module, but Practice 2 didn’t need it. Practice 1 activates the MicroMD RX module on the Additional Modules tab in their Practice Preferences window. Another example is that Practice 1’s provider is Dr. Kumar, and Practice 2’s provider is Dr. Davidson. Each can set their own default provider for posting purposes so they don’t have to scroll through a drop‐down each time they post a charge.
Practice Preferences
2.21
Setup and Preferences
Figure 2‐7 Practice Preferences Window
Create a List of Procedure Modifiers
Use the Modifier tab to enter any modifiers this practice needs for the different procedures in the system. The practice can use these modifiers at the time of posting charges, or the practice can set default values for each procedure on the Procedure Detail window.
To add a modifier, click the New icon, type the code (two‐digit maximum) you want to use in the Modifier column, and type the appropriate description in the Modifier Description column. Be sure to click the Save icon to commit the changes to the database.
Set Up Billing Messages for Statements/Bills
Patient dunning messages are the billing messages that print on the bottom of statements and bills, depending on the number of aging days specified in the From and To fields for each message on the Patient Messages tab and the patient’s last payment date. To activate these messages, the Auto checkbox on the Patient Detail must be checked. The system then assigns these messages automatically to the patient’s account based on the age of the account, incrementing them accordingly.
NOTE | The practice must have at least two messages listed on this tab for the system to progress a patient to pre‐collection.
To create these messages, click in the message row and edit the Message Description. This is the actual text of the message. Set the From and To days, creating a “bucket” that the system uses as the aging days to determine which message to print.
Populate the POS Drop-Down List
The Place of Service tab allows each practice to populate the POS drop‐down with only those places of service they need for posting and assigning to procedures. (You edit the system’s list of POS codes on the System POS tab under Setup > System Preferences.) These codes indicate where the provider performed the service.
If the practice’s billing requires an admission date or a service facility when posting certain POS codes, the practice can check the Admission Date checkbox and/or the Service Facility checkbox next to the appropriate POS entry. When posting charges that use the indicated POS, system alerts the user of the requirement and asks if they want to process the claim without the data. The user can choose to correct the mistake or continue without the information.
2.22
Practice Preferences
Setup and Preferences
Establish General Usage Preferences
The General Preferences tab is the place in the system where each practice can customize the overall use of the program for their needs and set some general field defaults.
Figure 2‐8 General Preferences Tab
For example, you want to make sure that all of the staff members entering patients in the system enter the date of birth for every patient, without fail. You can also set the default provider, location, service facility, etc. Choices Available on the General Preferences Tab:
Field
Description
Patient
Title
The Title drop‐down on the Patient Detail for new patients created in the system defaults to the selection made here.
Provider ID
The system requires practices to assign a provider to every patient. Selecting a provider from this drop‐down automatically assigns the chosen provider to new patients created in the system.
TIP | Choose None from this list to force the staff to select a provider, rather than accepting the default without examining this field.
Practice Preferences
2.23
Setup and Preferences
Location ID
If the practice has established locations in the system, choose the location that is assigned by default when users create a new patient in the system. TIP | Choose None from this list to force the staff to select a location, rather than accepting the default without examining this field.
Patient Category
If the practice has established patient categories, selecting a category from this drop‐down automatically assigns the chosen category to new patients created in the system. Notes Category
If the practice has established note categories, selecting a category from this drop‐down automatically assigns the chosen category to new notes added within a patient’s account. Service Facility ID
Select the default service facility that appears on the patient’s Cases tab when creating a new case. Users can change the service facility as needed when creating a new case. Release Code
This code indicates whether or not the provider has a signed statement by the patient authorizing the release of medical data to other organizations. This drop‐
down sets the default for the Release Code drop‐down on the patient’s Plan Sets tab for new plans added to the set. Users can change this as needed on the Plans Sets tab.
Signature Code
This code indicates how the provider obtained the patient or subscriber authorization signature and how the provider stores that signature. This drop‐
down sets the default for the Signature Code drop‐down on the patient’s Plan Sets tab for new plans added to the set. User can change this as needed on the Plan Sets tab.
Patient Sex
This field allows the practice to choose the default for the Sex field on the Patient Detail window when creating a new patient in the system. Users can change the Sex field as needed on the Patient Detail window.
TIP | Choose Required Entry from this list to force the staff to select the patient’s gender, rather than accepting a default without examining this field.
ZIP Code
This field allows the practice to specify the default for the ZIP code field on the Patient Detail window when creating a new patient in the system. Users can change this when entering the patient’s demographics on the Patient Detail window.
County of Residence
This field allows the practice to specify the default for the County on the Patient Detail window when creating a new patient in the system. Users can change this when entering the patient’s demographics on the Patient Detail window.
Area Code
This field allows the practice to specify the default area code for the Phone field on the Patient Detail window when creating new patients in the system. User can change this area code as needed on the Patient Detail window.
Recall Freq
This field is not currently used.
2.24
Practice Preferences
Setup and Preferences
Max Recall
This field allows the practice to set the default for the Max Recall field on the Patient Recall Options window (under Reports > Recall…by Dates > Patient Recall). Enter the maximum number of times to recall a patient for each Recall Reason. Once the patient receives this many recalls for this reason, they no longer appear on the Patient Recall Report for the indicated reason. Users can change this field as necessary for their reporting needs at the time. Sub‐Account
Check this box to enable the sub‐account feature in MicroMD PM for this practice. In the Guarantor/Patient List window, the sub‐account pane appears on the right half of the window and is useful for family billing. Enable Load Address Button
Check this box to activate the Load Address button on the Cases tab of the Patient Detail window. This gives you the ability to replace the patient’s address with the address of the service facility listed (if there is one) in the Service Fac field of the patient’s Cases tab. For example, Mr. Smith has been transferred to a nursing home and his address is now that of the facility.
Patient Name Upper Case
Check this box to change the patient’s name to ALL CAPS when typing in the Name fields on the Patient Detail window. Press the Tab or Enter key to trigger the change.
Enhanced Referral
Check this box to enter more in‐depth details about referring a patient out to another physician. Enable Patient Chart Notes
Remove the check mark from this field to disable Patient Chart Notes (the Red Book icon) if the practice does not use them.
Required Patient Fields
Address, County of Residence, DOB, Home Phone, Social Security Number, Work Phone, and ZIP Code
Check any or all boxes in this section to require staff to complete the indicated fields before saving a new patient. If the user does not enter information in the fields indicated here, the system does not allow them to save the new patient until they enter the data highlighted in yellow on the Patient Detail window. The Last Name, First Name and Provider fields are always required by the system. (You can have the system automatically enter a specific provider for every new patient..)
Refresh Rates (Sec)
Practice Preferences
2.25
Setup and Preferences
Appointments, Check‐In/Out, Temporary Patients, Pending Charges, Charge Slip List
The values in this section tell the system how many seconds should elapse before the window refresh automatically with changes made by other users. When the system refreshes your window, it puts your current task on hold, updates the window, and then allows you to begin working again. Normally, you do not notice the pause. If you have a large database, however, refreshing your Appointments window every five seconds could slow your system down considerably and inconvenience your staff. The same is true for other windows. Practices have the flexibility to tailor this window refresh action to their unique situations.
Set the timers for each of the modules listed to refresh in the best amount of time (in seconds) to serve your needs. For example, you can set the Pending Charges list to refresh every 10 minutes (600 seconds), while you want the appointment schedule to update every 10 seconds.
TIP | If you set any of your refresh rates too short, the system could slow down considerably and you may find tasks difficult to complete.
TIP | If you set a refresh timer by entering a 0, and you then log out and log back in, there will be a refresh icon in that area that will disable the automatic refresh and allow you to manually refresh the screen.
Miscellaneous
Use Alternate Name for Labels
Mainly for those reports where you can print labels directly from the report, this checkbox sets the default order for printing names on labels. Users have the options to print names in first/middle/last order (checked) or in last/first/middle order (unchecked). This box lets practices set the default and then change as needed on a case‐by‐case basis.
Anesthesia
Check this box to enable the anesthesia options in MicroMD PM for this practice. This includes unique billing features that anesthesia practices need. Dental/Oral Surgery
Check this box to activate the dental options for this practice. This includes a dental diagram for each patient and deductible tracking. To see the dental options immediately, close out of the system and log back in. This refreshes the system to recognize your change. Posting Default
If your practice performs both medical and dental services, select which charge posting window you would like to see by default when users enter the Charges/
Payments Module. The system enables this drop‐down when you place a check mark in the Dental/Oral Surgery checkbox.
Populate the TOS Drop-Down List
The Type of Service tab allows each practice to populate the TOS drop‐down with only those types of service they need for posting and assigning to procedures. (You edit the system’s list of TOS codes on the System TOS tab under Setup > System Preferences.) These codes indicate the category of service into which the service falls. To add a type of service to this tab, click the New icon on the Task Pane and select the TOS from the TOS – Description drop‐down list. Click the Save icon to commit your changes.
2.26
Practice Preferences
Setup and Preferences
Establish the Practice’s Billing Preferences
This tab contains some of the various default values for the practice’s billing requirements and preferences for the work flow of the practice.
Figure 2‐9 Billing Preferences Tab
For example, the practice can indicate where the cursor appears on the billing window, depending on the preference of their billers. The practice can also indicate the default POS and TOS for a brand‐new procedure in the system.
Choices Available on the Billing Preferences Tab:
Field
Description
Posting
Default Posting Cursor
Specify where you want the cursor’s focus when users first enter the Charges window to post their charges.
Default Provider
Enter the default provider for charge entry. For new charges, the system always defaults to the provider selected here if one is specified. The other two options are:
(None): Select (None) to force the operator to select a provider from the drop-down
list when posting charges.
(Default): Select (Default) to have the system post the provider listed on the Patient Detail window for each patient.
Practice Preferences
2.27
Setup and Preferences
Default Location Enter the default location and/or service facility for entering charges and for the and Default Batch Options window. If a location and/or service facility is selected, the system Service Facility
always defaults to that location and/or service facility when a user resets the Batch Options window. (None): Select (None) to force the operator to select one from the drop-down list
before saving the entered charges.
The Batch Options window shows (Default) in this case, but does not enter a location and/or service facility when posting charges.
(Default): Select (Default) to use the location and/or service facility from the Patient Detail window on the Detail tab (for Location) and the Cases tab (for Service Fac)
for the appropriate case.
Bill Flag
This field allows you to choose the default flag for the Bill column when posting charges. Users can change the Bill flag if needed as they enter charges or edit claims, but setting the default makes the process more efficient. You have three Bill flag options for the default when entering a new charge line:
Y ‐ Ins. Billing / Pat. Resp.: You are billing the insurance company, but the patient is
wholly responsible for the bill.
N ‐ Pat. Billing / Pat. Resp.: You are billing the patient, who is wholly responsible for
the bill.
X ‐ Ins. Billing / Ins. Resp.: You are billing the insurance, and the total bill is the
responsibility of the insurance until a response has been received from the insurance
company and posted into the system.
Cutoff Days
Enter the default value for the Cutoff Days field on the Patient Sequences window. This field allows staff members to filter out any patient sequences with a zero balance that fall outside the cutoff range. This is based on the posting date of the sequence compared with the current system date. Users can change this and click the Search icon on the Task Pane if needed to filter that window any further.
Split Charges By Prov
Check this box to split sequences automatically when posting charges for two or more providers, thus creating two separate claim forms. When this box is not checked, charges posted for multiple providers appear on the same claim form.
NOTE | If you have the CHC Module and have Split by Plan set, it will override the Split Charges by Provider setting that is set here.
Diagnosis Pointer All
Check this box to reference all the diagnosis codes entered when posting charges. These reference s appear in the Diag column of the Charges window. For example, if three diagnosis codes are specified for a claim, the default diagnosis pointer appears as 1,2,3 for each procedure line, which can be changed if needed.
When this field is not checked, the system automatically references the first diagnosis code for every charge line entered, regardless of how many diagnoses the user entered.
2.28
Practice Preferences
Setup and Preferences
Pend Chgs Ln Notes
For those practices that purchased MicroMD Mobile, the system holds all incoming charges from these applications in the Pending Charges List. Any notes associated with the charges transfer to the Sequence Notes area by default.
If you want to store the notes for each pending charge line in the line‐level adjustment window instead, place a check mark in the Pend Chgs Ln Notes checkbox. If there is no check mark in this box, the system continues to store the notes in the Sequence Notes area.
Auto Specialty Pop‐Up
For those chiropractic practices doing electronic billing: Check this checkbox to force the biller to enter appropriate information for a chiropractic electronic claim. If a biller saves posting activity without entering information under the Extra button on the Claim Transactions window, the system automatically displays that extra window for them. Track Co Pay
Place a check mark in this box to turn on the Track Co‐Pay feature. Maintenance
POS
Select the default for the POS drop‐down on the Procedure Detail window when creating new procedures in the system. Users can choose a different POS if needed when they create a new procedure.
TOS
Select the default for the TOS drop‐down on the Procedure Detail window when creating new procedures in the system. Users can choose a different TOS if needed when they create a new procedure.
RVU Multiplier
Select the default for the RVU Multiplier field on the Procedure Detail window when creating new procedures in the system. Users can change this multiplier as needed when creating new procedures. Charge Slip
Choose the default charge slip for this practice. This is the charge slip that appears by default when a user opens the Charge Slip Module (under Billing > Charge Slip).
This is useful if there is more than one practice in the system, especially if each practice is a different specialty and uses a different charge slip. For example, Advanced Family Practice is an OB\GYN and XYZ Group is a podiatry clinic. Advanced Family can create a charge slip named OB\GYN and set that slip as their default, while XYZ Group can create a charge slip named PODIATRIST and set that slip as their default. NOTE | If a staff member changes the charge slip when printing, that charge slip displays by default and is listed in this drop‐down until the charge slip is changed again.
Statement/Bill
Choose the default value for the Stmt/Bill field on the Patient Detail window when creating a new patient in the system. Users can change this as needed when entering the patient’s demographics. Auto Message
Check this box to turn on the automatic patient messaging feature for statements/
bills. Budget Amounts
Check this box to enable the Next Payment and Due On fields on the Patient Detail window. Practice Preferences
2.29
Setup and Preferences
Finance Charges and Finance Charge Code
The Finance Charge checkbox sets the default value for the Apply Finance Charge checkbox available when printing statements/bills and the Apply Fin Chgs checkbox when creating a new patient. Once you check the Finance Charge box, the Finance Charge Code drop‐down list appears. Once you create an appropriate adjustment code (i.e., an adjustment to increase charge) for applying finance charges, select the code to instruct the system to use it when posting the finance charges.
STOP | Please be sure you understand the Finance Charge feature completely before you use it. Claim/Billing
Print in Plan Order
Check this box to display the list of claims in the Claims Processing – EB and Claims Processing – Paper windows grouped by plan. This allows you to process the claims and keep all claims for each plan together.
Show Patient Payment
Check this box to print the patient payments in Box 29 on the CMS claim form.
Provider Service Code
For the Ohio Welfare 6780 claim form, the character in this field prints in the upper left‐hand corner of the claim form in the Provider Service Code box.
Payee Type
For claims to certain carriers, enter the appropriate payee type. This payee type informs the carrier about the practice for which claims are being generated (e.g., medical, anesthesia, dental, etc.).
For a group practice, there is a Provider Type field for each provider on their individual Provider Detail window. Address Code
For claims to certain carriers, enter the appropriate address code. This address code informs the carrier from which office you are billing. For a group practice, there is a Provider Address Code field for each provider on their individual Provider Detail window. Print Zero Fee Charges On Claim Forms
Check this box to include on the claim form those charge lines with a zero fee posted. This is mainly for community health centers.
Remove Claim if Fully Paid
Choose the action you want MicroMD PM to take when a claim is fully paid. There are three choices for each practice:
 Prompt: During AutoPayment Posting, the system leaves the fully paid claim as a patient‐responsible sequence. During manual posting, the system prompts the user to remove the claim no matter the responsibility.
 Yes: The fully paid claim is automatically removed, whether posting payments manually or with AutoPayment Posting.
 No: During AutoPayment Posting, the system leaves the fully paid claim as a patient‐responsible sequence. During manual posting, the system prompts the user to create a supplemental claim, cross it over or remove the claim.
2.30
Practice Preferences
Setup and Preferences
Show Diagnosis on Receipt
To help comply with privacy regulations, uncheck this box to remove diagnosis information from patient receipts. Show Federal ID on Receipt
Uncheck this box to prohibit printing the Federal ID on a patient’s receipt.
Show Prov On Stmt
Check this box to print the provider’s name on statements for each transaction line. If this field is not checked, the Description column on the statement expands.
Pat Full Name on For practices that print statements/bills and find that they need the patient’s entire Stmt
name to print in the name column (helpful when several patients with different last names have the same responsible party), there is an option to do just that. Check this box to print the patient’s first and last name on the statement next to each of the charges posted for that patient.
TIP | If you select this option, the system might truncate the procedure description to make room on the statement for the patient’s full name. This is especially true if you show both the patient’s full name and the provider name on the statement.
Aging Buckets Based On
Practices have the ability to display the aging dates in the Billing Inquiry window based on the aging date, the posting date, or the service date of the sequence. Select the type of date you want the system to use when displaying the aging buckets.
 Aging Date: This date is the date when the responsibility changes for a sequence. When a staff member originally creates the sequence, the Aging Date is the posting date of the sequence.
 Posting Date: This is the date that the sequence was originally posted and never changes.
 Service Date: This is the service date on the sequence and only changes when splitting sequences.
Extra button
Set the default values for the various forms on the Extra button for new cases on the Cases tab for patients across the practice. When you access this button from the Claim Modification window in the Posting Module, the system verifies if you have information stored in the individual patient’s Cases tab and if not, it uses the default information you enter here.
Add Optional Modules to the System
The MicroMD PM Import/Export Module allows you to exchange data with third‐party applications. Depending on the design of the third‐party application, you either import/export the data manually, or the system and/or the third‐party application captures the data from the daily activity in the database. The automatic capture saves you and your staff from duplicate work.
STOP | When using the export interface you must enter initial data and/or make changes in MicroMD PM. The system then passes the information to the third‐party application. The system only imports patient charge data and lab results.
Practice Preferences
2.31
Setup and Preferences
NOTE | For availability and installation of additional modules, contact your authorized reseller.
The system provides additional modules and interfaces with numerous third‐party applications. These optional features need to be activated before you can begin to use them. The Additional Modules tab (under Setup > Practice Preferences) is where you activate the interfaces and modules you purchase.
Figure 2‐10 Additional Modules Tab
Your authorized reseller typically installs the Import/Export Module program if needed, activates the additional module/interface for you and then runs the one‐time export, if necessary. They also provide you with any specific details of the interface and how to use an additional module in the system.
NOTE | For any questions relating to using the third‐party application itself, please contact the third‐party vendor.
STOP | Before continuing with ePayments and eStatements, please take a moment to review the prerequisites section below. Several items must be in place before using these additional features of MicroMD PM.
Prerequisites
In order to use Moneris ePayments and RevSpring eStatements with MicroMD PM, several security measures need to be in place. These security measures are the responsibility of the client and should be performed by trained IT staff. Your IT vendor will be able to assist you with these items. For further assistance in configuring SSL, please see Chapter 19 of the MicroMD Installation Manual.
 A domain name and hosting – Each practice using any eServices from Henry Schein Medical Systems will need to have their own domain name and hosting. For example, www.MyPracticeName.com, where “MyPracticeName” is the name of the practice.
 A static IP address – In most cases, this will be an upgrade from a dynamic IP address.
 An SSL Certificate – In order to ensure secure transactions, an SSL (Secure Socket Layer) certificate must be in place. This prevents any loss or sharing of private data from possible 2.32
Practice Preferences
Setup and Preferences
cyber criminals, and assures a smooth transaction. To activate an additional module or interface:
Procedure
Details
1. Select Setup > Practice Preferences from the main menu.
The Practice Preference window opens.
2. Select the Additional Modules tab.
3. Click the New icon on the Task Pane.
4. Select the interface or additional module from the Add‐On drop‐down list.
5. Complete the necessary columns for this interface or additional module.
6. Click the Save icon on the Task Pane.
The system prompts you for a security code when you attempt to save. Contact your local authorized reseller to obtain this key code.
Columns on the Additional Modules Tab
Field
Description
Add‐On
Select the additional module or interface you just purchased. One entry in this list is the Generic export. This export exists for programs not included in the export list. If you choose this export, the third‐party vendor must filter the data through an external script before importing it into their software. Please contact your local authorized reseller for more information.
Export Path
If you select an add‐on with a standard path and/or filename to which the system should save the data exported, the system enters that path by default. Otherwise, enter the correct path and/or filename required by the interface or additional module to pick up the exported data.
Notify User
Select the user from this drop‐down that you want to receive a system mail message when an error or warning occurs with the interface or additional module. That user can then highlight the module’s entry on this tab and click the View Log icon on the Task Pane to research the error. This opens a window with any errors listed in the top portion of the window and a description of the error for the selected log file in the lower portion.
Auto
Once you have entered the security key code for the interface or additional module, the system enables the Auto column. If the export or import can launch automatically, place a check mark in this column. The system automatically launches at specific time intervals defined while installing the program.
Setup Options
Depending on the interface or additional module you are adding to the system, you may need to enter some additional setup information. To do so, highlight the module’s or interface’s entry and Practice Preferences
2.33
Setup and Preferences
click the Setup icon on the Task Pane. Verify the requirements with the documentation provided by your local authorized reseller for the module or interface.
Importing Charge Data
You can only import patient charges into MicroMD PM automatically. The system imports these charges into the Pending Charges window at timed intervals established in the Import/Export Module installed by your support team. Imported charges appear in the Pending Charges window in the system for a biller to review and create the claim appropriately.
TIP | If you do not see the Pending Charges pop‐up window in the Charges/ Payments Module, verify that you have a check mark in the Pending Charges List box (under Utility > Workstation Setup > Display Properties). Exporting Data
You can export appointment data and patient demographics manually or you can have MicroMD PM export new and modified records at timed intervals. Your support team has information about editing the export.ini file to set these timer intervals.
Establish Automated HIPAA Alerts and Default Documents
The HIPAA Categories tab allows you to enable HIPAA‐related alerts for users in billing (patient demographic, posting, and billing inquiry), appointment, or check‐in/check‐out windows. Use the items under this tab to reinforce your compliance with the HIPAA privacy guidelines.
RULES MANAGER
When you generate an EB Summary Report before batching your claims, the system performs a series of checks according to the ANSI specifications to help you send clean claims. The Rules Manager gives you the ability to create custom EDI edit checks and messages to meet the needs of insurance companies you are submitting to. This allows you to catch as many errors as you can before you submit the claims. To access the Rules Manager, select Setup > Rule Manager from the main menu.
2.34
Rules Manager
Setup and Preferences
Figure 2‐11 EDI Rules Manager
The system comes built with many rules already created based on the ANSI specifications for electronic data. These are marked as system rules and cannot be changed. To view the details of a rule, simply double‐click the item in the Rules Manager window or click the Modify task in the Task Pane. NOTE | The system includes separate rules for 4010 and 5010 ANSI coding specifications. The system displays if a rule pertains to 4010 or 5010 coding in the Version column of the Rules Manager window. The IDs for 5010 rules begin at 101. Creating New Rules
When you create a new edit check for the electronic billing module, you establish the message that appears on the EB Summary Report and the situation that causes that message to appear. You also indicate the level of that error (i.e., WARNING or INVALID), whether the rule can be applied to all insurance plans throughout the system, or if the rule applies to only specific Insurance Classes and/or plans. You can also indicate which module the error brings up when you drill down in the EB Summary Report To create a new rule, simply click the New icon on the Task Pane and complete all sections of the window. Remember to save your changes.
Rules Manager
2.35
Setup and Preferences
Figure 2‐12 Rule Details
Rule Conditions
At the heart of each rule you create is the query. The query defines exactly what conditions each piece of data must meet before the error message can appear on the report. The piece of data is the information recorded for the patient’s claim—from NPI for the provider on the claim to the patient’s date of birth.
NOTE | Each of the queries in the rule must be addressed before the error message appears on the report.
This information is generally in the form of an ANSI code required by the insurance company in order to process your claim file. The Rule Manager was designed so you could create rules to meet these requirements that occur outside the standard. Information provided by your insurance company should contain any ANSI code(s) that should appear in the claim file.
NOTE | When entering data in the Value field for the rule, you need to include this data in single quotes (e.g., ‘F’ for female).
The system allows you to create two types of queries: simple and complex.
 Simple: A simple query consists of only one condition (i.e., Patient Gender = ‘F’)
 Complex: A complex query is a query made up of a number of simple queries. You join simple queries by the appropriate Boolean expressions “OR” or “AND” (i.e., Patient Gender = ‘F’ AND Procedure Code = 84153).
Some complex queries may include parentheses. For example, a user wants to create an edit check on claims submitted for female patients where the claim contains either procedure 84153 or procedure 84154. Her query would look like this: Patient Gender = ‘F’ AND (Procedure Code = 84153 OR Procedure Code = 84154).
You use the Conditions tab of the Rule Detail window to define this criteria. 2.36
Rules Manager
Setup and Preferences
Fields Available in the Rule Details Window:
Field
Description
Description
Enter useful text to describe the rule. Users should be able to understand the selection at a glance. This description appears in the list of rules in the Rules Manager window.
TIP | The Description field is not the text that appears on the EB Summary Report. The EB Summary Report contains the ID number of the rule to help you locate it in this list; however, making the text of your description similar to the text in the message will help you troubleshoot quickly if necessary.
Version In this drop‐down, select if the rule will apply to 4010 or 5010 coding.
Message
This text is the message that appears in the EB Summary Report between the asterisks. Those sending the claims should be able to understand the problem indicated by the rule so they can fix it quickly.
Error Level
Select the appropriate type of error message for this rule when the system needs to display the message:
 Warning: A warning message indicates a possible rejection by the insurance company and lists what the user should correct. It is up to the user whether to correct the error. The system will still send the claim.  Invalid: The system will not send any claims marked with an invalid message. This indicates that the insurance company will reject the claim for the reason listed in the message.
Location
From this drop‐down, select where you want the system to go when the user drills down from this error message. For example, if the error message indicates that the user needs to verify the diagnosis on the claim, you can have the Claim Transactions window open when they click the red error message.
Apply to All
Place a check mark in this checkbox if the rule should be activated for claims submitted for any insurance plan in the system.
NOTE | If you do not place a check mark in the Apply to All checkbox, you must make a selection(s) on the Insurance Classes and/or Insurance Plans tab.
Place
The Place drop‐down allows you to filter the Field drop‐down:
 Claim Level: The Claim Level option points to information contained in the Claim Processing Module of the system or header information.
 Practice EB Info: When you select Practice EB Info from this drop‐down, the system looks for the fields contain on the EB Setup window.
 Line Level: When you select Line Level from this drop‐down, the system looks at the transaction level of the claim (i.e., the Claim Transactions window).
Rules Manager
2.37
Setup and Preferences
Field
The Field drop‐down contains all of the fields in the system for the area selected in the Place drop‐down. When the field you select here meets the requirements you select in the Condition and Value fields, the system displays the text in the Message field.
Condition
The Condition field allows you to identify the relationship of the choice made in the Column drop‐down to the entry made in the Value field in order for the message to appear on the EB Summary report. For a simple example, you want the message This is a male patient to appear on the report. The Column drop‐down would be Gender, the Condition drop‐down would be =, and the Value field would be ‘M’.
The available conditions are:
 = (equal to)
 <> (not equal to)
 < (less than)
 > (greater than)
 <= (less than or equal to)
 >= (greater than or equal to)
 In List and Not in List: These options provide the ability to choose a list of values of which the selection from the Column drop‐down is either a member (In List) or not a member (Not in List) and that existence or non‐
existence causes the message to appear on the EB Summary Report.
 Is valid: Mainly for use with the NPI number, the Is Valid condition checks the format against known formatting requirements. For example, all NPIs are at least 10 digits and all numbers. The final digit is a check digit that is a result of a set of calculations of the other digits. If the system discovers that these calculations do not check out or that the number is less than 10 digits, the format is not valid.
 Length: The Length set of conditions allow you to create rules to check the length of identification numbers for providers, service facilities, and more.
For example, Length = means that if the number of characters in the field selected in the Column drop‐down is equal to the number you enter in the Value field, the system should display this message on the EB Summary Report.
 Field: The Field set of conditions allow you to create rules to check the relationship between two fields.
For example, the patient’s date of birth cannot be greater than the date of service on the claim. You would select DOB from the Column drop‐down, > Field from the Condition drop‐down and Service Date from the Value drop‐down.
2.38
Rules Manager
Setup and Preferences
Value
The Value field works in conjunction with the Condition and Column drop‐downs to control whether this rule applies to the claim and therefore displays the message on the EB Summary Report. This is the information the system looks for when applying the rule. This value is typically the ANSI value required in the claim file.
If you use one of the Field conditions in the Condition drop‐down, the drop‐down allows you to select from a list of fields in the system.
NOTE | When entering data in the Value field for the rule, you need to include this data in single quotes (e.g., ‘F’ for female).
NOTE | When you select 5010 in the Version drop‐down of the Rule Details window, insurance entries in the Value field are classified into primary, secondary and tertiary. For example, in the Value drop‐down, you can select Primary Insured DOB, Secondary Insured DOB or Tertiary Insured DOB—depending on your need to include the insured’s date‐of‐birth entered in the primary, secondary or tertiary plans.
drop‐downs
The choices in the unnamed drop‐downs are the Boolean expressions (i.e., OR and/or AND) used to connect queries, as well as the parentheses used to define complex queries.
Defining a Simple Query
You can apply rules using a simple query. A simple query is a single condition that the data should meet before the error message appears in the EB Summary Report. For example, a rule condition that applies to claims where the patient’s gender is female requires a simple query. That query would be Patient Gender = F.
To create a simple query:
Procedure
Details
1. Verify that you have the Rule Details window displayed.
1. In the Place drop‐down, select where the information you want to enter is found.
2. From the Field drop‐down, select the field you want the rule to check.
3. Select the appropriate operator from the Condition drop‐down.
Rules Manager
2.39
Setup and Preferences
4. In the Value field, enter the value you want the item to have before the system displays the error on the EB Summary Report. You can either type text in this field or select a value from the drop‐down, depending on the selection you make in the Condition drop‐down.
Congratulations! You’ve created a simple query. You can use this same principle when creating complex queries as well.
Defining a Complex Query
Applying some rules to a patient’s claim requires complex queries. A complex query contains a number of simple queries joined by Boolean expressions (i.e., OR and/or AND). If you want to create an edit check on claims submitted for female patients where the claim contains procedure 84513, you would need a complex query. That complex query contains the two simple queries: Patient Gender = ‘F’ AND Procedure Code = 84513.
Figure 2‐13 Example Complex Query
Some complex queries may require parentheses in order to correctly define the information you want to pull out of the database. If you want to create an edit check on claims submitted with either procedure 84153 or procedure 84154 where the patient is female, you would need a complex query. That complex query contains the two queries: Patient Gender = ‘F’ AND (Procedure Code = 84153 OR Procedure Code = 84154).
TIP | To allow for more complex queries when creating rules, the system includes three levels of parentheses. Figure 2‐14 Example Complex Query with Parentheses
TIP | You could also use the In List condition in this example for the procedure codes and avoid using parentheses.
2.40
Rules Manager
Setup and Preferences
Insurance Classes
The Insurance Classes tab in the Rule Details window allows you to narrow the application of the rule. If one of the Insurance Classes in your system (e.g., Anthem) has a specific requirement, but no one else has that requirement for you to submit claims successfully, you can create a rule specific only to those plans within that Insurance Class.
Figure 2‐15 Insurance Classes Tab
This tab lists all of the Insurance Classes in your system. To have the rule apply to specific Insurance Classes, simply place a check mark in the Active column. When the system finds a claim that meets the conditions you set in the rule and the rule isn’t a system‐wide rule, the system checks the Insurance Classes tab to see if there are any listed for the rule.
Insurance Plans
The Insurance Plans tab works much the same way as the Insurance Classes tab, but you might have a condition that applies only to a specific plan or just a couple of plans within an Insurance Class. In that case, you can use the Insurance Plans tab to indicate which plan(s) should be on the claim before the system displays the error message.
Figure 2‐16 Insurance Plans Tab
To have the rule apply to specific insurance plan(s), simply place a check mark in the Plan Active column. When the system finds a claim that meets the conditions you set in the rule and the rule isn’t a system‐
wide rule, the system checks the Insurance Plans tab to see if there are any listed for the rule.
You can also use the Insurance Classes and Insurance Plans tabs in conjunction with each other. There could be instances where the majority of the plans in an Insurance Class have a requirement that you want to Rules Manager
2.41
Setup and Preferences
check before the claim goes out, but there are a couple that do not have the same requirement. The Ins Cls Active column indicates if the Insurance Class associated with that plan is active on the Insurance Classes tab.
2.42
Rules Manager
IDENTITY AND ACCESS MANAGEMENT
The system presents a security module called Identity and Access Management. With these features, supervisors can create security groups such as FRONT DESK and BILLING, creating templates for common user access requirements. Supervisors can also establish a time period when the system reminds the users to change their passwords. The security module allows practices to tighten their security, audit system access, review security access changes. With this module, practices can also limit access to the system during specified days and times.
IN THIS CHAPTER
In this chapter, we cover how to:
 Limit access to the system
 Work with the security log
 Establish the format of passwords
 Reset user passwords
 Create users and user groups
 Understand the versatility of the module
 Change passwords from an individual user’s perspective
OVERVIEW
In the security module, practices have a central location where they can set user security permissions for nearly every aspect of MicroMD PM. All users must have a user name and password to access and use the system. There are two levels of users: supervisor and user.
 A Supervisor has access to the entire system with almost no restrictions.
 An Equivalent user has the same rights as the supervisor, except Equivalents cannot access the Identity and Access Management Module.
 A User initially has all access rights checked on the Permissions tab. You must establish the user’s access rights to the various areas of the program. If you have several users for whom you want to assign the same access rights, you can create a User Group for those users that require the same access. This allows you to maintain access rights for that group of users by changing them only at the group level. ESTABLISH SECURITY PREFERENCES
Practices have the ability with the Identity and Access Management Module to specify a great deal of information regarding the length of user names and passwords, the number of times a user can attempt to log in incorrectly, etc. To access these options, select Setup > Identity and Access Management > Security Administration from the main menu. This opens the Security Administration window.
In This Chapter 3.1
Identity and Access Management
Figure 3‐1 Security Administration Window
Limit Access to Your System
You can restrict the access to your system by specifying the days and times users are allowed to log in. In the Availability section of the Access tab, click the Modify button next to Day and Time Restrictions field. This opens the Access Days and Times window.
Figure 3‐2 Access Days and Times Window
On the left side of the window is the Standard Days and Times section. This section allows you to establish the standard access you want for the system. If your office is closed on Saturdays and Sundays, for example, you might want to uncheck Sunday and Saturday in this list. This prevents any user from logging into the system at any time on these days.
If members of your office staff work anywhere from 7:00 am through 7:00 pm on Monday, Tuesday, and Thursday, but they work anywhere from 7:00 am through 4:00 pm on Wednesdays and Fridays, you could change the times on Monday through Friday to reflect these time ranges.
3.2
Establish Security Preferences
Identity and Access Management
Any day that differs from this schedule, such as a holiday or closure for renovations, you can add that date to the right side of the window and prevent anyone from logging into the system at any time on those dates. To restrict total access for a specific date, click the New button on the bottom of the window. This adds a new row to the right side of the window. Simply enter the date and a user‐friendly description such as “Christmas Holiday”. When a user attempts to log in on a date indicated on the right side of the window, the system displays a message that the database is unavailable.
Log User Access
Practices can create a log file of attempts to access the system, based on your choices in the Access Log section of the Access tab. From the Access Log Action drop‐down, you can choose one of the following actions:
 Archive: When you choose this option, the system automatically saves the log file each day to the directory specified in the Archive Location field. The system names the file according to the date and time on the database server. The naming convention for this file is as follows: archivelogyyyymmdd_hhmmssssss.txt where “yyyy” is the four‐digit year, “mm” is the two‐
digit month, “dd” is the two‐digit day, and “hhmmssssss” is the time stamp from the database server in hours, minutes and seconds.
When you select this option, the system enables the Purge Every field. This allows you to set the system up to archive the log every day automatically and then purge the file(s) automatically for you. Simply select the number of days, weeks, months, or years you want to elapse before the system deletes the file(s).
 Manual Purge: When you choose this option from the drop‐down, the system knows that you want to review the log and then clear it out yourself. The system does not archive the log automatically when you choose this option.
 Automatic Purge: With this option, the system does not archive the log file. It simply keeps the information in the database and clears it out based on your entry in the Purge Every field.
Viewing the Current Log Files and Archiving Manually
The system stores the current log file in your system until it is archived, either automatically or by a supervisor. To view the current log, click the View Log button on the Access tab. This displays the System Access Log window with information that has not been archived yet. This displays information about each user’s access to the system, including when they connected, which practice(s) they entered, and when they disconnected.
Figure 3‐3 System Access Log
Establish Security Preferences
3.3
Identity and Access Management
To archive this log manually, click the Archive button. This opens the Archive System Access Log window to the location specified in the Archive Location field. Save the file.
Viewing Archived Logs
If you want to view archived logs that have not been purged yet, click the Archives button on the Access tab. Click the Open button at the top of the window. The system opens the directory listed in the Archive Location field. Select the text file you want to view and click Open. The system displays the log for you. Click Finish when you have completed your review.
Figure 3‐4 Open an Archived Log File
Failed Login Attempts
You can establish the requirements for failed attempts to log into your system. This includes the number of failed attempts you want to allow before the system closes the launch window. You can even lock the user out of the system after a specified number of attempts. Select Setup > Identity and Access Management > Security Administration from the main menu and click the Logins tab.
NOTE | This restriction applies only to a user who attempts to log in with the correct username and an incorrect password.
Figure 3‐5 Logins Tab
In the Number of Attempts field, enter the number of failed attempts you want to allow within the time period specified in the Within a Period of field before the systems closes the launch window. If you have a check mark in the Lock User Account checkbox, the system also locks the user out of MicroMD PM until the time period specified in the Unlock Account After field has passed.
If you want to view a list of those accounts currently locked within the system, click the Locked Accounts button. The system displays a list of those accounts where the user reached the number of attempts 3.4
Establish Security Preferences
Identity and Access Management
indicated in the Number of Attempts field without entering the correct password.
Figure 3‐6 Managing Locked Accounts
To unlock an account, simply place a check mark next to the user’s account and click Accept.
Specify Password Requirements
With the security module, users can create their own password the first time they log into the system. The practice can specify the makeup of that password. Select Setup > Identity and Access Management > Security Administration from the main menu. On the Security Administration window, click the Passwords tab. Figure 3‐7 Passwords Tab
Fields in the Password Characteristics Section:
Field
Description
Minimum Length
Minimum number of characters the system will accept for the user’s password.
Must Contain 1 or More
You can specify the makeup of passwords your users create.  If you want each user password to contain at least one letter, check the Alpha Characters (A‐Z) checkbox.  You can also specify that the user must include at least one number in their password.
 Place a check mark in the Numbers (0‐9) checkbox.
 To require at least one special character in user passwords, place a check mark in the  Special Characters checkbox.
Establish Security Preferences
3.5
Identity and Access Management
And The First Character Is
You must specify the format of the first character in user passwords (i.e., alpha, numeric, or a special character). The system prompts the user when they attempt to create a password that does not have the indicated first character.
Reset Passwords
Privacy regulations recommend that users of healthcare software reset their passwords at least every 60 days. The system provides practices with the ability to set the system to prompt users in a specified number of days to reset their passwords. Once you establish this timing, you no longer have to worry about users resetting their passwords. Simply select the number of days, weeks, months, or years from the Reset Passwords Every fields on the Passwords tab of the Security Administration window.
You also have the option to reset passwords manually. Click the Reset Passwords button to display a list of all users in the system. If you want to reset only certain user passwords, place a check mark next to the user(s) in the list and click Accept. To reset all user passwords, click Select All to mark all users in the list and click Accept. The next time the selected users log in, the system prompts them for a new password.
TIP | If you want to reset most user passwords but not all of them, click the Select All button to mark all users and then uncheck the few you do not want to reset.
USERS AND GROUPS
The Identity and Access Management Module provides practices with the option of creating user “groups,” in addition to creating individual user accounts. Practices can then specify the access privileges to various areas of the program and indicate the actions each user in their practice can perform. Practices can also specify which Launch Buttons are available to each user to customize their Navigation Pane. To access this portion of the Identity and Access Management Module, select Setup > Identity and Access Management > Users and Groups from the main menu. This displays the Users and Groups window.
Figure 3‐8 Users and Groups Window
About Permissions
You can limit the permissions of a user or a group of users. On the Permissions tab, you can limit the types of actions the user can perform in each module, such as creating a new patient, deleting appointments, modifying existing plans, or viewing other user’s tasks. You can also limit the practice(s) to which the user or group of users has access. Almost all folders within the security tree contain four common 3.6
Users and Groups
Identity and Access Management
permissions: add, modify, view, and delete. Many folders contain unique permissions relating to the use of that module. The security tree allows for very specific access rights for each user or group of users. For example, the user (or group of users) can view the Check‐In/Check‐Out Module but cannot check patients in or out.
Figure 3‐9 Editing User Access Rights
There are a couple of ways to provide or deny user permissions for the modules in the system. You can place a check mark next to each individual permission or remove the check mark from the box. TIP | Access in any group to which a user belongs provides them access. Specific practice settings override universal settings. User settings override group settings.
The system also provides a right‐click menu option to assign or remove rights for all permissions within a folder. When you right‐click a folder, a menu displays the following choices:
 Expand: Opens the selected folder and all of its subfolders.
 Collapse: Closes the selected folders and all of its subfolders.
 Full Access: Places a check mark next to every permission in the selected folder, including permissions in all of its subfolders.
 No Access: Removes the check marks from every permission in the selected folder, including permissions in all of its subfolders.
 Read Only: Places a check mark next to the View option in the selected folder, including the View option in all of its subfolders.
 No Delete: Places a check mark next to the View, Add, and Modify options in the selected folder and removes the check mark next to the Delete option in the selected folder. The same is done in all of its subfolders, as well.
STOP | Each new user created has check marks next to all permissions. We recommend that you establish access rights for each user or group of users as appropriate before they log in to the system.
Users and Groups
3.7
Identity and Access Management
Creating User Groups
When you create an entry on the Users tab of this window, you can create an individual user account (choose the User option from the Role drop‐down) or you can create a group of users (choose the Group option from the Role drop‐down). A user group contains any number of members. You can use these groups to make it easier to create new users and manage their security permissions. For example, you can create a Front Desk group and set the permissions on that group so that the members can only access the Appointment Module, Task Management Module, Maintenance Module, some limited reporting, and no billing functions. When you create the users and associate that group with each user, the user account takes on the permissions set for that group.
To create a new group:
Procedure
Details
1. Select Setup > Identity and Access This opens the Users and Groups window.
Management > Users and Groups from the main menu.
2. On the Users tab, click the New icon on the Task Pane.
You can also press the Ctrl + N key combination.
3. Enter the name of the group in the Name column.
For a group, this should be a useful term that lets staff members quickly understand to whom the group refers.
4. Select Group from the Role drop‐
down list.
Set Group Permissions
5. Click the Permissions tab.
Skip the Members tab since the tab will populate automatically when you create the individual user accounts and assign them to this group.
3.8
Users and Groups
Identity and Access Management
6. Click the New icon on the Task Pane. The system creates a new row with access to all practices selected by default and the user security level selected by default. Remember that when creating this group, everyone in the group will have the same permissions.
For example, ABC Group has three practices in their system and 20 users disbursed between them. They created three groups for the billers in the system: BILLERS – OB/GYN, BILLERS – PEDS, and BILLERS – GEN PRACT. Each of these groups was assigned only to their practice. Then the group was assigned the appropriate permissions on the right side of the tab.
7. Select the appropriate practice if applicable.
The system defaults to all practices. Change this only if the user should have limited access.
8. Set the appropriate permissions on the right side.
Configure Launch Pane for the Group
9. Click the Configuration tab.
This tab allows you to customize what Launch Buttons you want available to users associated with this group. 10. In the Available column, place a check mark next to any Launch Button users can pick as one of their shortcuts.
If the user does not have permissions for the item, the system disables the appropriate item(s) on this tab.
11. In the Display column, place a check mark next to any Launch Button you want to display by default for the users in the group.
This provides a default set of buttons for the user so they can begin using the system right away, allowing them the leisure of customizing as needed.
12. Click Save on the Task Pane.
13. Repeat steps 2 through 12 for each new group.
Creating a New User
Even if you want to use groups, you still need to create a user account to associate with the group.
Users and Groups
3.9
Identity and Access Management
To add a new user to the system:
Procedure
Details
1. Select Setup > Identity and Access Management > Users and Groups from the main menu.
The Users and Groups window opens.
2. On the Users tab, click the New icon on the This creates a new row on the Users tab.
Task Pane.
3. Enter a unique login name in the Name column.
TIP | User names are NOT case‐sensitive.
4. Select User from the Role drop‐down.
5. In the Password column, enter a temporary password for the user.
When the user logs in to the system for the first time, the system prompts them for a new password. When they enter that password, the system records it in the Password column on this tab.
6. Click the Save icon on the Task Pane.
This enables the remaining tabs of this window.
Associate the User with a Group
7. Click the Membership tab.
This tab allows you to associate this user with a group. If you do not want to associate this user with a group, skip to step 9.
8. From the Group drop‐down list, select the NOTE | When you associate a user with a group, the group’s permissions take precedence.
group to which you want this user to belong.
Set the User’s Permissions
9. Click the Permissions tab to establish this user’s security rights to the system.
10. Click the New icon on the Task Pane.
When you create a new row, the user automatically has full access rights applied. Supervisors can navigate through the security tree and select the specific modules to which this user may have access.
If you assigned the user to a group in step 8, the Permissions tab automatically populates with the permissions of the group.
3.10
Users and Groups
Identity and Access Management
Configure Launch Pane for the User
11. Click the Configuration tab.
This tab allows you to customize what Launch Buttons you want available to the user by default. If the user has been associated with a group, this tab populates automatically when a row is created on the Permissions tab. You can skip to step 14 if the user is part of a group.
12. In the Available column, place a check If the user or group does not have permissions for the mark next to any Launch Button users can item, the system disables the appropriate item(s) on this tab.
pick as one of their shortcuts.
13. In the Display column, place a check mark next to any Launch Button you want to display by default for the user.
This provides a default set of buttons for the user so they can begin using the system right away, allowing them the leisure of customizing as needed.
14. Click Save on the Task Pane.
15. Repeat steps 2 through 14 for each new user.
EXAMPLE OF THE VERSATILITY OF THE MODULE
With this module, you can have a variety of user/practice/permissions/Launch Pane configurations. For example, Kim’s main home is Advanced Family Practice. Kim is a staff member with user‐level access. She accesses schedules, billing, reports, etc. Jennifer is the practice administrator with supervisor‐level access. United Physicians Group is another practice in their database. Jennifer and Tom work with this practice, but they need an extra hand with their billing.
Kim needs access to more areas of the program for Advanced Family Practice than she does for United Physicians Group. She also does not need as many Launch Pane buttons displayed while she’s in the United Physicians Group practice as she does when she works in Advanced Family Practice. Jennifer sets Kim’s user up as follows:
 On the Permissions tab, Jennifer creates a row and selects Advanced Family Practice from the drop‐down in the Practice column. She sets the Security Level column to User and marks all of Kim’s access rights appropriately.  Then Jennifer creates another row and selects United Physicians Group from the drop‐down in the Practice column. She sets the Security Level column to User. Since Kim only does billing for United Physicians Group, Jennifer provides Kim only with billing‐related access rights. Kim won’t be able to schedule appointments, generate unnecessary reports, etc.
Example of the Versatility of the Module
3.11
Identity and Access Management
 Jennifer then saved her changes.
When Kim is working in the system under Advanced Family Practice, Jennifer wants her to have quite a few Launch Pane buttons available to customize her Launch Pane. While Kim works in the system under United Physicians Group, Jennifer needs to provide her with only the billing‐related Launch Pane buttons from which to customize her Launch Pane for that practice. To do this, Jennifer does the following:
 On the Permissions tab, she highlights the Advanced Family Practice row and then clicks the Configuration tab. On this tab, Jennifer marks the Available column and the Display column for everything Kim might frequently use. Jennifer saves her changes.
NOTE | Remember: These only set the defaults for users. If a user has already customized their Launch Pane, they will need to go back in and click the Reset button to get the new defaults.
 Then Jennifer goes back to the Permissions tab, highlights the United Physicians Group row, and clicks the Configuration tab.
 She edits the Launch Pane buttons that the system should make available and display by default for Kim when she is logged into the United Physicians Group practice to do billing.
 Jennifer saves her changes and is ready for Kim to access the system.
CHANGE PASSWORD UTILITY FOR USER
Not only can practices have users reset their passwords every so often, users can also choose to reset their own password. Maybe Kim chose a password that turns out to be difficult to remember. She can change her own password using the Change Password utility. Select Utility > Change Password from the main menu. This displays the Set Password window. Simply enter your new password and click Accept. The system displays the required format of the password the practice has established under Security Administration.
Figure 3‐10 Set Password User Utility
3.12
Change Password Utility for User
YOUR PRACTICE IN THE SYSTEM
NOTE | Your support team has done most of this building for you; however, over the years, you will need to understand how these modules work so you can maintain your system.
When you create a practice in MicroMD, there are several types of information you must have before you can actually create the practice and begin building the system. If you do not already have system classes set up in your system, build this part of the database by selecting Setup > System Classes/
Categories.
IN THIS CHAPTER
In this chapter, we cover how to:
 Add new providers to the system  Add a new practice
 Associate those new providers to the practice
 Associate locations with the practice
 Add insurance IDs to the system (practice‐level and provider‐level)
ADD NEW PROVIDERS
The system is flexible enough to meet each practice’s individual office needs. Before creating the practice in the database, there must be providers in the database to associate to the practice.
Figure 4‐1 Provider Detail Window
In This Chapter 4.1
Your Practice in the System
NOTE | A key code is needed for additional billing providers added to the system. Contact Henry Schein Medical Systems, Inc. or your authorized reseller to obtain this key code.
Procedure
Details
1. Select Maint > Provider from the main menu.
The Provider List window opens.
2. Click the New icon on the Task Pane.
A blank Provider Detail window opens.
3. Enter all applicable data.
Depending on the practice, not all fields require completion. Refer to the table below for an explanation of each field of the detail window.
If the provider is a billing provider, you must check the Billing Provider checkbox.
If the practice has more than one provider, fill in the Signature Box with this provider’s name. For a practice with only one provider, the Signature Box can be filled in on the Practice Detail
This is the last place that the system looks for the CLIA No. The system looks for this number in the following order: Practice Location, Practice Detail, and Provider Detail.
4. Click the Save icon to save this provider.
The system prompts you for the key code. Contact your authorized reseller to obtain this key code. Once you save the entry, the system assigns a unique system ID to this provider to identify the provider in the database.
Fields on the Provider Detail Window:
Field
Description
Title
Choose the provider’s title from the drop‐down (e.g., Dr., Ms., Mrs., Miss, Mr., etc.).
TIP | If you want to create mail merge documents with a salutation line that reads, “Dear Dr. Smith:” or “Dear Rev. Jones,” be sure to consistently use this Title field so you can use create documents that look like you typed them yourself..
Last Name, First Name and MI
Enter the provider’s last name, first name and middle initial. The information in these fields print on billing statements, receipts, etc. and are also available as mail merge fields.
Degree
Enter the provider’s degree.
4.2
Add New Providers
Your Practice in the System
E‐Mail Address
Enter this provider’s e‐mail address.
TIP | Remember that you can double‐click any E‐mail Address field in the system and create a new message with the address already in the message.
Billing Provider
Check this box to indicate that you submit claims under this provider. If this field is not checked, this provider is not available as a billing provider in other features of the program.
Non‐Person Entity For those entries that you create in the system for provider groups or other uses of the provider module, place a check mark in this checkbox to specify that the entry is not an individual provider. This box ensures that billing and ANSI requirements are met.
Appointments
Select one of the following from the drop‐down to indicate how this provider is involved with the Appointment Module.
 Include Appointment: This indicates that the system should make this provider available for scheduling in the Appointment Module.
 No Appointment: This option indicates that the system should not include this provider in the Appointment Module for scheduling.
 Appointment Only: This indicates that the system should only include this provider in the Appointment Module for scheduling.
TIP | When creating a provider entry to use for other resources (e.g., lab equipment), you would choose the Appointment Only option.
Default Appt Week
This field sets the default appointment‐week template for this provider. If you have no selections under this drop‐down list, you have no appointment templates created. CRNA
Check this box if the provider is a Certified Registered Nurse Anesthetist (CRNA). This makes the provider available in the Anesthesia Module. Not an EMR User
Place a check mark in this checkbox to indicate that the selected provider’s information does not transfer to an electronic medical records program. PDA Download
This checkbox is currently not in use.
Department
Select the department within the practice that you want to associate with this provider. This is for reporting purposes only. Cell Phone Number
Enter the provider’s mobile phone number, if available. This field is for informational purposes only.
Pager Number
Enter the provider’s pager number, if available. This field is for informational purposes only.
License No.
Enter the provider’s license number in this field. The system prints this number on claims if specified.
Add New Providers
4.3
Your Practice in the System
CLIA No.
Enter the CLIA number assigned to the provider by Medicare for billing lab‐related services (i.e., those procedure in MicroMD PM with the CLIA Flag checkbox marked). This number, assigned by Medicare, must appear in Box 23 on the CMS claim form or in the Medicare‐designated field for electronic billing if the provided service is lab‐related.
MicroMD PM checks for the CLIA number in the following order: by Medicare for
billing lab‐related services (i.e., those procedure in MicroMD PM with the CLIA Flag check box marked). This number, assigned by Medicare, must appear in Box 23 on the CMS claim form or in the Medicare‐designated field for electronic billing if the provided service is lab related.
The system checks for the CLIA number in the following order:
1. Practice Detail (Location tab)
2. Practice Detail (Practice tab)
3. Provider Detail.
a. If the system finds a CLIA number in the Practice Detail (Location tab), it ignores the rest. If the system does not find a number in the Practice Detail (Location tab), it moves on to the Practice Detail (Practice tab). If it finds a CLIA number in Practice Detail (Practice tab), it ignores the rest. If it does not find a number in the Practice Detail (Practice tab), it uses the CLIA number entered in the Provider Detail.Practice Detail (Location tab)
b. Practice Detail (Practice tab)
c. Provider Detail.
If MicroMD PM finds a CLIA number in the Practice Detail (Location tab), it ignores the rest. If MicroMD PM does not find a number in the Practice Detail (Location tab), it moves on to the Practice Detail (Practice tab). If it finds a CLIA number in Practice Detail (Practice tab), it ignores the rest. If it does not find a number in the Practice Detail (Practice tab), it uses the CLIA number entered in the Provider Detail.
Signature Box
If you have more than one provider, you should fill in the Signature Box with this individual provider’s name. If specified, it prints in Box 31 on Universal CMS 1500 insurance form. For a practice with only one provider, you can leave this field blank and complete only the Signature Box on the Practice Detail window.
4.4
Add New Providers
Your Practice in the System
Claim Indicator
For electronic billing, the system uses the Claim Indicator field on the Electronic Billing Setup window to determine the type of claim it should create when you process claims. However, if you have both medical and chiropractic physicians in your practice, you could manually change the indicator field before each batch.
You can also specify the type of claim with the Claim Indicator drop‐down on the Provider Detail window. This field defaults to (None), but if you need to identify your providers so you can use the same Form Type and process claims more efficiently, you can set this drop‐down as appropriate for your claims. If the system does not find an indicator specified on the Provider Detail window, the system uses the choice found on the Electronic Billing Setup window.
SSN
Enter the provider’s social security number. Unless specified to be included on a claim or in a claim file, this field is optional and for information only. It does not print and is not visible anywhere else in the program.
DEA
Enter the provider’s Drug Enforcement Administration (DEA) license number, if applicable. It is required if this physician prescribes narcotics. The number prints on the prescription form in the MicroMD RX module. For more details on MicroMD RX, please refer to that module’s documentation.
Provider Type and Enter these codes if required by any insurance carriers for claims processing. Provider Address Currently, Pennsylvania Medical Assistance and Illinois DPA require these fields for Code
their claims.
Taxonomy
Select the taxonomy code for this provider. The system uses the code entered here when creating the ANSI electronic claim file.
NPI
Enter this provider’s National Provider Identification (NPI) number provided by CMS. The system looks to the Provider Insurance ID tab on the Practice Detail window first. If it finds a number in the NPI column for the appropriate insurance class and location for this provider, the system uses that number for the provider’s NPI on the claim. If there is no match to insurance class and location, the system looks to the NPI field on the Provider Detail window and uses the number it finds there. If there is no number, the system leaves the item on the claim blank. Note
Use this field to enter any notes helpful to the staff regarding the provider. This field is for informational purposes only and does not print anywhere.
Field 1
These five fields allow the practice to create a storage place for some unique information related to the providers in the system. The fields on this window are different than the ones in the referring doctor, patient, and service facility windows. Those are drop‐down lists; the ones on the Provider Detail window are simple text field, specific to each provider, due to the sensitive nature of the information they could contain. The practice can customize the labels for these fields:
Field 2
Field 3
Field 4
Field 5
1. Click the User‐Field Label icon on the Task Pane.
2. Enter up to 15 characters for each label (e.g., Hobbies, Birthday, Holiday Gift).
3. Click the Save icon on the Task Pane.
Add New Providers
4.5
Your Practice in the System
ADD A NEW PRACTICE
After entering providers in the system, you now have the information you need to create the new practice(s) in the database and associate those providers with the practice. Once you create all of the practices in the system, each practice can then add their locations and continue setting up their preferences, based on how they plan to use the system.
NOTE | Creating a practice in the system requires a security key. Contact Henry Schein Medical Systems, Inc. or your authorized reseller to obtain this key code.
Figure 4‐2 Practice Detail Window
Procedure
Details
1. Select Maint > Practice from the main menu.
The Practice List window appears.
2. Click the New icon on the Task Pane.
A blank Practice Detail window appears.
3. Complete all applicable data on the Practice tab.
If the address where patients should send their payments is different from the practice’s physical location, enter the appropriate name and address in the Pay‐To Info fields.
4. Continue with Associate Providers with the Practice.
If you attempt to save this practice without associating providers, the system reminds you that you still have to perform this part of the process.
4.6
Add a New Practice
Your Practice in the System
Practice Detail (Practice Tab) Fields:
Field
Description
ID
The system assigns a unique system ID to each new practice. This is an internal identification number that the system uses throughout the program and is independent of all insurance IDs for this practice.
Name
Enter the name of the practice. This name appears on statements, bills, receipts, etc.—exactly the way you type it. The Name field can hold a maximum of 30 characters, including spaces, commas, periods, etc. for the practice name.
Address
This indicates the physical address of the practice. For a mailing address for patients sending payments that is different than this physical address, enter that information in the Pay‐To Info fields.
Phone and Qualifier
Enter the practice’s phone number in this field. The Phone field can also hold the EDI access number, electronic mail number or facsimile number for the practice. Be sure to specify the Qualifier for the ANSI claim file when submitting electronic claims. This tells the insurance plans the kind of number submitted.
Fax
Enter the practice’s fax number, if available. This information prints on statements, bills, etc.
Pay‐To Info
The system automatically completes these fields as you fill in the practice’s name and address to the left. You can change this information if it is different from the physical location of the practice. This information prints on patients’ monthly billing statements under the Pay‐To address.
STOP | Be EXTREMELY careful with these fields. The system creates a 2010AB loop in the electronic claim file if the information in these fields is different than the practice information, even if it is only by a single space or period. This could cause problems with your claims.
Federal ID
Enter the federal tax ID for the practice, if applicable. This number, in general, prints in Box 25 of the CMS claim form. Tax Type
Indicate the type of number entered in the Federal ID field: federal tax ID (E), provider’s social security number (S), or corporation using the social security number (X).
Year End Closing
This field indicates the date on which the practice ends its year. This field is for informational purposes only. Signature Box
Enter the information that should print on claims submitted from this practice. If the practice has multiple providers with their own information printing on claims, you can leave this box blank and complete the Signature Box field on each Provider Detail window.
TIP | The system checks for a signature in the provider’s Signature Box first. If there is none, it checks for a signature in the practice’s Signature Box field. Enter information in the practice’s Signature Box field as a master signature. If a provider does not have this field completed, the system could still print a valid signature on the claim.
Add a New Practice
4.7
Your Practice in the System
Group
This field is currently inactive.
CLIA No
Enter the CLIA number provided to the practice by Medicare for billing lab‐related services (i.e., those procedure in MicroMD PM with the CLIA Flag checkbox marked). This number, assigned by Medicare, must appear in Box 23 on the CMS claim form or in the Medicare‐designated field for electronic billing if the provided service is lab‐related.
The system checks for the CLIA number in the following order:
1. Practice Detail (Location tab)
2. Practice Detail (Practice tab)
3. Provider Detail
If the system finds a CLIA number in the Practice Detail (Location tab), it ignores the rest. If the system does not find a number in the Practice Detail (Location tab), it moves on to the Practice Detail (Practice tab). If it finds a CLIA number in Practice Detail (Practice tab), it ignores the rest. If it does not find a number in the Practice Detail (Practice tab), it uses the CLIA number entered in the Provider Detail.
Charge Class
Select a Charge Class from the drop‐down list if this practice charges a fee that differs from the standard fee established in the system for certain procedures.
For a system that contains only one practice or practices of the same specialty containing the same fees, leave the default value of 0 ‐ (None) in this field.
When there are multiple practices in a database (typical in billing services and practices with different specialties), there will be times when each practice needs to charge a different fee for the same procedure. Assignment
Check this box if the practice typically signs contracts with insurance companies and is willing to write‐off the difference between the fee they charge and the amount allowed by the insurance company.
This checkbox sets the default for the Assignment checkbox on the Plan Detail window when creating a new insurance plan from within this practice. You can uncheck this as needed for the new plan if there is no contract with the carrier. The system then copies the value (i.e., checked or unchecked) to the Plan Sets tab of the Patient Detail window for patients with that plan and then to the Claim Transactions window when posting charges against that plan.
For example, Advanced Family Practice has the Assignment box checked on their Practice Detail window, but United Physicians Group does not. If Advanced Family Practice creates a new plan, the Assignment checkbox on the new Plan Detail window is checked. If United Physicians Group creates a new plan, however, the Assignment checkbox is not checked on the new Plan Detail window.
Type of Bill
4.8
Enter the appropriate number that your practice must print in Box 4 of the UB‐92 insurance claim form. Add a New Practice
Your Practice in the System
Type of Practice
Select the item from this drop‐down that most closely resembles the services your practice provides.
Practice NPI
Enter this practice’s National Practice Identification (NPI) number provided by CMS. The system looks to the Practice Insurance ID tab on the Practice Detail window first. If it finds a number in the NPI column for the appropriate insurance class and location for this practice, the system uses that number for the NPI on the claim. If there is no match to insurance class and location, the system looks to the Practice NPI field on the Detail tab and uses the number it finds there. If there is no number, the system leaves the item on the claim blank.
NOTE | If there is an NPI entered on the Provider tab, that NPI overrides this Practice NPI field for that provider.
Note
Enter any notes that are helpful in relation to the practice (e.g., a primary contact person). This field is for informational purposes and does not print anywhere.
Associate Providers with the Practice
Each practice must have at least one provider associated with it, and you cannot complete the creation of a practice without associating providers. Figure 4‐3 Associate Providers with a Practice
Add a New Practice
4.9
Your Practice in the System
Procedure
Details
1. Click the Provider tab on the Practice Detail window.
2. Click the New icon on the Task Pane to add a new provider to the practice.
3. Select the appropriate provider from the This also adds the provider to the left side.
Provider drop‐down list.
4. Complete all necessary information for each provider.
The table below contains a detailed description of all the fields on this tab.
For each rendering provider, the user has the option to select a billing provider from the Billing Provider drop‐
down list. Only providers with a check mark in the Billing Provider checkbox on the Provider Detail window appear in this list.
When posting, the system defaults to the Billing Provider associated with each Rendering Provider on this tab. Users can change the defaults if needed when posting charges.
5. Click the Save icon after adding all providers to this practice.
When creating a new practice, the system prompts for a security key, which can be obtained from your authorized reseller.
6. For a new practice, enter the practice key code when prompted.
Your practice has been created. You must proceed to Associating Locations with a Practice before you enter any patients in the system.
Practice Detail (Provider Tab) Fields
Field
Description
Rendering Prov and Billing Provider
The Provider drop‐down list indicates the provider who renders services to patients in the practice. If this provider is also a billing provider with the practice, the same physician appears in the Billing Provider drop‐down.
If, however, the physician selected in the Provider drop‐down is not a billing provider, the system defaults the Billing Provider drop‐down to the first billing provider in the list. You can change this if necessary for the Rendering Provider highlighted in the left column.
The physician in the Billing Provider drop‐down list is the name that appears on the claim.
NOTE | Remember: To determine if the physician listed in the Rendering Provider column is a billing provider, the system checks to see if there is a check mark in the Billing checkbox on the Provider Detail window.
4.10
Add a New Practice
Your Practice in the System
Charge Slip
Select the charge slip to associate with this provider’s appointments. This charge slip only applies if the appointment class does not have a charge slip associated with it. Inactive
Rather than delete a provider from the system, you can make them an inactive provider. Simply check the Inactive checkbox. If this provider is listed as the billing provider for any other rendering provider, you cannot make them inactive. You must first disassociate them before you can make them inactive.
Practice Information If providers in the practice have separate billing information they need to Provider Override
supply to the insurance companies, this section allows the practice to print claims appropriately for each of the billing providers in the database.
The text in the Name, Address and Phone fields print on CMS claim forms in Box 33. (This is dependent upon choices made on the Form Options tab for the Form Type. If providers in the practice have separate billing, the practice can enter any pay‐
to address (per provider) that is different than the address of the practice. The system prints the information from these fields on patient billing statements under the Pay‐To address.
If a practice has multiple providers with different federal tax IDs, you need to enter the individual provider’s ID in the Federal ID field of this section. Practices that share certain items but not others find this beneficial. For example, providers in a practice may share patients, but they keep their billing separate. The federal ID, in general, prints in Box 25 on the CMS claim form.
The Practice NPI field on this Provider tab overrides the Practice NPI field on the Practice tab.
Associating Locations with a Practice
Along with associating providers to a practice, each practice must have at least one physical location assigned to it. When creating patients in the system, MicroMD PM requires the user to associate the patient with a practice location. If you have no locations associated to the practice, no one can enter patients to the database. Therefore, we recommend that you create your locations and assign them to the practice now, rather than later.
Once you define locations, you can then associate them with a practice. You must create at least one location, even if there is only one physical location for the practice.
Procedure
Details
1. On the Practice Detail window, select the Location tab.
2. Click the New icon on the Task Pane.
Add a New Practice
4.11
Your Practice in the System
3. Select a Location from the drop‐down list.
4. If the practice has been assigned more than one CLIA number due to different sites, enter those CLIA numbers in the Clia No column for each practice location.
TIP | Locations are the physical branches of the practice (also known as “cost centers”). Service facilities are areas where the providers perform services (e.g., nursing home, a specific hospital, a patient’s home).
Remember the system will check for CLIA numbers in the following order:
1. Practice Detail (Location tab)
2. Practice Detail (Practice tab)
3. Provider Detail
4. If the practice wants to assign an internal ID to each billing facility, enter that ID in the Location Code field.
5. If there is a specialty the practice wants to assign, select it in Taxonomy Code drop‐down list. 6. If the practice wants to include practice‐level information in RBRVS reporting, select the appropriate location in the CMS Location column. The system pulls the list of these locations from the data files downloaded from Medicare and included in the system’s database.
7. Click the Save icon.
Each practice can now establish their preferences and enter locations and insurance IDs as needed.
PROVIDER/PRACTICE IDS
Many insurance companies require that their unique identifying IDs print on the claim forms for proper claim processing and reimbursement. These are numbers provided at the practice and/or the provider level. There may also be times when the provider(s) are not eligible to bill to specific plans or they can bill, but they are still pending authorization with the plan. The system allows one central area where each practice can manage the identification numbers in the system.
4.12
Provider/Practice IDs Your Practice in the System
Practice Insurance ID Tab
This tab allows you to enter the IDs assigned to the practice by the various insurance plans for the different locations in your practice. To add a new entry to this tab, click the New icon on the Task Pane, enter the information, and save your changes.
Figure 4‐4 Practice Insurance ID Tab
Practice Detail (Practice Insurance ID Tab) Fields:
Field
Description
Location ID
Select the practice location to which you need to assign a practice ID. If multiple practice locations exist, but the insurance company assigns only one ID to the entire practice, then select (ALL) for the location.
Insurance Class
Select the Insurance Class to which this practice‐level insurance ID applies. For example, ABC Insurance Group assigned Advanced Family Practice an identification number and that number applies to claims submitted to all ABC‐
related plans. The practice selected their ABC GROUP Insurance Class they created and entered the number in the Practice Insurance ID column. Practice Insurance ID
Enter the ID provided by the insurance company for the location selected in the Location ID column.
Provider/Practice IDs 4.13
Your Practice in the System
Billing Qual and Rend Qual
When submitting electronic claim files, some insurance carriers require qualifiers for the ID numbers they provide to indicate the type of number that is listed in the Practice Insurance ID column for the billing and the rendering providers on the claim.  Billing Qual: This field indicates the type of number submitted in the claim file for the billing provider’s claims. This information appears in the 2010AA loop of the claim file.
 Rend Qual: This field indicates the type of number submitted in the claim file for the rendering provider’s claims. This information appears in the 2310B loop of the claim file.
NOTE | If there are no values entered in the Billing Qual and/or Rend Qual fields, MicroMD PM determines the proper qualifier automatically based on the Source of Payment field on the Plan Detail window for the plan on the claim.
NPI
Enter this practice’s National Practice Identification (NPI) number provided by CMS. The system looks for the practice’s NPI here first. If it finds a number in the NPI column for the appropriate insurance class and location for this practice, the system uses that number for the NPI on the claim. If there is no match to insurance class and location, the system looks to the Practice NPI field on the Detail tab and uses the number it finds there. If there is no number, the system leaves the item on the claim blank.
Provider Insurance IDs
This tab allows you to enter the individual provider IDs assigned by the various insurance plans to submit claims to the carrier properly. Since the numbers entered in this tab are provider‐specific, the tab is available only when a user highlights a rendering provider on the Provider tab.
To add a new entry to this tab, click the New icon on the Task Pane, enter the information, and save your changes.
NOTE | An entry in this tab must be made for a group practice when a provider within the group is assigned an ID by the insurance plan or if a solo practitioner has an assigned provider number.
4.14
Provider/Practice IDs Your Practice in the System
Figure 4‐5 Provider Insurance ID Tab
Practice Detail (Provider Insurance ID Tab) Fields:
Field
Description
Location ID
Select the practice location to which you want to assign an insurance ID number for this provider. If the carrier only assigns one number for this provider for all locations within this practice, select (ALL) from the Location ID drop‐down list.
Insurance Class
Select the Insurance Class to which this provider‐level insurance ID applies. For example, Anthem assigned this provider an identification number and that number applies to claims submitted to all Anthem‐related plans submitted from the practice location selected in the Location ID column. Select the ANTHEM Insurance Class you created and enter the number. Prov. Insurance ID
Enter the ID provided to this provider by the insurance company for the location selected in the Location ID column.
This number prints on the claim form, depending on the insurance form and the selections made for the form type on the Form Options tab.
Provider/Practice IDs 4.15
Your Practice in the System
B. Qual and R. Qual
When submitting electronic claim files, some insurance carriers require qualifiers for the ID numbers they provide to indicate the type of number that is listed in the Practice Insurance ID column.
 B. Qual: This field indicates the type of number submitted in the claim file for the billing provider’s claims. This information appears in the 2010AA loop of the claim file.
 R. Qual: This field indicates the type of number submitted in the claim file for the rendering provider’s claims. This information appears in the 2310B loop of the claim file.
NOTE | If there are no values entered in the Billing Qual and/or Rend Qual fields, the system determines the proper qualifier automatically based on the Source of Payment field on the Plan Detail window for the plan on the claim.
NPI
Enter the provider’s NPI provided by the insurance carrier within the selected Insurance Class for services rendered at this practice location. The system looks for the provider’s NPI here first. If it finds a number in the NPI column for the appropriate insurance class and location for this provider, the system uses that number for the provider’s NPI on the claim. If there is no match to insurance class and location, the system looks to the NPI field on the Provider Detail window and uses the number it finds there. If there is no number, the system leaves the item on the claim blank. Provider Network IDs
For those insurance plans in the system that are network‐based (HMPs or PPOs), there could be a network identification number for this provider, helping the insurance company determine if the patient saw a physician inside their network of approved physicians. The only plans that appear in the Plan drop‐down list are those that have a check mark in the HMP/PPO checkbox on the Plan Detail window (Maint > Plan).
If any of the insurance plans assign a network identification number to this provider, select the plan from the Plan drop‐down list and enter that ID number in the Network ID field. Since the numbers entered in this tab are provider‐specific, the tab is available only when a user highlights a rendering provider on the Provider tab.
PROVIDER CREDENTIALS
The Provider Credentials tab lists the provider’s eligibility to submit their services to insurance plans for payment. If the provider is not approved to provide services for the plans within an Insurance Class or is close to approval, you can communicate this status with the staff using MicroMD PM. Users receive a warning when attempting to make appointments or post charges for the provider with on this tab. This warning message contains the text entered in the Message field.
NOTE | You also have the option of entering a provider’s credentials under a single plan if needed, rather than for all plans within an Insurance Class. The table below explains the fields on the Provider Credentials tab. Since these credentials are provider‐
specific, the tab is available only when a user highlights a rendering provider on the Provider tab.
4.16
Provider Credentials
Your Practice in the System
Practice Detail (Provider Credentials Tab) Fields:
Field
Description
Insurance Class
Select the Insurance Class with which this provider is either eligible with conditions or ineligible to submit their services for payment. For example, this provider is in the process of enrolling with Anthem. The staff making appointments or posting charges need to know the status of this provider with Anthem‐related plans. Select the ANTHEM Insurance Class you created and any staff making appointments or posting charges for this provider for patients with a plan in this Insurance Class receive the warning you specify. Status
You have the ability to warn staff members that a physician is not fully credentialed with plans within the selected Insurance Class and the level of that authorization. These warnings appear on the screen for users that are scheduling appointments and those posting charges. There are two options available:
 Allowed: Select this option to display the text entered in the Message field and then permit the users to continue scheduling the patient’s appointment with that provider or to continue posting charges for that provider.
 Not Allowed: Select this option to display the text entered in the Message field. Users are then prohibited from saving the appointment or charges under the current provider. They do have the option to select a different provider and then continue their tasks.
Message
Enter the text that you want the system to display in the warning message for this entry. This warning message appears when a user that attempts to schedule an appointment or post charges for this provider for a plan within the indicated Insurance Class.
You should enter text in the Message field when making an entry on this tab. If you create an entry but do not enter text, the user receives a warning message that displays the text “unspecified warning.”
Provider Credentials
4.17
DIAGNOSIS AND PROCEDURE CODES
Practices sharing the same database also share diagnosis and procedure codes. MicroMD PM has two kinds of procedure codes: charge (CPT®/HCPCS and other medical procedure) codes and system billing codes. You can also use the Procedure Code Module to track inventory items such as splints and bandages. The database comes pre‐loaded with some permanent system billing codes discussed later in this chapter.
A brand‐new system does not contain any diagnosis or medical procedure codes. Each customer has the opportunity to purchase the Code Load program that imports the most current year’s list of codes. You can also enter every code manually, depending on the requirements of your business.
In the newest version of MicroMD PM, there are now 12 diagnosis codes per encounter (as opposed to 8). There are also areas for 12 diagnosis codes in Appointments, Claim Forms (including the 2/12 1500 form), Patient Recalls and tables, views, triggers and procedures in the database will now handle four extra attributes.
TIP | The Code Load program imports ICD‐9 and CPT® codes into the system. Code Load is an efficient way to add diagnosis and procedure codes to the system, saving the time of adding them manually. Code Load is an optional application, purchased separately each year. Contact Henry Schein Medical Systems, Inc. or your authorized reseller for more information.
After you create any system classes (optional) and practices, you can create the diagnosis and procedure codes in your system and identify those procedure codes for which each practice has different fees.
IN THIS CHAPTER
In this chapter, we cover how to:
 Add diagnosis codes to the system
 Establish whether users can post certain procedure codes with a specific diagnosis
 Add procedure codes to the system
 Establish whether users can post certain diagnosis codes with a specific procedure
 Understand and create system billing codes
DIAGNOSIS CODES
Over the years, you will have to maintain the list of diagnosis codes in your system, depending on the changing requirements from the carriers or codes that become inactive. You can enter diagnosis codes using the Code Load program, or you can enter them manually. The main window that helps you maintain your diagnosis codes is the Diagnosis Detail window. In This Chapter 5.1
Diagnosis and Procedure Codes
Figure 5‐1 Diagnosis Detail Window
Please contact Henry Schein Medical Systems, Inc. or your authorized reseller for more information about the Code Load program. Once diagnosis codes are entered into the system, they appear in the Diagnosis List window. Refer to the following steps to create new diagnosis codes manually.
Diagnosis detail can now be easily duplicated with the Duplicate button on the Task Panel for Diagnosis Detail. When selected, the current record will automatically be saved, and the entire record (including Cross‐code Messages) will be duplicated. This allows you to easily map multiple ICD‐10 codes to one ICD‐
9 code.
Figure 5‐2 The Duplicate Button for Diagnosis Codes
5.2
Diagnosis Codes
Diagnosis and Procedure Codes
STOP | If you want a diagnosis code only available to your practice, you MUST select your practice from the practice drop‐
down BEFORE saving the code. See step 3 under Creating a Procedure code.
TIP | The system tracks the diagnosis codes posted to the patient and you can view this information anywhere you find the floating toolbar. Adding a Diagnosis Code to the System Manually:
Procedure
Details
1. Select Maint > Diagnosis from the main menu.
You can also click the Diagnosis button on the Launch Pane, if available.
The Diagnosis List window appears.
2. Click the New icon on the Task Pane to add a new diagnosis.
A blank Diagnosis Detail window appears. 3. Enter the information for the new diagnosis.
STOP | If you want this code available only to a specific practice, you MUST specify it now. Once the code is saved, this field is disabled and cannot be changed again.
4. Click the Save icon on the Task Pane.
Diagnosis Detail (Diagnosis Tab) Fields
Field
Description
ICD‐9 Billing Code
Enter the correct ICD‐9 code for this diagnosis.
ICD‐10 Billing Code
Enter the correct ICD‐10 code for this diagnosis. Not that there may be several correct ICD‐10 codes that will pair with a single ICD‐9 code.
Description
Enter a brief description of the diagnosis code. The Code Load program enters this information automatically for you. There is a character limit on this field.
Class
Select the Diagnosis Class with which you want to associate this code. For example, if you created an INFECTIOUS & PARASITIC DISEASES Diagnosis Class and this code is or relates to an infectious or parasitic disease, select that Diagnosis Class from this drop‐down list. Diagnosis Codes
5.3
Diagnosis and Procedure Codes
Practice
Select the practice for which this code applies. If all practices within the database can use this code, select (ALL) from the drop‐down list.
STOP | You can change this field only while creating a new code. Once the code is saved, this field is grayed out and cannot be changed again. If you want this code only associated with your practice, you must specify that now.
Active From and Active Thru
Enter the effective dates for this diagnosis code if applicable. If staff members attempt to post an inactive diagnosis code on a date that falls outside this range, the system displays a warning that the code is inactive.
PDA Download
Check this box if you want this diagnosis to be available when using MicroMD Mobile. Please refer to that module’s documentation for more information.
PDA Common
Check this box to display this diagnosis code near the top of the drop‐down lists on the mobile device, along with other diagnosis codes that the practice’s providers use frequently. This eliminates the need to scroll through a long list of possible selections.
Any time a diagnosis code is displayed in the PM, there will be hover text so the user can hover over the code to see the ICD‐9 code, the ICD‐10 code and the Description, as shown below.
Figure 5‐3 Hover text in the PM for Diagnosis Codes
Practice Common List of Existing Diagnosis Codes for ICD-10
MicroMD PM has created a practice common list, similar to the EMR, based on all of the diagnosis codes used by your practice in the past. When searching for codes now, it will automatically open and search through the practice common list. The screen also presents the user with an “All” button which allows the user to see all ICD‐10 codes and gives them the ability to add them to the practice common list.
5.4
Diagnosis Codes
Diagnosis and Procedure Codes
Figure 5‐4 The Practice Common List
When the Practice button is in bold, as in the screen shot above, you are looking at the Practice Common List. If you click the All button, you will see a list of all available diagnosis codes, not just the ones currently used in your practice (see below).
Diagnosis Codes
5.5
Diagnosis and Procedure Codes
Figure 5‐5 The All Button Shows All Available Codes
If a code is not added to the Practice Common List, you can add it by double‐clicking the code in the list. This will open the Diagnosis Detail window. Follow the steps below to add a code to the Practice Common List.
Note that you now have the option to use the existing description for a diagnosis code that your practice uses, or you can choose the new ICD‐10 description.
Procedure
Details
1. Double‐click the diagnosis code you would like to add to the common list, or click the green “+” button.
This will open the Diagnosis Detail window.
2. If the Multiple ICD‐10 Codes box is checked, un‐check it. Click the drop‐
down arrow. This will open a new drop‐down list of matching ICD‐10 codes. 5.6
Diagnosis Codes
Diagnosis and Procedure Codes
3. Select the ICD‐10 code that you would like to map to your existing ICD‐9 code. You will be prompted with a pop‐up asking if you would like to keep the existing ICD‐9 description or use the new ICD‐10 description.
4. Click Yes or No depending on your preference. CrossCode Messages—Diagnosis with a Procedure
CrossCode Messages enable the practice to communicate with the staff when they post a specific charge code against a diagnosis code across all plans. The communication appears in a pop‐up message box and indicates if the staff member can or cannot continue posting the code combination.
TIP | If there is an insurance carrier who continues to deny claims because of a diagnosis/procedure combination, enter that combination on the plan’s CrossCode Messages tab instead.
The following steps explain how to create a CrossCode message for a diagnosis:
Procedure
Details
1. Select Maint > Diagnosis from the main menu.
The Diagnosis List window opens.
2. Double‐click on the appropriate diagnosis.
The Diagnosis Detail window appears.
If the diagnosis has not been created yet, refer to Adding a Diagnosis Code to the System Manually.
3. Select the CrossCode Messages tab.
4. Click the New icon on the Task Pane.
Diagnosis Codes
5.7
Diagnosis and Procedure Codes
5. Type the appropriate procedure code into the Proc column.
This is the procedure code you want to link to this diagnosis. The procedure description appears once the user selects a code.
The Proc column is a search field so you can search for the item either by the code or description. Remember that you can also use the wildcard characters (% or _ ).
TIP | If you only want the diagnosis available to a specific set of procedures and no other procedure, you can specify those few procedures as Allowed and then create another entry with ALL in the Description field (just tab or click out of the field) as Not Allowed for all other codes. 6. Use the Status drop‐down list to indicate Choose Allowed to permit the staff members that receive this warning to continue posting the procedure the status of the procedure code.
with this diagnosis. The Message field helps you communicate with the staff any information that need about this combination. If there is no text entered, the system does not display a message box.
Choose Not Allowed to prohibit the staff member from posting the procedure with this diagnosis. The Message field helps you communicate with the staff.
7. Type the text for the warning box in the Message field.
This message appears as the warning when staff member attempt to post the indicated procedure with this diagnosis. The maximum length in the Message field is 100 characters.
8. Repeat steps 4 through 7 for each procedure that requires a warning.
9. Click the Save icon on the Task Pane.
ICD SEARCHING
We have made several improvements when it comes to searching for ICD codes. First, the limit of 7 characters has been lifted. Second, users can now use “and”, “or” and wildcards as search arguments. In the example below, we searched on diabetes AND mellitus. This presents all results containing both diabetes and mellitus.
As a second example, if you wanted to search on the list of all diagnoses dealing with diabetes, you could enter “diabetes%” in the search box. The “%” is a wildcard, and this search would result in every diagnosis with the word “diabetes” in the subject.
ICD-10 DIAGNOSIS VALIDATION
In several areas of the PM, you can now search for an ICD‐9 code. If the code is not found, you will be presented first with a pop‐up notification that the code hasn’t been found, and then a new window will 5.8
ICD Searching
Diagnosis and Procedure Codes
pop up (the Diagnosis Search window, shown below) that will allow a look‐up of the code with both ICD‐9 and ICD‐10 codes displayed side by side.
Figure 5‐6 Diagnosis search validation in the Diagnosis Search window
PROCEDURE CODES—CHARGE CODES
Creating procedure codes in the system is the same whether creating medical procedure codes or billing (or non‐charge) codes. The difference is the kind of code and the choices available to you for each.
Procedure Codes—Charge Codes
5.9
Diagnosis and Procedure Codes
Figure 5‐7 Procedure Detail Window
You can enter charge codes using the Code Load program, or you can enter them manually. Please contact Henry Schein Medical Systems, Inc. or your authorized reseller for more information about the Code Load program.
STOP | If you want a procedure code only available to a specific practice, you MUST specify the Practice BEFORE saving the code. See step 3 under Creating a Procedure code.
NOTE | ICD‐10 codes will display on the CrossCode Messages tab where appropriate.
The Procedure Detail window allows you to enter the information necessary for posting this charge and submitting this service to the insurance companies on claim forms or in an electronic claim file for prompt payment. Once procedure codes are entered into the system, they appear in the Procedure List window. Refer to the following steps to create a new charge code.
Creating a Procedure Code
Procedure
Details
1. Select Maint > Procedure from the main menu.
You can also click the Procedure button on the Launch Pane.
The Procedure List window appears.
2. Click the New icon on the Task Pane to add a new charge code.
5.10
A blank Procedure Detail window appears. Procedure Codes—Charge Codes
Diagnosis and Procedure Codes
3. Enter the information for the new procedure.
STOP | If you want this code available only to a specific practice, you MUST specify it now. Once the code is saved, this field is disabled and cannot be changed again.
4. Click the Save icon on the Task Pane.
Fields on the Procedure Detail Window (Procedure Tab)
Field
Description
Code
Enter the code users will use to post this procedure. The code can be three to six alphanumeric characters long.
Qualifier
Select the appropriate code qualifier for this procedure, indicating if it is a non‐
HCPCS code (for use in ANSI claims processing). The system selects HC – HCPCS code by default.
You can also select the Qualifier by Insurance Class for this one procedure on the Code tab.
Description
Type the appropriate name for this charge code. This description prints on the claim forms and patient statements/bills.
Practice ID
Select the practice for which this code applies. If all practices within the database can use this code, select (ALL) from the drop‐down list.
STOP | You can change this field only while creating a new code. Once the code is saved, this field is disabled and cannot be changed again.
Pos
Select the place‐of‐service code to associate with this procedure. For charge codes, you can specify a default Pos, such as 11 for Office Visit or 21 for In‐
Patient. Staff members can change these codes as needed when posting charges.
For medical procedure codes, the choices in this drop‐down are populated from Setup > System Preferences first and then assigned to the practice under Setup > Practice Preferences > Place of Service tab. Tos
Select the type‐of‐service code to associate with this procedure. (Staff members cannot change this code when posting charges.) For medical procedure codes, the choices in this drop‐down are populated from Setup > System Preferences first and then assigned to the practice under Setup > Practice Preferences > Type of Service tab. Standard Charge
Enter the fee the practice wants to charge for this procedure. This amount appears in the Fee column when staff members post charges. You can enter the amount without the dollar sign; for whole dollar amounts, the decimal point is not needed.
Medicare Charge
If Medicare’s fee for this procedure is different than the amount entered in the Standard Charge field, enter that amount in the Medicare Charge field. The system automatically defaults to this fee for a Medicare patient when users post charges.
Procedure Codes—Charge Codes
5.11
Diagnosis and Procedure Codes
Estimated Cost
To track the cost the practice spends on purchasing the item represented by this procedure code, enter the estimated cost in this field. When generating the Procedure History report, be sure to select Detail in the Report Type section and Landscape in the Display Options section.
Modifiers
If this procedure always or mostly requires certain modifier(s), select them from the Modifiers drop‐down lists. If the procedure rarely requires a modifier, do not select them here. Users can select or change modifiers when posting charges, if needed.
The system populates this drop‐down list from the entries you created on the Modifier tab under Setup > Practice Preferences.
Coverage Class
Select the Coverage Class with which you want to associate this code. This tells the system to check the Plan Sched. tab on the patient’s plan for the percentage the plan pays on the allowed amount for this procedure. For example, if you created a SURGICAL Coverage Class and this code falls within that classification, select that Coverage Class from this drop‐down list. Financial Class
Select the Financial Class with which you want to associate this code. By assigning Financial Classes, you can keep track of how much money your practice generates for performing specific services. For example, if you created a Financial Class called LAB and this code is a lab‐related procedure code, select that Financial Class from this drop‐down list. RVU Multiplier and These fields allow the practice to update the fees for this procedure based on the RVU
relative value unit (RVU) assigned to help practices determine fees for their services based on the complexity and difficulty of the procedure. This allows five surgery procedures to have the same “weight” as 50 procedures done by a general practitioner.
Enter the whole or decimal value as the base units in the RVU field and select the multiplier from the RVU Multiplier field. The system then multiplies the value in the RVU field by the value in the RVU Multiplier field to reach the new fee. Use the Fee Update utility to make the changes.
Establish the list of multipliers for the RVU Multiplier drop‐down list on the RVU Mult tab under Setup > System Preferences.
UB Rev Code
Select the revenue code required on the UB‐92 (CMS 1450) institutional claim form when submitting claims for this procedure. These codes and descriptions are contained in the Master Table Setup. Post‐Op Period
If this is a medical procedure that has an established amount of time in which the practice must monitor the patient’s recovery, enter the number of days in that period of time in the Post‐Op Period field.
If a staff member posts this procedure to a patient’s account, the sytem adds the number of days specified in the Post‐Op Period field to the service date on the posted procedure. The system displays the resulting date as a Post‐Op Date alert in the Appointment Module and in the Charges Module until that date passes.
5.12
Procedure Codes—Charge Codes
Diagnosis and Procedure Codes
Active From and Active Thru
Enter the effective dates for this procedure code if applicable. If staff members attempt to post an inactive procedure code on a date that falls outside this range, the system warns them of the inactive code and allows them to continue.
NDC Code, Unit Count and Unit Price The National Drug Code (NDC), unit count and unit price print on a paper claim and appears on the line‐level Claim Adjustment Information window.
Unit of Measure
This field is a drop‐down that includes standard drug measurement units that print on a paper claim and appears on the line‐level Claim Adjustment Information window. NOTE | You can edit the options in the Unit of Measurement field in the Master Table Setup (under Setup >Master Table Setup).
Co‐Pay
This is strictly for system billing codes. Taxable
Check this box to indicate that the system should apply a sales tax when staff members post this procedure. The system automatically posts the sales tax code after a user posts a taxable procedure (e.g., eyeglass lenses, hearing‐aid batteries) and displays the total sales tax at the bottom of the Charges window. Each practice can specify the tax rate and billing codes the system should use on the Sales Tax tab under Setup > System Preferences. Patient Resp
Check this box if this charge procedure is always a patient‐responsible amount. When a staff member posts the procedure, the system automatically sets the Bill flag to N‐Pat. Billing/Pat. Resp.
CLIA Flag
If the carrier requires the rendering provider’s CLIA number when submitting this procedure on a claim, check this box. With this box checked, the system knows to include the provider’s CLIA number on the claim. Document Flag
Check this box if the insurance carriers require some kind of documentation for claims processing. When a staff member posts a procedure with this box checked, the system automatically places a check mark in the D column, reminding the staff to enter documentation. Users can uncheck this when posting, if not needed. Anesthesia
This field is not being used at this time.
Inventory
The Inventory checkbox works in conjunction with the Qty field. Check the Inventory box if this is an item you want to track for inventory purposes (e.g., vaccinations, bandages, etc.). To view an inventory list, simply generate an Inventory Report (Reports > Miscellaneous > Inventory Report). NOTE | Adjusting off an inventory item through the Posting Module does not add that item back into the inventory count. You must manually adjust the inventory Qty field to reflect the addition of the item back into inventory.
PDA Download
Check this box if you want this procedure available when using MicroMD Mobile. Please refer that module’s documentation for more information.
Procedure Codes—Charge Codes
5.13
Diagnosis and Procedure Codes
PDA Common
Check this box to display this procedure code near the top of the drop‐down lists on the mobile device, along with other procedure codes that the practice’s providers use frequently. This eliminates the need to scroll through a long list of selections.
EM Flag
Check the evaluation/management (EM) flag checkbox to flash a Co Pay Applies alert to users in the Posting Module if the patient’s plan requires a co‐pay for this procedure. This flag only works when there is an amount in the Co‐pay field on the patient’s Plan Sets tab. Update Flag
This checkbox sets the default for this procedure’s Update flag in the green Payment Calculation – Primary Insurance Plan window. This allows the system to track the most recent payment for this procedure for each insurance plan, updating the allowed amounts table automatically. We recommend that you check this flag for all medical procedures and uncheck it in the Payment Calculation window only if you do not want to update the stored allowed amount. Base Units
For an anesthesia procedure, enter the default number for the Base Units field on the procedure’s Transaction Information window. The system uses this number when calculating the total units for the procedure. P
Qty
The Qty field works in conjunction with the Inventory checkbox. If you want to track this item for inventory, check the Inventory box and enter the amount of the item you have in stock in the Qty field. The system deducts from this field as staff members post the item to patient accounts. When you receive more of the item, add to the number in this field. To view an inventory list, simply generate an Inventory Report (Reports > Miscellaneous > Inventory Report). Specify Different Codes/Modifiers for Different Plans
There are times when insurance companies require regional or payer‐specific codes or modifiers for the same procedure. For example, ABC Insurance Company as the primary requires the standard code 99213 for submitting an office visit on the claim. However, XYZ Health Care Group as the secondary requires the code 00001 for submitting the same office visit.
Since you only want to keep one record per procedure code and post (and remember) only one procedure code, MicroMD PM provides the Code tab to allow you to specify which Insurance Classes require what code when submitting claims, if different than the standard code. The system automatically prints the correct information on the claim form (or submits it in the electronic claim file).
NOTE | You will not see the information in the Charges window. The information only appears on the claim or in the claim file as indicated.
5.14
Procedure Codes—Charge Codes
Diagnosis and Procedure Codes
Procedure Detail (Code Tab) Fields
Field
Description
Insurance Class
Select the Insurance Class of plans that require the code, modifiers, and/
or qualifier specified on this tab for this procedure. Procedure Code
Enter the code required by the Insurance Class for this procedure instead of the standard code. This code can be the same as the standard code in the case of only needing different modifiers or a different code qualifier.
Modifier1, Modifier2, Modifier3, and Modifier4
Select any modifiers required by the Insurance Class for this procedure.
Qualifier
Select the code qualifier required by the Insurance Class for this procedure, indicating if it is a non‐HCPCS code (for use in ANSI claims processing). The system selects HC – HCPCS code by default.
Specify Different Fees for Each Practice in the Database
If you have different practices within your database, there are some procedures for which you may need to charge different fees or submit with different modifiers per practice. The Charges tab allows you to specify different fees for a given procedure (with or without modifiers) for various Charge Classes (or practices). Add Charge Classes to the system on the Charge Classes tab under Setup > System Classes/
Categories.
For example, you have two practices in your system. Advanced Family Practice charges $70.00 for an office visit (e.g., 99212), while United Physicians Group charges $80.00, which is the fee established for the procedure by default. Practices in the same database share the list of procedures and the information stored for each one. Creating a Charge Class and associating it with a procedure allows each practice in the same database the flexibility to still charge their own fees.
TIP | For a database with one practice, you can use Charge Classes to enter the correct fees based on modifiers—automatically—to save your staff members time.
If you have different fees based on specific modifiers for the procedure, select the 0‐(None) Charge Class, enter your modifier(s) and enter the correct fees. Be sure the Charge Class drop‐down on the Practice Detail is set to the 0‐(None) Charge Class.
When staff members post the procedure with any of the modifiers as specified on this tab for the 0‐(None) Charge Class, the system applies the appropriate fee. Otherwise, the system uses the standard fee for the procedure. To specify different fees for a procedure based on Charge Class:
Procedure
Details
1. Select Maint > Practice from the main menu.
The Practice List window appears.
2. Select the appropriate practice.
In the example, they double‐clicked Advanced Family Practice.
Procedure Codes—Charge Codes
5.15
Diagnosis and Procedure Codes
3. From the Charge Class drop‐down list on the Practice Detail window, select the appropriate class and save the change.
In the example, the practice chose the ADVANCED FAMILY Charge Class they created.
4. Select Maint > Procedure from the main menu.
The Procedure List window opens.
5. Select the procedure for which the practice has its own fee.
In the example, Advanced Family Practice chose 99212 from the list.
The Procedure Detail window opens.
6. Select the Charges tab.
7. Click the New icon on the Task Pane.
8. Select the practice’s Charge Class from the drop‐down.
They selected ADVANCED FAMILY in the example.
9. Enter any modifiers required by the practice for this procedure.
10. Enter the fees in the Std Charge and Med Charge fields that the practices wants to charge.
They entered $70.00 in both fields.
11. Save the changes.
Whenever someone posts this procedure for this practice, the system notices the Charge Class and enters the appropriate amount.
Procedure Detail (Charges Tab) Fields:
Field
Description
Charge Class
Select the Charge Class for which the modifier(s) and fees apply when submitting this procedure code on claims or in claim files.
Mod1, Mod2, Mod3, If this procedure requires a different fee based on certain modifier(s) for the and Mod4
practices within this Charge Class, select them from the drop‐down lists. When the staff members posting charges (for practices within the Charge Class) select the indicated modifier, the Fee column updates accordingly.
Std Charge
Enter the fee that practices associated with the indicated Charge Class want to charge for this procedure. This amount appears in the Fee column when staff members post charges. Enter the amount without the dollar sign.
Med Charge
If Medicare’s fee for this procedure is different than the amount entered in the Std Charge field, enter that amount in the Med Charge field. The system automatically defaults to this fee for a Medicare patient when users post charges for this procedure for the practices associated with the indicated Charge Class.
5.16
Procedure Codes—Charge Codes
Diagnosis and Procedure Codes
Specify Plans for Capitation
The Capitation tab for a procedure allows the practice to flag this procedure for applying a co‐pay amount. Allowed Amounts for the Procedure
The system keeps track of the allowed amounts that staff members post from the Explanation of Benefits (EOB) supplied by the carrier. The system stores this information for each procedure by plan and provider on the Plan Allowed tab of the Procedure Detail window. The Plan Allowed tab is directly linked to the Procs Allowed tab on the Plan Detail window. When MicroMD PM updates one tab, it updates the other automatically. The update process described in this section applies to both tabs.
There are two ways to enter the initial information in this table. You can enter information manually before staff members post any payments in the system at all, or you can have the system complete this information for you. The update process works the same.
To enter an entry manually, click the New icon on the Task Pane, select the appropriate provider(s), plan, amounts, POS, any modifiers, and save the changes. If the amounts apply to all providers in the system, select (ALL) from the Provider drop‐down list.
Figure 5‐8 Plan Allowed Tab
Once the Update column is checked on the green Payment Calculation – Primary Insurance Plan window, MicroMD PM stores the initial payment amount in the Contracted column of the Plan Allowed tab as it is posted from each insurance carrier per provider (if it does not already exist). The next time that a staff member enters the green Payment Calculation window to post payments to the same procedure for the same plan and provider (with the same POS and modifiers), the system automatically inserts the stored Allowed amount for them. If they change that amount and there is a check in the Update column, the system updates the stored amount accordingly. The initial Contracted amount remains the same.
TIP | You can sort the columns on the Plan Allowed tab. This helps, for example, when you want to see all of the contracted amounts for a specific provider or plan to edit those amounts for a new year.
Procedure Codes—Charge Codes
5.17
Diagnosis and Procedure Codes
Also important in this process is the Update Allowed Amt checkbox on the carrier’s Plan Detail window. The Update Flag checkbox on the Procedure Detail window activates the entire tracking process for each procedure. The Update Allowed Amts checkbox controls whether the system updates the procedure’s allowed amount for the plan.
For example, if you check the Update Allowed Amts box for ABC Insurance Company but leave the Update Flag box unchecked for the procedure, there is no check mark in the Update column for the procedure in the green Payment Calculation – Primary Insurance Plan window. If you check the Update Allowed Amts checkbox and check the Update Flag box for the procedure, there is a check mark in the Update column for the procedure, and the system updates the stored amount.
However, if you leave the Update Allowed Amts box unchecked for ABC Insurance Company, there is no check mark in the Update column for this plan, regardless of the procedure’s default. Users can always check or uncheck the Update column as needed when posting payments.
Fields on the Plan Allowed Tab of the Procedure Detail Window:
Field
Description
Effective
The system can archive a payment profile by plan(s) or Insurance Class(es) while maintaining a current profile with an effective date. The options at the top of the tab allow you to view either profile in the system. Provider
This column displays the provider for whom the system recorded the contracted and allowed amounts for the plan specified in the Plan column. This allows the system to record different allowed amounts for different providers from the same insurance carrier for the same procedure code.
If entering an allowed amount manually, select the provider from this drop‐down list or select (ALL) from the drop‐down to make the entry applicable to all providers in the system.
Plan
This column displays the plan for which the system recorded this allowed amount entry.
If entering or editing an allowed amount manually, enter the appropriate plan by ID, name or part of either. A Plan Search window appears if necessary to allow you to choose the correct plan.
Name
This column only displays the name of the insurance carrier that corresponds to the ID in the Plan column. It is not an editable field.
Effective
The Effective column displays the current effective date for the procedure’s payment amount for the specified plan and provider. POS
This column displays the place‐of‐service code posted for this procedure when the system recorded the initial Contracted amount. If staff members post this same procedure to the same provider and the same plan but with a different POS, the system creates another entry on this tab.
M1, M2, M3, and M4
These columns display the modifiers posted for this procedure when the system recorded the initial Contracted amount. If staff members post this same procedure to the same provider and the same plan but with a different modifier or order of modifiers, the system creates another entry on this tab.
5.18
Procedure Codes—Charge Codes
Diagnosis and Procedure Codes
Contracted
This field displays the contracted amount recorded agreed upon with the insurance plan for the indicated plan and provider. This amount displays on the green Payment Calculation – Primary Insurance Plan window for informational purposes only and cannot be changed on that window. This amount does not change as the system updates the amount in the Allowed column.
Fee
There may be times when a practice needs to charge a different fee for a procedure based on the modifier posted with it. This Fee field allows you to set that up.
Create a new line with provider, plan, modifier, contracted amount, the fee and the allowed amount. Remember that these fields are linked directly to the fields on the Procs Allowed tab of the Plan Detail window.
When a staff member posts this procedure code to a patient whose active primary plan is one of the plans indicated on this tab, for the provider indicated, and for the modifier listed, the fee listed appears instead of the standard fee listed on the Procedure tab or the Charges tab of the Procedure Detail window.
NOTE | This amount is stored with the first provider for whom you posted payments (if you chose (ALL) for the provider). When you post payments for the next provider, the system simply stores the contracted and allowed amounts for that provider on his/her line for that procedure.
Allowed
This field displays the latest amount the insurance company allowed for this procedure for the provider and plan indicated, if there was a check mark in the Update column of the green Payment Calculation – Primary Insurance Plan window the last time payments were posted. While this column updates, the Contracted column remains the same.
Paid
This column displays the latest amount the carrier paid on this procedure (up to four decimal places) for the provider and plan indicated, if there was a check mark in the Update column of the green Payment Calculation – Primary Insurance Plan window the last time payments were posted. While this column updates, the Contracted column remains the same. Use the horizontal scrollbar at the bottom of the window to view this column.
Procedure Codes—Charge Codes
5.19
Diagnosis and Procedure Codes
Sliding Level Overrides for Procedures
Figure 5‐9 Sliding Level Override on the Procedure List setup window
When an override has been added to a procedure, it can be edited by clicking the small document edit icon next to the checkbox. This will open the Override Levels window as shown below.
Figure 5‐10 Editing override levels in the Override Levels window
5.20
Procedure Codes—Charge Codes
Diagnosis and Procedure Codes
CrossCode Messages—Procedure with a Diagnosis
CrossCode Messages enable the practice to communicate with the staff when they post a specific diagnosis code against a procedure code across all plans.. The communication appears in a pop‐up message box and indicates if the staff member can or cannot continue posting the code combination.
TIP | If there is an insurance carrier who continues to deny claims because of a diagnosis/procedure combination, enter that combination on the plan’s CrossCode Messages tab instead.
Procedure
Details
1. Select Maint > Procedure from the main menu.
You can also click the Procedure button on the Launch Pane, if available.
The Procedure List window opens.
2. Double‐click on the appropriate procedure.
The Procedure Detail window appears.
If the procedure has not been created yet, refer to Creating a Procedure Code.
3. Select the CrossCode Messages tab.
4. Click the New icon on the Task Pane.
5. Type the appropriate diagnosis code into This is the diagnosis code you want to link to this procedure. The diagnosis description appears once the the Diag column.
user selects a code.
The Diag column is a search field so you can search for the item either by the code or description. Remember that you can also use the wildcard characters (% or _ ).
TIP | If you want the procedure only available for a specific set of diagnosis codes and no others (e.g., the EKG charge code should only be used when a heart‐
related diagnosis is posted), you can specify those few diagnosis codes as Allowed and then create another entry with ALL in the Description field (just tab or click out of the field) as Not Allowed for all other codes.
6. Use the Status drop‐down list to indicate Choose Allowed to permit the staff members that receive this warning to continue posting the diagnosis whether users can post the diagnosis with this procedure. The Message field helps you with this procedure.
communicate with the staff any information they need about this combination. If there is no text in this field, the system does not display a message box.
Choose Not Allowed to prohibit the staff member from posting the diagnosis with this procedure. The Message field helps you communicate with the staff.
Procedure Codes—Charge Codes
5.21
Diagnosis and Procedure Codes
7. Type the text for the warning box in the Message field.
This message appears as the warning when staff member attempt to post the indicated diagnosis with this procedure. 8. Repeat steps 4 through 7 for each diagnosis that requires a warning. Click the Save icon on the Task Pane.
Explosion Codes
Explosion Codes allow the practice to create groups of codes that are frequently posted together. For example, when a patient comes in for their yearly physical, you post the same five procedure codes almost every time. You may add to, remove from, or edit those procedures for a particular visit, but the core codes are the same every time the staff posts the Explosion Code.
When using the Explosion Code, type the @ sign, followed by all or part of the code when posting a new charge line. The system automatically posts the codes contained in that Explosion Code, or it displays the Explosion Search window and allows the staff member to choose the appropriate Explosion Code.
To create a new Explosion Code:
Procedure
Details
1. Select Maint > Explosion Codes from the main menu.
The Explosion Procedure List window opens.
2. Click the New icon on the Task Pane.
The Explosion Procedure Detail window opens.
3. Select the practice from the Practice ID drop‐
down list for which the Explosion Code applies.
4. Enter the shortcut text in the Explosion Code field For example, the Explosion Code for the charge codes most commonly associated with that staff members should type after the @ a yearly physical could be PHYS.
symbol to post the group of codes.
5. If you want to track the charge codes posted in this Explosion Code, place a check mark in the Track Code checkbox.
For example, to track immunizations, enter those immunization charge codes within an explosion code, and place a check mark in the Track Code box.
The system makes these tracked codes available through the floating toolbar in the Patient, Charges/Payments, Billing Inquiry and Appointment Modules. Click the Track Code Hist icon to access this list.
6. Click the New icon on the Task Pane to begin adding charge codes to this Explosion.
7. Enter the appropriate information for the charge code when posted using this Explosion Code.
8. Repeat steps 6 and 7 for each charge code you want to add to this Explosion Code.
5.22
Procedure Codes—Charge Codes
Diagnosis and Procedure Codes
9. Click the Save icon on the Task Pane.
Remaining Fields on the Explosion Procedure Detail Window
Field
Description
Code
Enter the procedure’s code. A procedure code must exist in the system before you can associate it with an explosion code.
M1, M2, and M3
Choose any modifiers needed for the procedure code when posted using this Explosion Code.
Units
Enter the number of units staff usually post for this procedure when they post it in this situation represented by this Explosion Code. By default, this field lists one unit. Staff can change this as needed when posting.
Description
This field displays the name of the procedure chosen in the Code column.
PROCEDURE CODES—SYSTEM BILLING CODES
Now that we have covered medical procedure codes, we can move on to system billing codes. The system billing codes are based on the accounting principles of payments, write‐offs and refunds. (The charges principle was covered in the previous section.) These codes either debit (increase) or credit (reduce) the patient’s balance with the practice.
NOTE | The database comes pre‐loaded with some permanent billing codes necessary to perform some automatic calculations throughout the system and are discussed in this section.
Creating a new billing code is the same as creating a charge code in MicroMD PM, except there are fewer options available or necessary for the billing code. Depending on the type of code (payment, write‐
off, adjustment, etc.), those few options also differ slightly and are explained in each of the succeeding sections.
Payment and Write-off Codes
The payment codes in the system allow you to track the payments from the insurance carriers, as well as from your patients. Write‐off codes allow you to track the amount of your fees for which you do not receive payment. Payment and write‐off codes relate to each other and creating consistent codes is important. The section you are in now explains how to create and edit the codes you use when posting. Once you have the codes you want, you can set default codes per plan and by default when creating new plans.
The following codes are permanent payment codes in the system:
 1 (PAYMENT – CASH)credits the account/reduces amount owed
 10 (PAYMENT MISCELLANEOUS)credits the account/reduces amount owed Codes 2 through 40 are reserved for user‐defined payment codes, while 43 through 98 are reserved for user‐defined write‐off codes. The system has these codes programmed as permanent payment and Procedure Codes—System Billing Codes
5.23
Diagnosis and Procedure Codes
write‐off codes that you can change the Description and the kind of payment or write‐off (using the Tos field).
TIP | We recommend that you create payment and write‐off codes in a consistent manner. For example, you decide to use code 3 for Medicare payments. You should then use code 43 for Medicare write‐offs. This makes it easier for staff members to remember.
Payment and write‐off codes in MicroMD PM are whatever you make them. You should, however, be consistent in the way you create them. The system users can search code fields based on the descriptions of the codes you create. For example, if every payment code starts with PAY, searches for PAY return all of the payment codes. Also, if all write‐off codes start with W/O, searches for W/O return all of the write‐
off codes. This ensures that every staff member has the opportunity to choose the codes you want them to use.
Some examples of using the built‐in payment and write‐off codes:
 Code: 2Description: PAYMENT CHECK#
 Code: 3Description: PAYMENT MEDICARE
 Code: 43Description: W/O MEDICARE
 Code: 4Description: PAYMENT MEDICAID
 Code: 44Description: W/O MEDICARE
 Code: 5Description: PAYMENT ANTHEM
 Code: 45Description: W/O ANTHEM
Other examples of possible codes you can create to help make your billing consistent and your financial reporting accurate:
 Code: MO
• Description: PAYMENT ‐ MONEY ORDER
• Pos: PO ‐ PAYMENT ‐ OTHER
• Tos: PM ‐ PATIENT ‐ OTHER
 Code: VISA
• Description: PAYMENT VISA
• Pos: PO ‐ PAYMENT – OTHER
• Tos: PD ‐ Patient ‐ Credit Card
 Code: COPAY1
• Description: CO‐PAY CASH
• Pos: PO ‐ PAYMENT – OTHER
• Tos: PC ‐ PATIENT – CASH
• Co‐pay field: checked
 Code: COPAY2
5.24
Procedure Codes—System Billing Codes
Diagnosis and Procedure Codes
• Description: CO‐PAY CHECK
• Pos: PO ‐ PAYMENT – OTHER
• Tos: PM ‐ PATIENT – OTHER
• Co‐pay field: checked
•
To create a payment or write‐off code:
Procedure
Details
1. Select Maint > Procedure from the main menu.
You can also click the Procedure button on the Launch Pane, if available.
The Procedure List window appears.
2. Click the New icon on the Task Pane to add a new code.
3. Enter the appropriate Code staff members The code can be up to six characters long. Remember that codes 2 through 40 are already set as payment will use to post this procedure.
codes you can just name and use, and codes 43 through 98 are already set as write‐off codes you can name and use. 4. Type the appropriate name for this procedure in the Description field.
This description prints on patient statements/bills. Keep in mind that staff members can search for this billing code by this description. Try to keep the payment and write‐off codes named consistently (e.g., all payment codes begin with PAY, all write‐off codes begin with W/O, etc.).
5. If the Practice ID field is available for this STOP | If available, you can change this field only new code and you want to create a billing while creating a new code. Once the code is saved, this field is disabled and cannot be changed again.
code only for your practice, you must select your practice from this drop‐down now.
Procedure Codes—System Billing Codes
5.25
Diagnosis and Procedure Codes
6. Select the appropriate Pos for your payment or write‐off code.
Two of the options available in the Pos drop‐down relate to creating a payment or write‐off code (PO‐
PAYMENT OTHER and WI‐WRITE‐OFF). The other codes in the drop‐down relate to adjustments.
For the built‐in the system billing codes you use in the range of 2 through 40, the system automatically assigns a Pos of PO‐PAYMENT‐OTHER for the new code. For built‐in write‐off codes in the range of 43 through 98, it automatically assigns a Pos of W1‐
WRITE‐OFF for the new code.
You can still create system billing codes that fall outside the range of 2 – 40 and 43 – 98. These codes might include other payment, refund, balance forward and write‐off codes you need in the system if you run out of built‐in system codes, or you want a specific code name. For example, you can create a CAPIT code for posting your capitation payments by selecting PO‐PAYMENT‐OTHER from the Pos list.
7. Select the appropriate Tos from the drop‐
down list.
The list of choices in the Tos drop‐down list depends upon the choice made in the Pos drop‐down.
If the Pos is PO ‐ PAYMENT ‐ OTHER, then you can designate that payment as a patient cash payment, a patient credit card payment, just a payment note, or other patient payment, depending on your practice needs. This payment code could also be an insurance payment code.
When staff members post this code, the system automatically defaults to the appropriate Bill flag based on the Tos. For example, if a posted code has a Tos of II ‐ INSURANCE, the Bill flag defaults to either “Y” (or “X” if there is no secondary insurance). 8. If this code is for posting co‐pay amounts, This checkbox is enabled only for a patient payment code. Check this box to flag this patient payment code check the Co pay checkbox.
as a co‐pay procedure.
On the day sheet, there is a section listing the totals of charges, payments, etc. When there is a check mark in this box and staff members use this procedure consistently when posting patient co‐pays, the system displays the total amount of co‐pays that are included in the Total Payments line.
This field is also important when using the Capitation Module.
9. Click the Save icon on the Task Pane.
5.26
Procedure Codes—System Billing Codes
Diagnosis and Procedure Codes
Adjustment Codes
Adjustment codes allow staff members to correct posting mistakes, keep track of those corrections, produce accurate day sheets, and produce accurate financial reports. The most important concept to grasp is that these codes either increase or reduce the patient’s balance. The other important understanding to have is that the system already has a complete list of codes you can use to correct any posting mistakes that happen. This section explains the built‐in codes and how to create codes for which there is no built‐in code you can use. The following codes are the built‐in adjustment codes in the system and the effect it has on the amount the patient owes the practice:
 41 (ADJ‐‐REDUCE CHARGE)
• Pos: CR ‐ ADJ ‐ REDUCE CHARGE
• Action on patient’s account: credits the account, reducing the patient’s balance
 42 (ADJ‐‐INCREASE PAYMENT)
• Pos: PI ‐ ADJ ‐ INCREASE PAYMENT
• Action on patient’s account: credits the account, reducing the patient’s balance
 99 (BALANCE FORWARD CREDIT)
• Pos: BR ‐ BALANCE FORWARD ‐ CREDIT
• Action on patient’s account: credits the account, reducing the patient’s balance
 100 (ADJ TO REFUND)
• Pos: RR ‐ ADJ TO REFUND
• Action on patient’s account: credits the account, reducing the patient’s balance
 101 (ADJ‐‐REDUCE PAYMENT)
• Pos: PR ‐ ADJ ‐ REDUCE PAYMENT
• Action on patient’s account: debits the account, increasing the patient’s balance
 102 (ADJ‐‐INCREASE CHARGE)
• Pos: CI ‐ ADJ ‐ INCREASE CHARGE
• Action on patient’s account: debits the account, increasing the patient’s balance
 103 (REFUND)
• Pos: R1 ‐ REFUND
• Action on patient’s account: debits the account, increasing the patient’s balance
 104 (ADJ TO WRITE‐OFF)
• Pos: WR ‐ ADJ TO WRITEOFF
• Action on patient’s account: debits the account, increasing the patient’s balance
 105 (BALANCE FORWARD—DEBIT)
• Pos: BI ‐ BALANCE FORWARD ‐ DEBIT
• Action on patient’s account: debits the account, increasing the patient’s balance
Procedure Codes—System Billing Codes
5.27
Diagnosis and Procedure Codes
Creating Extra Adjustment Codes
The system uses the Pos and Tos fields on the Procedure Detail window to tell the code which action to perform on the patient’s balance (increase or reduce) and the responsibility (patient or insurance). When you select the appropriate Pos, the system provides choices in the Tos field where you can indicate the responsibility for the action.
Selecting one of the following Pos entries creates an adjustment code:
 BI ‐ BALANCE FORWARD – DEBIT
BI = Balance Increase. Any code with this selected in the Pos drop‐down increases the patient’s balance by the amount the staff member specifies when posting.
 BR ‐ BALANCE FORWARD ‐ CREDIT
BR = Balance Reduce. Any code with this selected in the Pos drop‐down reduces the patient’s balance by the amount the staff member specifies when posting.
 CI ‐ ADJ ‐ INCREASE CHARGE
CI = Charge Increase. If you want to correct a charge amount that was inadvertently set too low, a code with this selected in the Pos drop‐down increases the patient’s balance by the amount the staff member specifies when posting.
 CR ‐ ADJ ‐ REDUCE CHARGE
CR = Charge Reduce. If you want to correct a charge amount that was inadvertently set too high, a code with this selected in the Pos drop‐down reduces the patient’s balance by the amount the staff member specifies when posting.
 PI ‐ ADJ ‐ INCREASE PAYMENT
PI = Payment Increase. If you want to correct a payment applied to the patient’s account that was accidentally posted as less than the amount actually paid, a code with this selected in the Pos drop‐down reduces the patient’s balance by the amount specified by the staff member when posting.
 PR ‐ ADJ ‐ REDUCE PAYMENT
PR = Payment Reduce. If you want to correct a payment applied to the patient’s account that was accidentally posted as more than the amount actually paid, a code with this selected in the Pos drop‐down increases the patient’s balance by the amount specified by the staff member when posting.
 R1 – REFUND[make less confusing]
Any code with this selected in the Pos drop‐down indicates an amount that you return to either the patient or the insurance company. Posting this amount increases the balance by the amount the staff member specifies when posting (e.g., if the amount posted as a refund is $7.00 to a ($7.00) balance, the system increases the balance by $7.00 and zeroes it out).
 RR ‐ ADJ TO REFUND
RR = Refund Reduce. If you want to correct a refund applied to the patient’s account that was accidentally posted as more than the actual amount, a code with this selected in the Pos drop‐
down decreases the patient’s balance by the amount specified.
5.28
Procedure Codes—System Billing Codes
Diagnosis and Procedure Codes
 WR ‐ ADJ TO WRITEOFF
WR = Write‐off Reduce. If you want to adjust off a write‐off amount applied to the patient’s account for any reason, a code with this selected in the Pos drop‐down increases the patient’s balance by the amount specified by the staff member when posting.
To create an adjustment code other than the built‐in code:
Procedure
Details
1. Select Maint > Procedure from the main menu.
You can also click the Procedure button on the Launch Pane, if available.
The Procedure List window appears.
2. Click the New icon on the Task Pane to add A blank Procedure Detail window appears. a new code.
3. Enter the appropriate Code staff members will use to post this procedure.
The code can be up to six characters long.
4. Type the appropriate name for this procedure in the Description field.
We recommend that, if you create your own adjustment codes, you enter consistent descriptions that have ADJ at the beginning. When staff members search for ADJ to find the correct code, the system returns all of the adjustment codes. This ensures that every staff member has the opportunity to choose the codes you want them to use.
STOP | You can change this field only while creating 5. If you want to create an adjustment code only for your practice, you must select your a new code. Once the code is saved, this field is disabled and cannot be changed again.
practice from the Practice ID drop‐down list now.
6. Select the appropriate Pos for your system adjustment code.
7. Select the appropriate Tos from the drop‐
down list.
When staff members post this code, the system automatically defaults to the appropriate Bill flag based on the Tos.
8. Click the Save icon on the Task Pane.
Billing Note Codes
Billing note codes allow the practice to enter a line‐item that displays information in relation to the sequence and that prints on statements/bills to help communicate with patients. When you create a note code (those codes with PO‐PAYMENT‐OTHER as the Pos and PN‐NOTES as the Tos), the system disables the fee fields in the Posting Module so staff members do not inadvertently enter an amount in this field. Billing notes are just plain notes.
For example, Advanced Family Practice created a note code called DEN. The Description of this code is SERVICE NOT COVERED. If an insurance carrier denies coverage for a service rendered to a patient, staff members can add this code to the sequence, and it will print on the statement/bill that goes out to the patient to help explain why they are now responsible for a $200.00 amount.
Procedure Codes—System Billing Codes
5.29
Diagnosis and Procedure Codes
As mentioned at the beginning of this section, the system has three built‐in note codes. The NOTE code allows staff to enter text. The system posts the other two codes—COINS and DEDUC—automatically during the payment posting process.
 NOTE‐‐: The NOTE‐‐ code allows the staff member posting the code to enter text after the hyphens as it pertains to the current billing situation. For example, Advanced Family Practice could have used the built‐in NOTE‐‐ code to indicate that the service was not covered by the insurance company. If they posted the NOTE‐‐ code through the blue Payment Calculation – Patient and Non‐Primary Insurance window, they could type SERVICE NOT COVERED after the hyphens in the Description field.
 COINS: The system automatically posts this code when staff members enter an amount in the Co‐Ins column of the green Payment Calculation – Primary Insurance Plan window. The amount entered then appears in the Description field as a reminder of the amount for which the patient is responsible.
The COINS code is the default for a new system for displaying co‐insurance amounts listed on the EOB. If you want to change the code that the system uses, you can do so on the System Preferences tab under Setup > System Preferences.  DEDUC: The system automatically posts this code when staff members enter an amount in the Deduc column of the green Payment Calculation – Primary Insurance Plan window. The amount entered then appears in the Description field as a reminder of the amount for which the patient is responsible and to let them know how much was applied to their deductible.
The DEDUC code is the default for a new system for displaying amounts applied to the patient’s deductible as listed on the EOB. If you want to change the code that the system uses, you can do so on the System Preferences tab under Setup > System Preferences. To create a billing note code:
Procedure
Details
1. Select Maint > Procedure from the main menu.
You can also click the Procedure button on the Launch Pane, if available.
The Procedure List window appears.
2. Click the New icon on the Task Pane to add A blank Procedure Detail window appears. a new code.
3. Enter the appropriate Code staff members The code can be up to six characters long.
will use to post this procedure.
4. Type the appropriate name for this procedure in the Description field.
This description prints on patient statements/bills.
5. If you want to create a code only for your practice, you must select your practice from the Practice ID drop‐down list now.
STOP | You can change this field only while creating a new code. Once the code is saved, this field is disabled and cannot be changed again.
6. Select PO‐PAYMENT‐OTHER from the Pos drop‐down list.
Selecting PO‐PAYMENT‐OTHER enables the appropriate list of choices in the Tos drop‐down list.
5.30
Procedure Codes—System Billing Codes
Diagnosis and Procedure Codes
7. Select PN‐NOTES from the Tos drop‐down list.
8. Click the Save icon on the Task Pane.
Procedure Codes—System Billing Codes
5.31
INSURANCE PLANS
You need insurance plans in the system before you can create patients and begin billing. You also need to know about insurance plans in the system over the years as their billing requirements change. The list of insurance plans in the system is common to all practices in the current database. We recommend you create an entry in the system for each individual insurance carrier. The system tracks volumes of information throughout the program specific to each insurance plan. IN THIS CHAPTER
In this chapter, we cover how to:
 Search for a plan
 Create a new plan in the system
 Specify the requirements for a plan’s policy numbers
 Establish the payment schedule for a plan
 Specify procedures that a plan considers capitated procedures
 Establish alerts for those procedures for which a plan requires pre‐certification
 Enter appropriate identification numbers to include in electronic claim files
 Create and maintain a payment profile for a plan
 Specify those providers who are eligible or ineligible to receive payment from a plan
 Use the Plan Copy Utility to create a plan from an existing plan
 Delete plans from the system
SEARCH FOR A PLAN
Procedure
Details
1. Select Maint > Plan from the main menu.
You can also click the Plan button on the Launch Pane, if available.
The Plan List window opens.
2. Enter the plan name you are searching for in the Search for: text box.
3. Check the Active Only checkbox if you are searching for only active plans.
If unchecked and searched, the retrieved list should include active and inactive plans. The inactive plans should have gray background. 4. Click the Search button.
In This Chapter 6.1
Insurance Plans
Figure 6‐1 The Active Only checkbox on the plan search window
TIP | Plans that are marked as inactive will have a gray background when they are in the results of the Reference Code Listing Plan report TIP | In the following three areas, if the user enters a plan that is inactive, a pop‐up message will notify the user that the plan is inactive:
Patient Detail > Plan tab
Procedure Detail > Plan Allowed tab
Employer Detail > Plans
6.2
Insurance Plans
CREATE A NEW PLAN
The Plan Detail window is the central location where the practice stores and maintains each plan’s information regarding insurance IDs, allowed procedures, eligible/ineligible providers, etc. This also allows the practice to link the plan to various other data in the system to help automate several processes.
Figure 6‐2 Plan Detail Window
To create a new plan, use the following procedure: Procedure
Details
1. Select Maint > Plan from the main menu.
You can also click the Plan button on the Launch Pane, if available.
The Plan List window opens.
2. Click the New icon on the Task Pane.
A blank Plan Detail window opens. 3. Enter all necessary information for this plan.
4. Check the Active checkbox if this plan will be active. This box will default to a checked state.
5. Click the Save icon on the Task Pane.
Create a New Plan
6.3
Insurance Plans
Plan Detail (Plan Detail Tab) Fields:
Field
Description
ID
The system creates this unique system ID once you save this plan.
Group No
Enter the group number for this plan if applicable. This field provides the default value for the Group field under the Plan Sets tab in the Patient Detail window if the user selects this plan.
Source of Payment
Select the appropriate source of payment for this plan. This indicates from where this plan sends payment to the practice. The system needs this information for submitting electronic claims.
Plan Name
Enter the appropriate name or description for this insurance plan entry. The system includes the information from this field on insurance claims or in electronic claim files.
Address
Specify up to two lines for the address of the entity. The system prints this information on a patient’s claims or includes it in the electronic claim file.
ZIP Code
Enter a five‐digit ZIP code or a part of a city name, and the system completes the city and state automatically. Users can enter partial city names in the ZIP code field, and the system displays all matching entries. Users can enter wildcard characters (% or _). Phone, Alternate Phone, and Other Phone
Users may enter a seven‐digit phone. Type an X followed by up to a four‐
digit extension. Do not use parentheses, spaces, or hyphens. Enter an area code, if applicable.
Fax
Users may enter a seven‐digit facsimile number. Enter an area code, if applicable.
PreCert Contact
Enter the name of the contact person for pre‐certification in this field. This name appears when users make appointments (along with the phone number entered in the PreCert Phone field) if the scheduled procedure (listed in the Procedure field of the appointment window) requires pre‐
approval from the insurance plan. PreCert Phone
Enter the phone number that leads to the person listed in the PreCert Contact field. This number appears when users make appointments (along with the person’s name entered in the PreCert Contact field) if the scheduled procedure (listed in the Procedure field of the appointment window) requires pre‐approval from the insurance plan.
Family Deductible, Family Max Yearly, Individual Deductible, and Individual Max Yearly
These fields are used for setting the appropriate deductibles and yearly maximum amounts. The system uses these fields actively for the Dental Module. However, you can use these fields only for informational purposes, if needed.
Year Type, Year Start, Deduct Type and Max Type
The system uses these fields mainly for the Dental Module. However, you can use these fields only for informational purposes, if needed.
6.4
Create a New Plan
Insurance Plans
Co Pay/Co‐Insurance drop‐down (above the Referral checkbox)
Select Co Pay or Co Insurance from the drop‐down. Enter the default amount of this plan’s co‐pay or co‐insurance.. When a staff member adds this plan to a patient’s Plan Sets tab, the amount entered here appears in the Co Pay field on the Plan Sets tab.
Referral
Check this box to indicate that, when a patient is referred to the practice, that referring physician’s information is required on claims to this plan before it can be processed properly. When the system encounters a claim to a plan with this box checked, it displays a warning message to the staff as they post charges, alerting them if they forget to enter the referring physician.
Batch
Check this box to include this plan in the batch payment posting. This limits the number of plans that staff members need to scroll through to choose the plan to which they need to post payments. Dental
The system does not currently use this field.
Form Type
Choose the form type to use when submitting claims to this carrier. This form type indicates how paper claim forms print and which electronic billing type to use for this insurance plan. The default for this drop‐down is the Form Type drop‐down under Setup > System Preferences > System Preferences tab in the Maintenance section.
Payment Code
Select the appropriate system billing code to use when the staff posts payments from this carrier. The system automatically enters this code when staff members post payments for this plan through the green Payment Calculation – Primary Insurance Plan window and the blue Payment Calculation – Patient and Non‐Primary Insurance window. If you use the AutoPayment Posting Module, MicroMD PM uses the code selected here when posting.
Payment codes help track payments by various plans. We recommend that you assign a separate payment code for each of the major carriers in the system (e.g., Anthem, Blues, Medicare, etc.) and assign a miscellaneous payment code for the other plans in the system. Write‐off Code
Select the appropriate system billing code to use when the staff posts write‐
offs from this carrier. The system also uses the code selected here when posting payments automatically through the AutoPosting Module.
Write‐off codes help track write‐off amounts by various plans. We recommend that you assign a separate write‐off code for each of the major carriers in the system (e.g., Anthem, Blues, Medicare, etc.) and assign a miscellaneous write‐off code for the other plans in the system. This is especially helpful for those providers that accept assignment. Create a New Plan
6.5
Insurance Plans
Adjust to Writeoff Code
This write‐off code is used for carriers that return encounter‐based payments instead of payments per charge. If that is the case, verify that you placed a check mark in the Encounter Rate Posting checkbox on the Billing Preferences tab (under Setup > Practice Preferences).
This allows you to enter an allowed amount greater than the charge in the green Payment Calculation — Primary Insurance Plan window. If the payment is greater than charge, the system creates the transaction as an adjustment with a positive amount added to the account. If the payment is less than the charge, the system uses the code selected in the Adjust to Writeoff Code field to create the transaction as a write‐off with a negative amount. The system computes co‐insurance at 20% of charge amount.
Insurance Class
Select the Insurance Class with which you want to associate this plan. For example, if you created an ANTHEM Insurance Class and this is an Anthem‐
related plan, select that ANTHEM Insurance Class from this drop‐down list. Insurance Category
Select the Insurance Category with which you want to associate this plan. Insurance categories help group insurance plans that may not be in the same Insurance Class.
For example, include the Anthem HMO plan in the HMO category and at the same time, include it with the ANTHEM Insurance Class. You would be able to include this plan in Anthem‐related reports, as well as those reports generated based on the HMO category.
CHC Payor Category
This field is for use with the MicroMD CHC Module to indicate that the selected plan qualifies as an uninsured plan and helps generates accurate reporting. The CHC payor category can be used to create “dummy” plans in the system, such as ones used for slide plans. This drop‐down list pulls from Payor Category list in the Master Table Setup.
Contact
Enter the name of the contact person at this insurance carrier, if available. This field is for informational purposes only and does not print anywhere.
Active (checkbox)
This defaults to checked for all existing plans, denoting these plans as active.
Assign Benefits (Prim)
This checkbox sets the default value for the Assign Benefits box on the Plan Sets tab in the Patient Detail window. If there is a check mark in the Assign Benefits box on the patient’s Plan Sets tab for
this plan, the system prints Signature on File in Box 13 of the CMS claim
form. It also marks the appropriate field within the electronic billing batch file. This
information instructs the insurance company to send payment directly to the
provider’s office and not to the patient.
6.6
Create a New Plan
Insurance Plans
Responsibility ‐ Sec
Check this box if this insurance plan makes payments to the provider when it is the secondary carrier. The system keeps the sequence as an insurance‐
responsible amount when the claim is sent to this plan as a secondary plan.
For example, the patient has a primary insurance (Anthem) and a secondary
insurance (Cigna, with this box checked). The practice receives and posts a payment
from Anthem. The sequence still appears as an insurance-responsible sequence until
the provider receives a payment from Cigna.
Leave this box unchecked to transfer the responsibility automatically to the patient, even if the patient has a secondary insurance. This may be helpful to do in a case where the secondary insurance company pays the patient, and not the provider, directly.
Compute Write‐off
Check this box to compute the insurance write‐off amounts automatically when users post insurance payments. The practice must specify a default write‐off code for the plan in the Write‐off Code drop‐down list for this to work properly.
Specify the default value for this checkbox under Setup > System Preferences > System Preferences tab in the Maintenance section.
Generate Sec Claim
In the AutoPayment Posting Module, the system makes a number of decisions when processing payments (primary payments in this case). If the primary plan crossed the claim over to the patient’s supplemental insurance and the claim is not fully paid, the system needs to know if you want to create a claim to this plan in the system or if you want to delete the claim and transfer the responsibility of the charges directly to the patient (perhaps the supplemental insurance sends their payments directly to the patient and you need to bill the patient for that amount).
To have the system go ahead and generate that secondary claim automatically for you for a plan, check the Generate Sec Claim checkbox on that plan’s Plan Detail window. You can set the default for new plans in the system on the System Preferences tab under Setup > System Preferences.
Update Allowed Amts
The Update Allowed Amts checkbox controls whether the system updates procedure allowed amounts for this plan as staff members post payments.
Lab
Check this box to indicate that this insurance plan requires the patient to use a specific lab for lab work. This box activates the Lab Name field where the practice can enter the lab name. This information prints on the patient’s charge slip.
Lab Name
Enter the name of the preferred laboratory of this plan that its patients must use. This information prints on the patient’s charge slip so the provider and staff are aware that this patient needs to have lab work done elsewhere.
Service Facility
The system does not currently use this field.
Remarks
Add any helpful notes pertaining to this plan, if necessary. This information only prints on the Plan Report (under Reports > Reference Codes Listing) and is mostly for informational purposes only.
Create a New Plan
6.7
Insurance Plans
HMP/PPO
Check this box to indicate that this insurance plan may require a provider network ID number for proper claim processing.
Practices can specify the Provider Network ID for a provider under the Provider Network ID tab in the Practice Module. Only those plans with this box checked appear in the drop‐down list on that tab. Capitation
Check this box to indicate that this plan is a capitated plan. The system triggers a number of events automatically for capitated plans. Assignment
This checkbox sets the default value for the Assignment box on the Plan Sets tab in the Patient Detail window when adding a new plan to the tab.
Check this box to indicate that the provider accepts assignment from this insurance plan. The system then completes Box 27 on the CMS claim form appropriately.
Change Resp and # of Days
These fields allow you to specify the required number of days that pass without a payment from this plan before the system includes this plan in the Batch Responsibility Change utility (under Utility > Batch Responsibility Change). The system pulls the default value for these two fields on the System Preferences tab under Setup > System Preferences, but users can change this value when entering a new plan. VALIDATING POLICY NUMBERS FOR THE PLAN
There may be times when the edit checks in MicroMD PM do not catch a particular plan’s requirements for policy numbers submitted on claims or in electronic claim files. For example, all policy numbers for ABC Insurance Plan begin with the patient’s birth year and the first letter of their last name. Their policy numbers are also between eight and ten characters long. The system allows you to enter specific validation for a plan’s policy numbers if needed. When staff members attempt to enter a policy number for a patient with this plan that does not fit the description you enter, the system alerts them with a warning and the format required so they can fix the mistake right away.
To specify the format of the plan’s policy numbers:
Procedure
Details
1. Select Maint > Plan from the main menu.
You can also click the Plan button on the Launch Pane, if available.
The Plan List window opens.
2. Double‐click on the appropriate plan.
6.8
The Plan Detail window opens.
Validating Policy Numbers for the Plan
Insurance Plans
3. Click the Plan Edits icon on the Task Pane.
The Validation Information window opens.
4. Enter the length of this plan’s policy numbers For example, ABC Insurance Plan has policy numbers that range from eight character to ten in the Length from and to fields.
characters. Advanced Family Practice types 8 in the from field and 10 in the to field.
TIP | Enter the same number in both fields for those plans that have a specific number of characters. For example, if all of their policy numbers are 10 characters, enter 10 in both the from and to fields.
Validating Policy Numbers for the Plan
6.9
Insurance Plans
5. If there is a specific format for the characters The Mask field tells the system the specifics of the order and type of characters in the policy number in the plan’s policy numbers, enter that for this plan. If the plan has a specific kind of format in the Mask field.
character in a specific position (e.g., the last character of the policy number is a letter), the Mask field allows you to enter an outline for the system to follow.
0 indicates numeric characters only (0 – 9)
X indicates alpha characters only (a – z, A – Z)
A indicates alphanumeric characters
(0 – 9, a – z, A – Z)
TIP | You only need to specify each character if the character is in a particular position.
For example, ABC Insurance Plan has policy numbers where the first two characters are the patient’s birth year (numeric) and the third character of the policy number is the first letter of the patient’s last name (alpha). The remainder of the policy number could be letters or numbers (alphanumeric).
To have MicroMD PM verify policy numbers and make sure their staff enter correct numbers right from the start, Advanced Family Practice typed 00XA in the Mask field.
6. Click the Finish button to save your changes.
7. Save the changes to the plan.
ENTER THE PAYMENT SCHEDULE FOR THE PLAN
Insurance plans provide schedules for the percentages they pay on certain groups of procedures (e.g., 80% of the patient’s medical expenses, 75% of their surgical expense, 80% of anesthesia charges, etc.). The system can use that information to help automatically calculate the amount in the Paid column of the green Payment Calculation – Primary Insurance Plan window.
Once staff members enter an amount in the Allowed column of this payment window, the system automatically calculates the percentage of that amount that the insurance pays (in the Paid column) and the percentage for which the patient is responsible (in the Co‐Ins column).
TIP | On the Coverage Classes tab under Setup > System Classes/ Categories, you can indicate which Coverage Classes you want to appear for every new plan you create. Then you can remove or add to the list. 6.10
Enter the Payment Schedule for the Plan
Insurance Plans
To enter a payment schedule for this plan:
Procedure
Details
1. Click the New icon on the Task Pane.
1. From the Coverage Class drop‐down, select the group of procedures to which this entry pertains.
1. Enter the percentage of the allowed amount that the plan pays for procedures in this class.
1. Click the Save icon on the Task Pane.
SPECIFY CAPITATED PROCEDURES FOR THE PLAN
The Capitation Procs tab for a plan allows the practice to indicate all procedures this carrier considers capitated.
INDICATE PROCEDURES REQUIRING PRE-CERTIFICATION
If the insurance carrier requires pre‐certification for a number of procedures or they will deny those claims, you can enter those procedures on the PreCert Procs tab. When staff members create a new appointment for a patient and enter one of these procedures in the Procedure field of the Appointment window, the system displays an alert message for the staff member to call for pre‐certification.
Figure 6‐3 Pre‐Certification Alert on Appointment Window
To add a new code to the PreCert Procs tab, click the New icon on the Task Pane, enter the procedure code in the Procedure column and save your changes. The system displays the procedure’s description automatically.
IDS TAB
The IDs tab in the Plan Detail window houses several types of identification numbers and information needed for submitting electronic claims and paper claims to this carrier. Specify Capitated Procedures for the Plan
6.11
Insurance Plans
Figure 6‐4 IDs Tab on Plan Detail Window
On the Plan Detail window, under the IDs tab, we have added a checkbox (shown above). If this plan requires the use of ICD‐9 codes after the changeover date of October 1, 2015, place a check in this checkbox. This will override the automatic date‐driven changeover to ICD‐10.
Fields Available on the IDs Tab:
Field
Description
Claims Processing Information
Plan Practice ID
For a new system, this field is generally not used. For an existing system, the Plan Practice ID field may contain the identification number assigned by the insurance company to the practice to include on the claim form. Payer Type
This is a carrier‐assigned value. These values include BNC (Blanket No Card), NC (No Card), and C (Card). These are required values for clearinghouses and insurance carriers to effectively process claims. The system completes this field automatically when you complete the Payor Id field on this tab based on the Type column for the ID on the payer ID Search window.
6.12
IDs Tab
Insurance Plans
Payer ID and Qualifier
Enter the plan’s identification number (typically a five‐digit number found on the list supplied by the clearinghouse you use). This identification number is a carrier‐assigned value that identifies the insurance company in the electronic claim file. This allows clearinghouses or the insurance carriers themselves effectively process the claim. You must also indicate the type of number used for the Payer ID field. Select the type of number from the Qualifier drop‐down list. Typically, the carrier provides this information.
If you know the payer ID for this insurance plan and this entry is in the list, you can type it into this field, and the system enters information in the Payer Type and Claim Office ID fields automatically.
If you do not know the payer ID for this insurance plan, the Payer ID field is a search field where you can double‐click the field to access the Search window. You could also type in full or partial payer names, including the wildcard characters (% and _) if you want to use them to access the payer Search window.
From the Search window, you have several options:
 You can select the correct payer ID from the existing list and click the green check mark to accept your selection.
 You can add a new entry to the list manually. Click the Insert button. Enter the name of the payer in the Payer Name column, the ID in the Payer column, and the payer type in the Type column. Click the green check mark to accept and save you addition.
 You can remove a payer ID from the list. Highlight the row and click the Delete button.
 You can also import a list of payer IDs into the system. There are some requirements for the import file:
• The import file must be a tab‐delimited text file with four entries: key number, payer name, payer id, and payer type.
• The payer name cannot be longer than 40 characters.
• There must be more than one entry in the file.
• You must place that text file on the server in the database path (typically c:\medical on the server’s machine)
IDs Tab
• You must name that file envoy_list.txt. The system looks for a file with this name to import. 6.13
Click the Load button to remove the old list and replace it with the new list. Or you can click the Update button to update the existing list with only new entries in the envoy list.txt file. This compares the entries in the text file with the Insurance Plans
Claim Office Id
This is a carrier‐assigned value, if they require one. The Claim Office ID is a code that identifies which claims processing center to which the carrier should route this claim file once they receive it. The system completes this field automatically when you complete the Payor Id field on this tab. For most payers, there is no requirement, and the system enters NOCD in this field by default. You can change this value if needed.
Org Name (1000B) and Org Id (1000B)
If this insurance plan requires other than the normal receiver information in the ANSI claim file when batching by plan, you can specify the information for the 1000B loop of the ANSI claim file. Enter this information in the Org Name (1000B) and Org ID (1000B) fields if needed. The system uses these numbers if there is a check mark in the Batch by Plan checkbox on the EB Setup window.
Policy Qual
Select the default for the Policy Qual drop‐down list for this plan on the patient’s Plan Sets tab. You can change this value per patient if needed. The system includes this information in the ANSI claim file only if there is a check mark in the Batch by Plan checkbox on the EB Setup window.
NOTE | When you change the Policy Qual field on this tab, the system prompts you to update this field for all patients. You cannot undo this action.
Referral Taxonomy
In ANSI 4010 837P claims, a check mark here creates a REF segment with the Taxonomy in the referring doctor loop 2310A.
Medigap Id
If applicable, enter the Medicare‐assigned five‐digit number the system should include on the primary paper claim or in the electronic claim file to Medicare. This ID number identifies the carrier to whom Medicare should forward the secondary insurance claim for further processing. If there is no number present, the system uses the number in the Payer ID field.
On the patient’s Plan Sets tab, verify there is a check mark in the Assign Benefits box for the secondary carrier to which Medicare is forwarding the claim.
NOTE | If you need more information about submitting a Medigap number to Medicare, please contact your local authorized reseller.
Plan Code
Primarily used by Blue Shield carriers, the plan code identifies who should receive the electronic claim file. This facilitates forwarding claims to the proper company. Enter this number if provided by your insurance carrier.
NAIC Code and NAIC The NAIC Code identifies this insurance plan to Pennsylvania Blue Shield out of the multitude of electronic insurance claims accepted by the carrier. Often, a Suffix
suffix code is also part of this identifier, and you should enter that additional code in the NAIC Suffix field. The insurance carrier provides both of these numbers.
Insured Address
When billing a claim to this plan for a patient who is not the insured and this plan requires the address of the insured party on the claim (rather than just the patient’s), check the Insured Address checkbox. Uncheck to exclude the information.
Insured Policy
When billing a claim to this plan for a patient who is not the insured and this plan requires the insured’s policy number in the claim file, check the Insured Policy checkbox. Uncheck to exclude the information.
6.14
IDs Tab
Insurance Plans
Insurance Type
Select the appropriate code to identify the type of insurance policy this carrier typically offers. The electronic claim file requires this code. Your support team has the appropriate documentation to help you with your plan.
NOTE | When you change the Insurance Type field on this tab, the system prompts you to update the Ins Type Code field for all patients. You cannot undo this action.
Emdeon 2310D
Check this box to replace rendering provider information in the claim file to Emdeon in loop 2310D with the service facility information instead (from the 2420C loop). This is for Emdeon claims only.
Eligibility and Claim Status Information
Status Payer ID, These fields are used for MicroMD ECM. Please refer to that module’s Qualifier, and Status documentation for more detailed information about their use. Basically, these Form Type
fields tell the system what payer ID to include in the electronic claim status request file, what type of number was used, and the form type to use when sending the request. These are required fields to submit requests.
Eligibility Payer ID, Qualifier, Elig Form Type, and Provider ID
These fields are used for MicroMD ECM. Please refer to that module’s documentation for more detailed information about their use. Basically, these fields tell the system what payer ID to include in the electronic eligibility request file, what type of number was used, and the form type to use when sending the request. These are required fields to submit requests.
From the Provider ID drop‐down, practices can select which type of identification number the plan requires for the electronic eligibility files. The system defaults to the provider’s federal ID number since this is what most carriers require.
ANSI fields for electronic billing
IDs Tab
6.15
Insurance Plans
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Encounter Rate Remittance Processing Information Encounter Rate Remittance Processing Place a check mark in this checkbox to activate encounter‐based remittance processing for AutoPayment Posting. Confirm that you placed a check mark in the Encounter Rate Posting checkbox on the Billing Preferences tab (under Setup > Practice Preferences) and entered the correct code in the Adjust to Writeoff Code field. Remittance Code (s)
This field appears when the Encounter Rate Remittance Processing checkbox has been checked. Enter the remittance codes that contain the payment and adjudication information for the plan.
The system looks for these codes when reading the files for processing. The claims containing these codes are reviewed and processed with the proper write‐offs. Others are marked as Not To Be Processed in the AutoPayment Posting window. 6.16
IDs Tab
Insurance Plans
Partial Pmt Status Reset When this field is unchecked, the system withholds unaddressed claims and leaves them in the Processed status. This is used when receiving a partial payment in the AutoPayment Posting Module.
For example, you know the remit file from ABC Insurance separates each item in a sequence into individual claims, and some of the claims will not be addressed in the file because the carrier will pay them at a later time. You do not want the system to automatically send a claim back to the carrier for those unaddressed items. You remove the check mark from the Partial Pmt Status Reset checkbox and the system will leave them in the status of Processed until you receive payment.
Ignore Sec. Writeoff
Organization Override
Because some insurances require the sending of organization details in claim data, an Organization Override has been added.
ALLOWED AMOUNTS FOR THE PLAN
When you learned about procedures, you learned about storing and tracking the allowed amounts across all plans for a procedure. The information on the Procs Allowed tab is directly linked to the Plan Allowed tab on the Procedure Detail window. When the system updates one tab, it automatically updates the other. The difference between the two tabs is the Procs Allowed tab here on the Plan Detail window displays the procedures per provider for the plan, and the Plan Allowed tab on the Procedure Detail window displays the plans per provider for the procedure.
NOTE | For more details on updating this tab while posting payments, please refer to the section about the green Payment Calculation – Primary Insurance Plan window.
To enter a procedure to this tab manually, click the New icon n the Task Pane, select the appropriate provider(s), procedure, modifiers, amounts and save the changes. If the amounts apply to all providers in the system, select (ALL) from the Provider drop‐down list.
Plan Detail (Procs Allowed Tab) Fields:
Field
Description
Effective
The system can archive a payment profile by plan(s) or Insurance Class(es) while maintaining a current profile with an effective date. The options at the top of the tab allow you to view either profile in the system. Proc
This column displays the procedure for which the system recorded the contracted and allowed amounts for this plan and for the provider indicated. This allows the system to record different allowed amounts for different providers for different procedure codes for the same insurance plan.
If entering an allowed amount manually, enter the procedure code in this column. The system displays a search window if the code you entered is not unique in the system. Remember that you can use the wildcard characters % and _ to search.
Allowed Amounts for the Plan
6.17
Insurance Plans
Description
This column only displays the description of the procedure code listed in the Proc column. It is not an editable field.
POS
This column displays the place‐of‐service code posted for the procedure in the Proc column when the system recorded the initial Contracted amount. If staff members post this same procedure to the same provider for this plan but with a different POS, the system creates another entry on this tab.
M1, M2, M3, and M4
These columns display the modifiers posted for this procedure when the system recorded the initial Contracted amount. If staff members post this same procedure to the same provider but with a different modifier or order of modifiers, the system creates another entry on this tab.
Contracted
This field displays the contracted amount recorded that was agreed upon with the insurance plan for the indicated procedure and provider. This amount displays on the green Payment Calculation – Primary Insurance Plan window for informational purposes only and cannot be changed. This amount does not change as the system updates the amount in the Allowed column. If you don’t actually enter anything on this tab, the system takes the first allowed amount posted as the procedure’s contracted amount. Fee
There may be times when a practice needs to charge a different fee for a procedure based on the modifier posted with it. This Fee field allows you to set that up.
Create a new line with provider, procedure, place of service, modifier, contracted amount, the fee and the allowed amount. Remember that these fields are linked directly to the fields on the Plan Allowed tab of the Procedure Detail window.
When a staff member posts this procedure code to a patient whose active primary plan is one of the plans indicated on this tab, for the provider indicated, and for the modifier listed, the fee listed appears instead of the standard fee listed on the Procedure tab or the Charges tab of the Procedure Detail window.
NOTE | This amount is stored with the first provider for whom you posted payments (if you chose (ALL) for the provider). When you post payments for the next provider, the system simply stores the contracted and allowed amounts for that provider on his/her line for that procedure.
Allowed
This field displays the latest amount the insurance company allowed for the indicated procedure for the provider indicated, if there was a check mark in the Update column of the green Payment Calculation – Primary Insurance Plan window the last time payments were posted. While this column updates, the Contracted column remains the same.
Paid
This column displays the latest amount the carrier paid on the indicated procedure for the provider indicated, if there was a check mark in the Update column of the green Payment Calculation – Primary Insurance Plan window the last time payments were posted. While this column updates, the Contracted column remains the same. Use the horizontal scrollbar at the bottom of the window to view this column.
6.18
Allowed Amounts for the Plan
Insurance Plans
PROVIDER CREDENTIALS
The Provider Credentials tab lists the provider’s eligibility to submit their services to this insurance plan for payment. It is not necessary to include a provider on this tab if the provider is credentialed with the plan unless a message is needed when scheduling appointments or posting charges. By default, any provider not included on this list is Allowed, and no message appears when scheduling appointments for this provider.
If the provider is not approved to provide services for this plan or is close to approval, you can communicate this status with the staff using MicroMD PM. Users receive a warning when attempting to make appointments or post charges for the provider with information on this tab. This warning message contains the text entered in the Message field. NOTE | You also have the option of entering a provider’s credentials for all plans within an Insurance Class. To add a provider to this tab, click the New icon on the Task Pane, select the provider from the drop‐down list and select their status with the insurance plan. Type the alert message you need to display to the staff for this provider and save your changes.
Fields Available on the Provider Credentials Tab:
Field
Description
Provider
Select the provider who is either eligible with special requirements or ineligible to submit their services for payment. You can also indicate providers who are pending authorization with a plan.
For example, Dr. Kumar is in the process of enrolling with ABC Insurance. The staff making appointments or posting charges need to know the status of this provider with this plan. Select Dr. Kumar from the Provider drop‐down list and any staff making appointments or posting charges for this provider for patients with ABC Insurance receive the warning you specify.
Status
You have the ability to warn staff members that a physician is not fully credentialed with this plan and the level of that authorization. These warnings appear on the screen for staff that are scheduling appointments and those posting charges. There are two options available:
 Allowed: Select this option to display the text entered in the Message field and then permit the users to continue scheduling the patient’s appointment with that provider or to continue posting charges for that provider.
 Not Allowed: Select this option to display the text entered in the Message field. The staff are then prohibited from saving the appointment or charges under the current provider. They do have the option to select a different provider and then continue their tasks.
Provider Credentials
6.19
Insurance Plans
Message
Enter the text that you want the system to display in the warning message for this entry (a maximum of 100 characters). This warning message appears when a staff member attempts to schedule an appointment or post charges for this provider for this plan.
You should enter text in the Message field when making an entry on this tab. If you create an entry but do not enter text, the user receives a warning message that displays the text “unspecified warning” for those that have Allowed in the Status drop‐down list and “Unspecified error” for those that have Not Allowed in the Status drop‐down list.
CROSSCODE MESSAGES—COMBINATIONS ALLOWED WITH THIS PLAN
CrossCode Messages enable the practice to communicate with the staff when they post a specific diagnosis/procedure code combination for this plan. The communication appears in a pop‐up message box and indicates if the staff member can or cannot continue posting the code combination.
TIP | If there is an insurance carrier who continues to deny claims because of a diagnosis/procedure combination, enter that combination on the plan’s CrossCode Messages tab.
The following steps explain how to create a CrossCode message for a plan for a specific diagnosis/ procedure combination.
Procedure
Details
1. Select Maint > Plan from the main menu.
You can also click the Plan button on the Launch Pane, if available.
The Plan List window opens.
2. Double‐click on the appropriate plan.
The Plan Detail window appears.
3. Select the CrossCode Messages tab.
4. Click the New icon on the Task Pane.
5. Type the appropriate diagnosis code into This is the diagnosis code you want to link to the procedure selected in the Proc column.
the Diag column.
6. Type the appropriate diagnosis code into The system completes the Proc Desc field automatically once you select the procedure code.
the Proc column.
The Proc column is a search field so you can search for the item either by the code or description. Remember that you can also use the wildcard characters (% or _ ).
TIP | If you need to allow only a few diagnosis/ procedure combinations and disallow all others in the system, enter those few and then create another entry with ALL in both the Diag and Proc columns. Make this entry Not Allowed.
6.20
CrossCode Messages—Combinations Allowed with This Plan
Insurance Plans
7. Use the Status drop‐down list to indicate Choose Allowed to permit the staff members that whether users can post the combination receive this warning to continue posting the diagnosis/
procedure combination for this plan. The Message for this plan.
field helps you communicate with the staff any information they need about this combination. If there is no text in this column, the system does not display a message box.
Choose Not Allowed to prohibit the staff member from posting the diagnosis/procedure combination for this plan. The Message field helps you communicate with the staff.
8. Type the text for the warning box in the Message field.
This message appears as the warning when staff member attempt to post the indicated diagnosis/
procedure combination for the plan. The maximum length in the Message field is 100 characters.
9. Repeat steps 4 through 8 for each diagnosis that requires a warning.
10. Click the Save icon on the Task Pane.
REFER DR. TAB
This tab relates to the Enhanced Referral Module. MISCELLANEOUS TAB
Enter additional plan contact information in the following fields of the Misc tab:
Fields available on the Misc Tab:
Field
Description
E‐Mail Address
Enter the e‐mail address for your main contact with this insurance plan, if available. Remember that you can double‐click this field and launch your e‐mail program with the message already addressed with this address. Web Site Address
Enter this plan’s internet address or other frequently used web site, if available. If a staff member double‐clicks this field, the system launches the default browser with this address. Note
Enter any notes regarding this insurance plan. This is for informational purposes and does not print anywhere.
RECORD ADDITIONAL CONTACTS
If you have additional contact information that you want to record for this carrier, you can do so on the Contacts tab. This window allows you to enter as much or as little information as you need about the contact. To view details about a contact, highlight the contact in the upper portion of the window. The Contact Information section in the bottom portion of the window changes to reflect that contact’s Refer Dr. Tab
6.21
Insurance Plans
details. Click the New icon on the Task Pane to add a contact to your list. Remember to save your changes.
Figure 6‐5 Phone Fields
Simply click to the right of the label to access the drop‐down list. The system displays a check mark next to the phone number field labels that you have already used to store a number for this contact. Any label without a check mark is an empty slot. Select the label you want to use and enter you number.
NOTE | Changing a label only changes the label for that contact.
PLAN COPY UTILITY
If you need to create similar plans in the system, the Plan Copy Utility allows you to copy information between plans. This makes it less time‐consuming when creating new plans in the system with the exact same information. For example, consider a case where many different AETNA plans exist. You can create one AETNA plan and then copy that information to help create all of the other AETNA plans.
To create a new plan from an existing plan:
Procedure
Details
1. Select Maint > Plan from the main menu.
You can also click the Plan button on the Launch Pane, if available.
The Plan List window opens.
2. Highlight the plan from which you want to copy information.
6.22
Plan Copy Utility
Insurance Plans
3. Click the Copy Plan icon on the Task Pane.
The Plan Copy Utility window appears.
4. In the To drop‐down list, leave the default selection at (ALL).
If you have an existing plan to which you want to copy information, you can select that plan from the To drop‐down list, and the system edits the plan appropriately.
5. Check the option in the Information Selection The system will copy the information selected in the Information Selection section to the plan section for each aspect of the existing plan selected in the To drop‐down list.
that you would like to copy.
All other tabs in the new plan must be manually updated to reflect the correct information.
6. Click the Copy button to accept the options and create the new plan.
STOP | When the new Plan Detail window appears, the name of the existing plan appears as the plan name. Remember to edit this field as appropriate to distinguish the new plan from the existing one.
7. Make any modifications to the new entry as needed, including changing the plan name.
8. Click the Save icon.
DELETING PLANS
If you no longer need a plan in your system, you can delete the plan. However, if there are patients in the system with this plan listed on their Plan Sets tab, MicroMD PM prevents you from deleting the plan and provides you with the option of printing a list of those patients so you can remove the plan from their account. STOP | This list of patients contains only those patients in your practice with the plan listed on their Plan Sets tab. If there are multiple practices in your database with this plan associated with any of their patients, you cannot delete the plan.
Deleting Plans
6.23
Insurance Plans
To delete a plan from the system:
Procedure
Details
1. Select Maint > Plan from the main menu.
You can also click the Plan button on the Launch Pane, if available.
The Plan List window opens.
2. Double‐click on the appropriate plan.
The Plan Detail window appears.
3. Click the Delete icon on the Task Pane.
If there are no patients with this plan, the system deletes the entry.
4. If there are patients with this plan in your practice, click OK to print a list of those patients.
You can do a few things with this list in the system.
If you would like to send a letter to all of these patients, you can create a patient mail merge letter (and label document) using the Create Mail Merge Documents utility. Then select Reports > Correspondence/ Letters > Patient Letters. You can enter the patients from this list quickly using the Patient Selection window and then print letters and labels. If you want to call all of these patients, you can use the same report to generate a call list. There is no need to create the mail merge letter if all you want is a call list. Just enter the patient names in the Patient Selection window as before and click the Print icon on the Task Pane.
THE PLAN LIST REPORT
The Plan List report will show all of the plans currently in your system. New to this report is the ability to group the plan report results by ICD type. Under the Choose From section, there is a new radio button called ICD Type. If this button is checked, a new check box option under the Group By section will appear called ICD Type. If this box is checked, the report will group by ICD type.
6.24
The Plan List Report
Insurance Plans
Figure 6‐6 Group by ICD options on the Plan List Report
The Plan List Report
6.25
OTHER NECESSARY DATA FOR SETUP
The other data you need to enter into the database concerns service facilities, employers and ZIP codes. If the physicians listed in the database for any practice visit nursing homes or hospitals, or they go out on house calls, the system needs this information to help you process your insurance claims accurately and to provide important information in the Hospital Rounds Module.
You may have quite a few patients that work with the same company in your area. These patients probably have the same insurance plans. If you create an employer in the system and associate the correct plans to that employer, MicroMD PM will alert staff members when they add a plan to a patient’s account who works at that company. This helps ensure that there is no “guesswork” for the user.
The system comes with thousands of ZIP codes in the database already. However, down the road a decade or two, you may need to add or delete ZIP codes from the system—easily accomplished in the system.
IN THIS CHAPTER
In this chapter, we cover how to:
 Create and maintain the list of service facilities
 Create and maintain the list of patients’ employers
 Create and maintain the list of ZIP codes in the system
SERVICE FACILITY
Service facilities are those hospitals, nursing homes, and other facilities where providers in the practice typically perform out‐of‐office services. Different branches of the practice (e.g., one office in Rock City and the other in Orange County) are LOCATIONS, while places where the physicians perform out‐of‐
office services (e.g., Mr. Smith’s home, Westview Regional Hospital) are SERVICE FACILITIES.
TIP | If an insurance carrier requires information in Box 32 of the CMS 1500 claim form for all of your claims, you can create a service facility for office locations and assign that service facility when posting charges. This list of service facilities is common to all practices in the database. For those patients at nursing homes or other facilities, the practice can set the patient’s service facility on the patient’s Plan Sets tab (on their Patient Detail window). When posting charges to this patient, the Service Facility field defaults from this window. When adding and maintaining service facilities in your database, the system uses the Service Facility Detail window to house much of the information. In This Chapter 7.1
Other Necessary Data for Setup
Figure 7‐1 Service Facility Detail Window
Add a Facility to the Database:
Procedure
Details
1. Select Maint > Service Facility from the main menu.
The Service Facility List opens.
2. Click the New icon on the Task Pane.
A blank Service Facility Detail opens.
3. Enter the appropriate information for this service facility
4. Click the Save icon on the Task Pane.
7.2
Service Facility
Other Necessary Data for Setup
Service Facility Detail (Detail Tab) Fields:
Field
Description
ID
This is a unique internal database number assigned by the system when you save a new entry.
Facility Type
Select the kind of facility represented by this entry. The following options are available:
 IP – Hosp: Choose this option for those facilities that are primarily in‐patient hospitals.
 IP/OP – Hosp: Choose this option for those hospital facilities that perform both in‐patient and outpatient services.
 NH: Choose this option for a nursing home facility.
 OP – Hosp: Choose this option for those hospital facilities that only perform outpatient hospital services.
 Other: Choose this option for all other facilities you create in the system (e.g., house calls, treatment centers)
Name
Enter a useful name or description for the facility this entry represents.
Address and ZIP Code
Enter up to two lines for the facility’s address and enter the ZIP code. The city and state display automatically when the user enters a unique ZIP code.
Phone, Alt Phone, and Other Phone
Users may enter a seven‐digit phone. Type an X followed by up to a four‐
digit extension. Do not use parentheses, spaces, or hyphens. Enter an area code, if applicable.
Fax
Users may enter a seven‐digit facsimile number. Enter an area code, if applicable.
Web Site Address
Enter the facility’s web site address, if applicable. Users can then double‐
click on this field to launch their default internet program and view the address entered in this field.
Web Site Sched.
Enter the facility’s scheduling web site, if applicable. The scheduling web site typically is a secure site.
E‐Mail Address
Enter the facility’s e‐mail address, if applicable, or a contact person’s e‐mail address. Users can then double‐click on this field to open a new e‐mail message to this address using the default e‐mail program.
Mammo. Cert
Enter the facility’s Mammography Certification number assigned to the mammography machine, if applicable, for submitting claims to insurance companies.
NPI
Enter this service facility’s NPI number provided by the insurance carrier.
Service Facility
7.3
Other Necessary Data for Setup
CMS Location
Select the appropriate CMS location. The system pulls the list of these locations from the data files downloaded from Medicare and included in the system’s database. This information is used in RBRVS reporting. Default POS
To set the default place of service code for all charges posted for a certain facility, select that code from this drop‐down. When this facility appears on the Charges window when billers post charges, the system automatically changes the choice in the POS column for all procedures to this POS code.
For example, anyone that lives at the South Avenue Skilled Nursing facility would have the majority of their charges posted with a POS of 31 – SKILLED NURSING FAC. However, that is not true for all of Advanced Family Practice’s patients. Specifying the default place of service for the South Avenue facility as 31 allows them to take some of the human error out of the billing equation.
Field 1
Field 2
These five fields allow the practice to create a storage place for some unique information related to the facility.
Field 4
The system generates this list from the entries made for other facilities. You have the option to select an entry from the drop‐down list or create a new one. The practice can also customize the labels for these fields:
Field 5
1. Click the User‐Field Label icon on the Task Pane.
Field 3
2. Enter up to 15 characters for each label (e.g., Hobbies, Birthday, Holiday Gift).
3. Click the Accept button.
Enter a Facility’s Insurance ID
This facility could have different insurance IDs assigned by different classes of insurance plans. For example, Anthem could assign one number while Medicare assigns a different number for claims submitted for services rendered at the same facility. The ID tab allows you to specify those different identification numbers. If specified, this information prints in the appropriate position on the claim form.
To add an item to this tab, click the New icon on the Task Pane, enter the information and save the changes.
Service Facility Detail (Insurance ID Tab) Fields:
Field
Description
Insurance Class
Select the Insurance Class of plans for which the insurance identification number entered in the Facility Insurance ID column applies. Facility Insurance ID
Enter the insurance ID assigned to the service facility by the Insurance Class.
Qualifier
Enter the ANSI qualifier for the electronic claim file that indicates to the insurance companies the kind of ID number used. For example, the number used could be a state license number, an employer ID, a provider commercial ID, etc.
7.4
Service Facility
Other Necessary Data for Setup
Add the List of Care Units to the Facility
In a service facility, there are typically different areas of the facility in which a provider can render services, such as the Intensive Care Unit (ICU) or Critical Care Unit (CCU) of a hospital. The Unit tab allows the practice to enter a list of those areas to use for the Unit drop‐down list on the Hospital Rounds detail window.
To add a unit to this list, click the New icon on the Task Pane, enter the description and save the changes.
Service Facility Detail (Unit Tab) Fields:
Field
Description
ID
This is a system‐generated unique number assigned to this service facility unit once the user saves the entry.
Description
Enter a useful description of this area of the service facility (e.g., ICU, North Wing, South Wing, Surgery, etc.).
Record Additional Contact Information
If you have additional contact information that you want to record for this service facility, you can do so on the Contacts tab. This tab on the Service Facility Detail window works just like the one on the Plan Detail window. EMPLOYERS
Patients typically have their insurance plans through their employer or the employer of a spouse. Practices can enter a list of common employers and the plans associated with that employer. When a staff member adds a new plan to a patient’s Plan Sets tab and they have the employer specified on the Detail tab, the system displays the list of the employer’s plans. The staff can choose to use one of these plans or enter a different plan.
Figure 7‐2 Employer Detail Window
Employers
7.5
Other Necessary Data for Setup
Once employers are added to the system, they appear in the Employer List window. This list is common to all practices in the current database and is useful if you have many patients from one place of employment. The employer prints on the claim form, if indicated. NOTE | The Employer Module is also used for third parties associated with a patient’s case. To add an employer to the database:
Procedure
Details
1. Select Maint > Employer from the main menu.
You can also click the Employer button on the Launch Pane if available. The Employer List window opens.
2. Click the New icon on the Task Pane.
A blank Employer Detail opens.
3. Click the Save icon on the Task Pane.
Fields on the Employer Detail Window:
Field
Description
Employer Tab
ID
This is a system‐generated unique number assigned to this employer once the user saves the entry.
Record Type
The system uses the Employer List for all of your third parties that might be involved with patient cases, including attorneys. In order to do this, each of the entries in the employer table must have an identifier. The system already has the choices of E – Employer or A – Attorney you can use to identify new entries. The system defaults this drop‐down to E – Employer, so unless you need to identify the record as a party other than an employer, you can leave this as it is.
Name
Enter a useful name for this employer. This information prints on the claim form if specified by the carrier’s official requirements.
Address and ZIP Code
Enter up to two lines for the facility’s address and enter the ZIP code. The city and state display automatically when the user enters a unique ZIP code.
Phone, Alt Phone, Fax
Users may enter a seven‐digit phone. Type an X followed by up to a four‐digit extension. Do not use parentheses, spaces, or hyphens. Enter an area code, if applicable.
E‐mail Address
Enter the facility’s e‐mail address, if applicable, or the e‐mail address of the person listed in the Contact field. Users can then double‐click on this field to open a new e‐mail message to this address using the default e‐mail program.
Contact
Enter the name of the contact person for this employer. To record additional contact information for this employer, click the Contacts tab and enter the additional contacts.
7.6
Employers
Other Necessary Data for Setup
Plans Tab
Plan ID
The user can either enter a plan ID or the name of the plan. Partially entered descriptions bring a up a search list. Users can also use the wild card characters to find the correct plan (% or _). Plan Name
This field displays the name of the corresponding plan once the user completes the Plan ID field.
Contacts Tab
The Contacts tab on the Employer Detail window works the same as the one on the Plan Detail window. ZIP CODES
The system comes preloaded with nearly 35,000 ZIP codes. ZIP code fields throughout the program are lookup fields. When a user enters the five‐digit ZIP code in a ZIP code field, the system automatically displays the appropriate city and state associated with that ZIP code. If a user only knows the city, they can type in all or part of the city name, and MicroMD PM displays a list of matches from the database.
It is possible to have multiple cities assigned to the same ZIP code. For example, a ZIP code of 44512 causes the sytem to prompt you to choose BOARDMAN, S. BOARDMAN, or YOUNGSTOWN.
Adding ZIP Codes to the System
If you need to add a ZIP code to the system, use the following procedure:
Procedure
Details
1. Select Maint > ZIP Code from the main menu.
The ZIP Code window opens.
2. Click the New icon on the Task Pane.
A blank line appears under the column headers.
3. Complete the ZIP Code, City and State fields.
TIP | Users can add a new ZIP code while working in another module. For example, if they enter a ZIP code that is not in the system in the Patient Detail window, the ZIP Code window opens automatically and the user can add the new ZIP code right away.
4. Click the Save icon on the Task Pane.
Country Codes
For those practices that border either Canada or Mexico, the system allows you to create appropriate postal codes in the system. The system also allows you to enter an alphanumeric code if necessary, to help accommodate those unique postal codes. You must first build the list of countries that you need to associate with ZIP codes in your database. You do so using the Master Table Setup. Be sure to select Country from the drop‐down list.
Once you have the country codes you need in the system, you can simply select the appropriate code from the Country drop‐down. Select Maint > ZIP Code from the main menu. Either create a new ZIP code ZIP Codes
7.7
Other Necessary Data for Setup
and select the appropriate country code from the Country drop‐down, or edit an existing ZIP code appropriately.
Figure 7‐3 Country Drop‐down List
Deleting ZIP Codes
There may be different descriptions for the same ZIP code in MicroMD PM, resulting in two or more entries in the system for the same ZIP code (e.g., the system prompts the user to choose BOARDMAN, SOUTH BOARDMAN, or YOUNGSTOWN when they enter ZIP code 44512). Practices have the ability to delete ZIP codes from MicroMD PM to help remove these duplicate entries. Once you delete an entry, the system warns you if that ZIP code has been used anywhere in the system and allows you to reassign those instances (e.g., patients, plans, providers, etc.) to the correct ZIP code entry.
Procedure
Details
1. Select Maint > ZIP Code from the main menu.
2. Highlight the entry you want to delete.
3. Click the Delete icon on the Task Pane.
4. If there are any references to this ZIP code, the system prompts you with the opportunity to reassign those references. Click Yes to reassign those entries.
NOTE | You must reassign all references before the system permits you to delete the ZIP code from the database.
5. If the system does not prompt you to reassign ZIP code references, proceed to step 10.
6. Enter the ZIP code to which you want to assign The system displays the ZIP Code Search window to help verify that the ZIP code is in the the selected references.
database.
7. Highlight the ZIP with the description to which you want to assign the selected references and click the green check mark button.
7.8
ZIP Codes
Other Necessary Data for Setup
8. Place a check mark next to each item you want TIP | Don’t forget that Select All and Deselect All to reassign to the ZIP code you entered in the buttons can help select or deselect a large quantity of entries.
Reassign ZIP field.
If you want a hard copy of this list, you can print these references by clicking the Print button.
9. Click the Reassign button.
If the Reassign button is not visible, you forgot to accept a ZIP code in the Reassign ZIP field.
10. Click the Close button.
11. Click the Save icon on the Task Pane to save the changes to the database.
ZIP Codes
7.9
PATIENT MODULE
Once you have all the providers, plans, service facilities, etc., in the database, you can easily create patients in your system. It is possible that you have a conversion from a previous software vendor that entered the patient data for you. This chapter also provides information for maintaining your existing patients. Patient lists in the database are practice‐specific. Staff members for other practices cannot view or edit your patients unless you set MicroMD PM up to do so.
IN THIS CHAPTER
In this chapter, we cover how to:
 Create and maintain patient demographic, personal, medical, and account data from one window
 Add insurance information to the patient’s account for processing their claims
 Enter emergency contact information for the patient, along with other important information
 Enter and manage notes about the patient’s account
 Create sub‐accounts
 Edit patient information
 Use other tools available
PATIENT ACCOUNTS IN THE SYSTEM
There are a couple of ways to enter a new patient into the database. You can do so directly from the Patient Module as you are about to learn, or you can create a patient in the database from a temporary patient entry. TIP | Press the Ctrl + F5 keyboard combination from anywhere within the system to display the last Patient Detail window viewed.
Adding a Patient
When a new patient is added, the patient data is entered in the Patient Detail window. Initially, the system only enables the Detail tab. Once you save the information on this tab, and the system has generated and assigned a patient ID, the remaining tabs become available.
In This Chapter 8.1
Patient Module
Figure 8‐1 Patient Detail Window
TIP | Each practice can set several bits of information as defaults for every new patient. NOTE | he Detail tab and the Cases tab of the Patient Detail window have been modified to accept up to twelve (12) diagnosis codes. The top section of the Detail tab includes the patient’s demographic data, as well as basic personal information. The middle section provides management tools for tasks performed throughout the system for the patient and for reporting purposes. The bottom section displays the patient’s billing information. The Reporting Module uses this information for financial reports. The system enters and updates most of the information in the third section automatically. When entering new patients into the system, the 8.2
Patient Accounts in the System
Patient Module
majority of these fields are blank. The information on this window provides immediate access to the patient’s financial data without opening extra modules or windows.
To add a new patient to the system manually:
Procedure
Details
1. Select Maint > Patient from the main menu.
You can also click the Patient button on the Launch Pane, if available.
The Guarantor/Patient List window opens.
2. Click the New icon on the Task Pane.
The Patient Detail window opens.
3. Complete the necessary information in the Patient Detail window.
Many fields in this window encompass more information than just the patient’s demographics. TIP | You can set certain fields as required fields before a staff member can save a patient to the database.
4. Click the Save icon to save this patient.
The system performs a duplicate patient check, based on the social security number, once you save your new patient. If the social security number for this patient matches an existing patient, you will be prompted with the message “SS Number already exists – Save patient record?”
This could happen for any number of reasons. You could have misspelled a patient’s name when you tried to find their account (e.g., Taskar vs. Tasker), or the patient’s name may have changed recently.
Choosing Yes allows you to save a duplicate entry for the patient.
STOP | In most cases, the original patient that the system found with the same social security number is the account you want to use. That account already has activity associated with it.
Choosing No does not save the record, and you can exit without saving. In the example above, you could then search for the patient’s account by their social security number.
In the Patient Log, the system records who created the patient account and when. Click the Patient Log icon on the Task Pane to access this log.
Patient Accounts in the System
8.3
Patient Module
Fields on the Patient Detail Window (Detail Tab):
Field
Description
Address
Patient ID
Once you save a new patient entry (or the system saved the entry during the conversion process), the system assigns an internal patient account number and it cannot be changed. This number makes up part of the account number that MicroMD PM submits on paper claims and in electronic claim files (along with practice and sequence numbers).
Chart No
The system also generates a chart number for the patient, but you can change this number if needed. For a new patient in the system, the chart number is the same as the patient’s ID number with the letter “M” as a prefix. If a data conversion was performed, and an established patient was entered, the Chart No field should reflect the patient identification number in the previous system with the letter “C” as a prefix.
Last Name, First Name, and MI
Enter the patient’s name in these fields as indicated. The Last Name and First Name fields are always required fields for every patient in a system. If you need or want the patient names entered in all capital letters, you can set this requirement on the General Preferences tab under Setup > Practice Preferences.
Title
Choose an appropriate title from the drop‐down list. Create this list on the Title tab under Setup > Miscellaneous Preferences. You can set the default for this field for new patients on the System Preferences tab under Setup > System Preferences.
Address
Enter the patient’s address. There are two parts to the address if you need to enter additional information (perhaps an apartment number or “c/o” information). The first text field is Address 1, and the second text field is Address 2. You can specify the Address 1 field as a required field before a staff member can save a patient to the database. You can indicate this on the General Preferences tab under Setup > Practice Preferences.
Do not enter city and state in these fields. The ZIP code fields handle the city and state information automatically.
ZIP code
Enter the patient’s ZIP code. The system automatically displays the correct city and state based on the ZIP code. The additional four‐digit code is optional. The ZIP code field is a search field. It allows you to enter either a ZIP code or the partial name of a city to find the appropriate ZIP code.
You can set the default for this field for new patients on the General Preferences tab under Setup > Practice Preferences. You can also make this field a required field when staff members create new patient accounts. Place a check mark in the ZIP Code box on the same tab. Additional
Race
Select the race or races with which the patient most closely identifies. Ethnicity
Indicates whether or not the patient is of Hispanic descent.
8.4
Patient Accounts in the System
Patient Module
County
A useful tool for rural health and CHC practices, the County field allows staff members to select the patient’s county of residence. You can build this list of counties specific to your area using the Master Table Setup. Student
If the patient is a college student, select their enrollment status from this drop‐down list. Some insurance carriers require this information on claim forms or in an electronic claim file. Please refer to your carrier’s specifications regarding this information.
Death Date
Enter the date of the patient’s death. When staff members enter a date and tab off the Death Date field, the system performs an appointment scan. The system notifies the user if any future appointments exist for that patient and provides instant access to the patient’s appointment history window. Alias
Enter any alternate names, maiden names or nicknames the patient uses. Staff members can use this field to search for a patient in the database.
Language
Select the language of the patient from the drop‐down.
Occupation
Select the occupation of the patient from the extensive drop‐down list.
Primary Phone #
The main phone number contact of the patient. This can be either Home, Work, Cell or Alternate.
Secondary Phone #
The secondary phone number contact of the patient. This can be either Home, Work, Cell or Alternate.
Demographics
Sex
Enter whether the patient is female or male. You can set the default for this field for new patients on the General Preferences tab under Setup > Practice Preferences.
Home, Work, Alternate, and Cell Enter the patient’s contact phone numbers. The number in the Home field displays in the pop‐up information box in the appointment views. You can make the Home and/or Work phone fields required fields when staff members create new patient accounts. Check the appropriate box on the General Preferences tab under Setup > Practice Preferences. You can set the default area code for new patients created in the system. Staff members can change this on a case‐by‐case basis if needed. Enter the area code on the General Preferences tab under Setup > Practice Preferences.
Marital Status
Select the patient’s marriage status from this drop‐down list.
Patient Accounts in the System
8.5
Patient Module
Social Sec
Enter the patient’s social security number in this field. You can make this field a required field when staff members create new patient accounts. Check the Social Sec box on the General Preferences tab under Setup > Practice Preferences. When staff members save a new patient, the system checks for existing patients with the same social security number to verify that the staff is not duplicating a patient. If the social security number for this patient matches an existing patient, the user receives a prompt that the social security number they entered already exists. They have the option to either save the patient record with the duplicate social security number (click Yes) or to go back to the new record and correct the mistake (click No).
DOB
Enter the patient’s birth date. The system automatically calculates the patient’s age based on today’s system date and the date entered in this field, including days and months for infant patients. When there is a date entered in the patient’s Death Date field, the system stops calculating the patient’s age.
Referring Dr
Enter the physician who referred this patient to your practice. The physician entered in this field appears by default on the patient’s Claim Transactions window. The list of referring physicians can be found under Maint > Referring Doctor.
When staff members enter the physician in the Referring Dr field, the system completes the PCP field automatically with the same provider since most often the primary care physician is the physician that referred this patient to your practice.
PCP
The PCP field contains the patient’s primary care physician and defaults from the Referring Dr field, but staff can change this field, if necessary. The PCP field uses the list of referring physicians. This list of physicians can be found under Maint > Referring Doctor.
The PCP field is for informational purposes only and does not appear on claims. You can include this physician on charge slips, however, provided the user sets the options on the Charge Slip Options window.
Employer ID
8.6
Enter the patient’s employer in the Employer ID field. The system pulls this list from the list created under Maint > Employer. If there are insurance plans created for the employer, the system prompts the staff members with the option to use those plans for this patient. The employer information is required by some insurance carriers to properly process a claim.
Patient Accounts in the System
Patient Module
Category
Patient Categories allow the practice to group patients for various reasons and in different ways throughout the life of the patient’s account. You can use this field in the Reporting Module, pulling out patients within this category for review (see the MicroMD PM Reports Guide for more information on reports). You could also choose to print this category on patient charge slips). For example, Mr. Smith became a patient and his category started off at REGULAR PATIENT. Mr. Smith worked out a budget amount during a time when he had some financial problems, so they changed his category to BUDGET. They used the BUDGET category to review all patients with budget agreements for payment history. You can set the default for new patients on the General Preferences tab under Setup > Practice Preferences.
Provider
Select the patient’s primary provider from the drop‐down list. The practice can set a default provider for new patients entered in the system. The Provider ID drop‐down list on the General Preferences tab under Setup > Practice Preferences sets this default.
TIP | If you set the default to (None), the system forces the staff to select a provider before saving the patient’s record. This is beneficial in a multi‐provider practice to help ensure that staff members select the correct provider for each patient.
The system uses this provider as the patient’s default provider when staff members post charges for this patient when no other provider has been specified. If staff members post charges through the Check In/Check Out Module, the system automatically selects the provider with whom the patient had the appointment. If the Default Provider drop‐down list on the Billing Preferences tab has a specific provider selected, that selection overrides all other choices.
Location
Select the practice location that the patient typically visits. For a practice with only one location or a main location where most of the patients visit, you can set the default for new patients created in the system. Select that location from the Location ID drop‐down list on the General Preferences tab under Setup > Practice Preferences.
TIP | If you set the default to (None), the system forces the staff to select a practice location before saving the patient’s record. This is beneficial in a multi‐location practice to help ensure that staff members select the correct location for each patient.
The system uses this location as the patient’s default location when staff members post charges for this patient when no other location has been specified. If staff members post charges through the Check In/Check Out Module, the system automatically selects the location where the patient had the appointment. If the Default Location drop‐down list on the Billing Preferences tab has a specific location selected, that selection overrides all other choices.
Medical Alert
Enter any allergies or special medical needs a patient may have. You can include this information on the charge slip if the option is chosen on the Charge Slip Options window.
Patient Accounts in the System
8.7
Patient Module
Remarks
Enter any information that may be helpful regarding the patient in this field. For example, Mr. Smith is hard of hearing. Staff entered this information in the Remarks field of his account. Now they know to speak a little louder for him, avoiding any awkward situations.
The system displays this information in posting, billing and appointments. You can also elect to print Remarks information on patient charge slips.
STOP | The Remarks field available in the Patient Detail, appointment, and Billing Inquiry window are linked. Essentially, they are the same field. A change in one module is reflected in the others.
NOTE | Even though the Remarks field can store a vast amount of data, it is not private enough to keep a patient’s medical records. Patient‐sensitive information should be documented on the patient’s Notes tab or in their chart.
E‐mail Address
Enter the patient’s e‐mail address, if available. When a staff member double‐
clicks this field, the system launches their e‐mail program with a new blank message already addressed to this patient’s address.
Creation Date
This field displays the date on which a staff member enter the patient into the system. The system enters this date automatically, but users can change this date if necessary.
TIP | The system tracks who created this patient and when in the patient log. With the Patient Detail window open, click the Patient Log icon on the Task Pane to access the log.
ROI Date
The date in this field is the date the patient signed their release of information form. Staff members must manually enter the date in this field.
Confidential Communication Select the patient’s preference of how the office should contact them with private information.
Education Level
Select the patient’s education level from choices in the drop‐down.
Highest Grade Completed
If the patient is still a student or did not complete school, select the highest grade the patient has completed.
User Fields
8.8
Patient Accounts in the System
Patient Module
User Fields
Each practice in a database has five user‐definable patient fields in the system. These fields allow the practice to track any type of information and generate a Patient Report (under Reports > Reference Codes Listing) based on these five fields.
The system builds the drop‐down lists from the entries made in each patient’s drop‐down list. To edit the labels for these fields, click the User Defined Labels icon on the Task Pane, edit the text in the Label Text column, and click Accept to save the changes.
NOTE | If a staff member edits an entry in the drop‐down list while in a patient’s account and no other patient’s drop‐down list uses this entry, the entry itself changes. If another patient’s drop‐down list uses this item, MicroMD PM adds a new entry to the list.
NOTE | It is also possible to free‐type into user‐defined fields. However, in the Search Argument Report, any free‐typed fields that are being reported on will not be displayed in the report.
Search Argument
Select the Search Argument you want to associate with this patient. These drop‐down lists allow practices to store up to three reporting criteria for each patient to generate unique reporting for data that the system does not normally record.
For example, Advanced Family Practice wants to track each of its patients that have a pacemaker and which company supplied the device. They created a search argument for each of the companies they use to supply pacemakers. Mr. Jones’ pacemaker is from the Acme Medical Devices company. They chose ACME MEDICAL DEVICES CO. from one of Mr. Jones’ Search Argument drop‐down lists. If any recalls for the device were to occur (or any other reason they need to get in touch with patients with this company’s device), they can simply generate a Search Argument report (under Reports > Patient) for ACME MEDICAL DEVICES CO and contact those patients, including Mr. Jones.
NOTE | As with User-defined fields, it is also possible to free‐type into search argument fields. However, in the Search Argument Report, any free‐typed text entered in the Search Argument drop‐downs will not appear in any report.
Billing
Bill / Stmt
Select whether this patient should receive a bill (lists only patient‐responsible sequences) or a statement (lists both patient‐ and insurance‐responsible sequences). Staff members can also indicate that the practice should send no bill or statement to the patient.
You can set the default for new patients on the Billing Preferences tab under Setup > Practice Preferences. Last Bill/Stmt
This field displays the date that the most recent bill or statement for the patient was generated and printed. The system automatically updates this field, but users can change this date if necessary.
Patient Accounts in the System
8.9
Patient Module
Force Stmt
When using Cycle Billing, you can force the system to print a statement or bill for a patient even though the patient is not due to receive one. Check the Force Stmt checkbox. Then, the next time you print statements or bills, the system includes this patient in the list of patients that will receive a mailing. Once the system prints a statement or bill for this patient, the system clears this checkbox. Message and Auto Message
The Message drop‐down field displays the most recent dunning message that a patient has received on their statement or bill. Establish your dunning messages on the Patient Message tab under Setup > Practice Preferences.
The system automatically increments this message when printing statements and bills if there is a check mark in the Auto Message checkbox of the Patient Detail window and you click Yes to the prompt when printing statements or bills. If the Auto box is not checked, you have to manually increment the Message field each time you send a statement or bill to this patient.
NOTE | In general, you should not change the Message drop‐down when you have the Auto field checked.
Personal Msg and Reset Msg
Enter a message that you want to have printed on this patient’s statement or bill in the Personal Msg field. Since this message is patient‐specific, you must manually enter it for each patient. The system clears this message field after it prints the patient’s statement or bill if there is a check mark in the Reset Msg checkbox. This allows you to enter a unique message just for this patient each month, enhancing your communication with the patient.
Total Balance
Apply Fin Chgs
Last Fin Chg and Amount
8.10
This field displays the patient’s total balance, including patient‐ and insurance‐responsible sequences. The system automatically updates this balances as staff members post charges and payments to the account. Users cannot edit this field directly, only by posting charges and payments.
STOP | Be sure you fully understand applying finance charges in the system before you begin using this feature. These fields display the date and total amount of the most recent finance charge applied to this patient’s account. The system updates these fields automatically.
Patient Accounts in the System
Patient Module
Next Payment and Due On
The Next Payment field allows the practice to enter a budget amount for a patient with whom they have arranged to reconcile the balance due. This amount prints on the statement in the Arranged Payment Amount box (the label changes from Please Pay to Arranged Payment Amount when using budget entry). If no amount appears in this field, MicroMD PM reverts to the balance due.
The Due On date is the date upon which the patient and the practice agree that the patient will pay the next arranged amount (entered in the Next Payment field). It is for informational purposes only at this time and only appears on this window.
To activate the use of budget amounts, check the Budget Amounts checkbox on Billing Preferences tab under Setup > Practice Preferences. This displays and enables the Next Payment and Due On fields on the Patient Detail window.
TIP | We recommend changing the patient’s category to a BUDGET category when you enter the budget amount. This allows you to use the Patient Aging report based on this patient category (and in landscape mode). Users can then view the last time the patient made a payment and the amount paid to see if the patient continues to meet their budgeting agreement.
Pre‐Collect
This field displays the last pre‐collection letter that was generated for the patient. This drop‐down list can also be used to change the letter to be sent or to move a patient into the Pre‐Collection Module manually by choosing the Pre‐Collection Pending option. PC Date
This field displays the date that the Pre‐Collect drop‐down list changed and the patient was moved into the indicated pre‐collection status. Collect Date
This field displays the date that the patient’s account was turned over to the practice’s collection agency. The system updates this field automatically when the practice (or the system) changes the patient’s Pre‐Collect drop‐down list to the Collections option. The system updates these fields automatically only when you use the Pre‐Collection Module. Last Visit
Last Visit
This field displays the last date on which the patient had services performed. The system uses the service date of the last charge transaction posted to the patient’s account as the date of their last visit and updates this field automatically.
Last Pat Pmt
These fields display the date and total amount of the most recent payment made by the patient. The system automatically updates both of these fields when staff members post a payment with a bill flag of N.
Last Ins Pmt
These fields display the date and total amount of the most recent insurance payment. The system automatically updates both of these fields when staff members post a payment with a bill flag of Y.
Patient Accounts in the System
8.11
Patient Module
Last ICDs
The system updates these fields automatically from the Posting Module. These are the last eight diagnosis codes posted for the patient, and they display in the Patient Last Diagnosis pop‐up window in the Posting Module. Staff members can also change these codes from this tab if necessary, although it is not recommended.
Deleting a Patient Account
If a person in the database is no longer a patient with your practice, you have the ability to delete their record from the database. However, you cannot delete a patient account with an outstanding balance or sub‐accounts. Once any outstanding balances has cleared, you can delete accounts. If a patient account has sub‐accounts, those sub‐accounts must have no outstanding balances and then must be deleted before deleting the main account.
To delete a patient account:
Procedure
Details
1. Select Maint > Patient from the main menu.
You can also click the Patient button on the Launch Pane or press F5 on the keyboard.
The Guarantor/Patient List window opens.
2. Search for the patient you want to delete.
3. Double‐click the patient account you want to delete.
4. Click the Delete icon on the Task Pane.
The Patient Detail window opens.
NOTE | You need to delete any sub‐accounts first, if there are any, so be sure to select those first.
You can also press the Delete key on the keyboard. 5. Click Yes when prompted to confirm that you want to delete this account.
6. Repeat these steps for any other accounts you want to delete.
Temporary Patients
The system provides practices with the ability to register patients as temporary entries in the database until the practice is ready to commit the patient to a permanent account. Generally, staff members create temporary patients in the Appointment Module when a new patient calls to schedule an appointment. You can create permanent accounts out of a temporary patient entry in a couple of modules, including the Patient Module. However, you are most likely to create the permanent account through the Charges Module.
You can display the list of temporary patients in your practice. Click the Temporary Patients icon on the Task Pane to show the list in a separate list window. If you prefer to view the list in the Guarantor/Patient List window, click the icon again to toggle the list into the list window.
8.12
Patient Accounts in the System
Patient Module
TIP | If you are unable to click the icon, verify that you have the Temporary Patient List box checked under Utility > Workstation Setup > Display Properties.
To make the temporary patient into a permanent account, double‐click the patient’s entry and proceed editing and adding information as you would for any new patient. To delete a temporary patient from this list without saving them to the database, highlight the patient in the Temporary Patient List window and press the Delete key on the keyboard. The system verifies if you would like to delete the current item or all of the items in the list. Make your selection and click Accept.
Patient Sub-Accounts
Creating sub‐accounts is a useful feature when there is more than one patient in a family seen by the practice. This concept is most common with primary care providers and pediatricians, rather than with specialists. Sub‐accounts allow the practice to keep each family member’s account separate, but bill all of the transactions for a family together. You must have done the following before you can use sub‐
accounts:
 You must have main accounts created before attaching any sub‐accounts.
 You must also place a check mark in the Sub‐Account checkbox on the General Preferences tab under Setup > Practice Preferences.
When the sub‐account feature is active, MicroMD PM divides the Guarantor/Patient List window into two sections. The sub‐accounts associated with the selected guarantor account display in the right‐hand section of the window. The main account ends in .0 while any sub‐accounts associated with it end in a non‐zero number (e.g., main account=1001.0, sub‐account=1001.1)
Adding a Sub-Account
When a staff member creates a sub‐account, the system enters much of the information from the main account automatically into the sub‐account’s Patient Detail window—last name, address, and telephone number in the top section and all of the middle section. The bottom section of the window is patient‐specific and completed by the system at the appropriate times. The system also copies the Default Plan Set into the sub‐account, but it does not copy any other plan sets contained in the main account. The system also does not copy information from the Cases tab of the main account, since case information is patient‐specific.
Once a sub‐account is added, staff members can search by either the sub‐account or the main account name. All of the sub‐accounts are associated with the main account name, even if the last names are different.
NOTE | When the Insurance ID of the Guarantor (main account) is changed, the sub‐account will only be updated with the correct Insurance ID if it matches the Insurance ID of the Guarantor.
Patient Accounts in the System
8.13
Patient Module
To create a patient sub‐account:
Procedure
Details
1. Select Maint > Patient from the main menu.
You can also click the Patient button on the Launch Pane or press the F5 key.
The Guarantor/Patient List window opens.
2. Highlight the account of the person to whom you want to add a sub‐account.
3. Click anywhere in the right‐hand side of the window (the Sub‐Account section).
NOTE | This is an important step. Make sure that you have the Sub‐Accounts section of the window active before you create a new patient; otherwise, you will create a new main account.
4. Click the New icon on the Task Pane.
Notice that sub‐account numbers end with an x until the user saves the entry.
5. Edit the information as needed.
6. Click the Save icon on the Task Pane.
Editing Patient Information in Sub-Accounts
Most of the editing in a sub‐account is the same as editing any patient account. However, if the information is based on the main account holder’s information (e.g., default plan set, telephone, address), staff members should make those changes to the main account. The system prompts the staff when they change the information on the main account if they want to make the same change to any sub‐accounts. You can select to update this information for specific sub‐accounts. Simply uncheck the sub‐accounts you do not want to update.
ENTER THE PATIENT’S PLAN INFORMATION
The Plan Sets tab of the Patient Detail window allows you to specify a patient’s insurance information and set up information needed for the submitting the patient’s claims. The system allows unlimited insurance plans for each patient. These plans could be a combination of primary, secondary, and tertiary insurance. Practices can group a patient’s insurance plans into “plan sets.” Grouping insurance plans into sets allows each patient to have more than one primary insurance plan. Staff members can then assign plan sets to cases on the Cases tab.
TIP | Remember that you need to save a new patient’s entry before the system activates all of the tabs in this window.
8.14
Enter the Patient’s Plan Information
Patient Module
Figure 8‐2 Plan Sets Tab on Patient Detail Window
The Plan Sets tab is divided into two panes. The left side lists the plan sets and the individual insurance plans contained in each set. The right side displays the information for the insurance plan selected in the left pane. The system displays the information for one plan at a time. To display the information for an insurance plan, click on the plan in the left pane.
Next to the plan name on the left, the system displays whether each plan is primary (P or p), secondary (S or s) or tertiary (T or t). A capital letter (P, S, T) indicates that the plan is currently active. A lowercase letter (p, s, t) indicates that the plan is not currently active for this patient.
TIP | If a patient is self‐pay, we recommend that you do not complete the plan sets tab for the patient.
You may want to create a Patient Category of SELF PAY for your self‐pay patients. You could also insert a note in the Remarks field for each patient to indicate if the patient is a self‐pay.
TIP | The system also provides the ability for practices to scan patient pictures and insurance cards into the system. Enter the Patient’s Plan Information
8.15
Patient Module
About the System’s Default Plan Set
When you first select the Plan Sets tab, you should notice that there is already one plan set created in the left pane called “default.” The Default Plan Set always appears at the top of the left pane. Users can rename this plan set, and if a user deletes the current Default Plan Set, they can create a new one. The system uses the Default Plan Set in several modules throughout the program:
 When charge slips are created, the Default Plan Set prints at the top of the charge slip.
 When sub‐accounts are created, only the Default Plan Set is added to the sub‐accounts.
 When using batch charging or auto charging, only the Default Plan Set is used.
When there is more than one plan set available, users have the ability to set the default plan set by choosing which plan set to use. The default plan set will be identified by a yellow label box called Default Plan Set. The default plan set will also be at the top of the plan set list.
to set a plan set as default, right‐click on the plan set in the list and choose Set as Default from the menu as shown below.
Figure 8‐3 Setting the default plan set in Patient Demographics
Add Plans to a Plan Set
When you first create a patient, you can begin adding plans to their Default Plan Set right away.
Procedure
Details
1. Right‐click in the left pane and select Add New Plan from the pop‐up menu.
You could also click the New icon on the Task Pane or press the Ctrl + N key combination.
The system automatically selects the appropriate Plan Type from the drop‐down list based on the order the user added plans to the plan set. For example, the second plan entered defaults to Secondary. Users can change this selection if necessary.
8.16
Enter the Patient’s Plan Information
Patient Module
2. Enter the appropriate plan in the Plan ID field.
The Plan ID field is a search field. Staff members can enter the plan’s internal ID number, a full or partial name, or use the wildcard characters (% and _) to search for the correct plan in the system.
NOTE | If you purchased the MicroMD ECM module and the plan entered is capable of electronic eligibility verification, the Eligibility icon is enabled. For more information about using this feature, please refer to that module’s documentation. 3. Select Primary, Secondary, or Tertiary from the Plan Type drop‐down. NOTE | If you select Secondary, you have the option to choose the default MSP (Medicare Secondary Payor) type to populate on the Claim Modification window for Medicare secondary claims.
Place a check mark in the Medicare as Secondary Payer Applies field and select the appropriate default MSP code in the MSP Type Code drop‐
down. If the Ins Type field on the Claim Modification window is blank, the system includes the default code, saving you the trouble of manually inserting the code. If the Ins Type field is already populated, the system does not populate the default code.
4. Enter the patient’s policy number in the Policy field. Select the type of number from the Policy Qualifier drop‐down list.
TIP | If the patient’s social security number is part of the policy number, you may type the letters “SS” in this field and press Enter. The “SS” is substituted with the patient’s social security number.
5. In the Group No field, enter the patient’s insurance group number, if supplied.
6. n the drop‐down, select if the patient uses co‐pay or coinsurance and enter the amount or percentage in the corresponding field. The system completes this field automatically if there is an amount or percentage in the on the Plan Detail window. Staff members can change this per patient if needed. The system displays the patient’s co‐pay amount when staff members post charges. However, coinsurance amounts do not display in the Posting Module. 7. If the provider accepts assignment from this insurance plan, check the Assignment checkbox.
The Assignment checkbox on the Plan Detail window sets the default for the checkbox here. Generally, you do not need to change this on the patient’s Plan Sets tab if set up appropriately in the Plan Module.
Enter the Patient’s Plan Information
8.17
Patient Module
8. If the patient’s payment authorization signature is on file a, check the Assign Benefits checkbox.
If Assign Benefits is checked, the system prints SIGNATURE ON FILE in Box 13 of the CMS 1500 claim form.
The Assigned Benefits checkbox on the Plan Detail window sets the default for the Assign Benefits checkbox here. Staff members can change this per patient if needed.
9. If the patient’s release of information signature is on file with the practice, select Yes from the SOF drop‐down.
If you select Yes in the SOF drop‐down, the system prints SIGNATURE ON FILE in Box 12 of the CMS 1500 claim form. If you select Except from the drop‐down, the system prints SIGNATURE EXCEPTION in Box 12.
10. Enter the active dates of the patient’s The system defaults to the appropriate plan automatically when staff members post charges participation in the plan in the Effective From that fall within the effective date range for the and To fields.
plan.
For example, today is 12/15/2010. Mr. Smith has ABC Insurance Plan as his primary insurance (indicated with a capital “P” right now) with his employer, but he quit his job and that coverage ends on 12/31/2010. His new primary insurance plan is XYZ Group Insurance. Coverage begins on 01/01/2011.
Advanced Family Practice added XYZ Group Insurance (now indicated by a lowercase “p”) to Mr. Smith’s Plan Sets tab. Then they set the Effective To date for ABC Insurance Plan to 12/31/
2010 and the Effective From date for XYZ Group Insurance to 01/01/2011.
Now when staff members post charges on or after 01/01/2011, the system knows to switch primary plans to XYZ Group Insurance without any interaction from the staff, and the correct plan receives the claim.
Patient is the Insured
11. If the insured is the patient, leave the default You are finished adding this plan to the patient’s in the Insured field and click the Save icon on plan set.
the Task Pane to save the patient’s plan information.
12. Return to step 1 and repeat the procedure for each plan that needs to be added to the patient’s plan set.
Patient is not the Insured, Insured is in Database
8.18
Enter the Patient’s Plan Information
Patient Module
13. If the patient is not the insured, but the insured is a patient in your database, enter the patient’s ID number in the Insured field.
The Insured field is a search field where staff members can enter all or part of a patient’s name or ID. The system displays a Search window to allow the staff to select the correct patient.
14. From the Relation drop‐down list, select the For example, Mr. Jones is the insured for his son, appropriate relationship of the patient to the Anthony. Advanced Family Practice would choose Natural Child from the Relation drop‐down list insured.
because that is what the patient is to the insured.
The system uses the information from the insured patient’s profile to submit claims, etc.
15. Click the Save icon on the Task Pane to save the patient’s plan information.
16. Return to step 1 and repeat the procedure for each plan that needs to be added to the patient’s plan set.
Patient is not the Insured, Insured is not in Database
17. If the patient is not the insured and the insured is not a patient in your database, change the Insured field to 0 and press the Tab or Enter key.
The system removes the patient’s name as the insured.
18. From the Relation drop‐down list, select the For example, Mr. Jones is the insured for his son, appropriate relationship of the patient to the Anthony. Advanced Family Practice would choose Natural Child from the Relation drop‐down list insured.
because that is what the patient is to the insured.
TIP | You can edit the entries that appear in this drop‐down list using Master Table Setup, provided you have security privileges to do so. Once you select the relationship of the patient to the insured, the Insured Information fields appear at the bottom of the window.
19. Enter the insured’s name, address, sex, phone number, date of birth, and employer in the Insured Information fields.
20. Click the Save icon on the Task Pane to save the patient’s plan information.
21. Return to step 1 and repeat the procedure for each plan that needs to be added to the patient’s plan set.
Enter the Patient’s Plan Information
8.19
Patient Module
Create Additional Plan Sets
If you need to create additional plan sets for patients in your practice, MicroMD PM provides an easy and consistent way to create and name new plan sets. There may be times when your patients get injured at work and worker’s compensation insurance covers the costs of their treatments. Creating a WORKER’S COMP plan set allows you to submit worker’s comp claims for a patient, in addition to any other medical claims you need to submit for services unrelated to the work injury.
NOTE | The system tracks the name of every new plan set created in the system by all users. The Plan Set Name drop‐
down list contains all of these names, making it easy for staff members to choose consistent names for similar plan sets.
For example, Mr. Smith has Anthem of Ohio as his primary insurance, but he also has ABC Insurance for worker’s compensation. Advanced Family Practice created two plan sets: his main plan set (containing his Anthem of Ohio plan) for basic medical cases and a worker’s compensation plan set (containing ABC Insurance) to apply to any worker’s comp cases.
To create an additional plan set:
Procedure
Details
1. Right‐click the left pane and select Add Plan Set from the pop‐up menu.
To create a new Default Plan Set, just select Create Default Plan Set. The remaining steps are the same.
2. Select the name of the new plan set from the Plan Set Name drop‐down list or type a new name.
3. Type a useful description for this patient’s plan set in the Description field.
4. Add plans to this plan set.
5. Be sure you save your changes.
6. Repeat these steps for each plan set that needs to be created for this patient.
Deleting a Plan Set
If you need to delete an entire plan set for any reason, right‐click on the plan set and select Remove Plan Set from the pop‐menu. If the plan set you want to remove is the Default Plan Set, MicroMD PM prompts you to confirm this action.
Changing Insurance Plans
There is no limit to the number of plans that a practice can enter for each patient. Once a plan has been used for posting insurance charges and payments, those financial transactions are attached to that plan and patient; therefore, we recommend that practices change the Effective From and To dates for the plans rather than deleting them.
8.20
Enter the Patient’s Plan Information
Patient Module
When adding or updating plan information within the patient demographics plan window, and after Save is selected, the system will update any current and future appointments with the proper plan set and within the appointment and plan date ranges.
When a staff member changes the effective dates for a plan, the system alerts them of any outstanding claims that were previously filed under the old plan. The system retrieves those claims and displays the Update Open Claims window. All claims selected with a check mark are updated. Staff members can also change the status of the claim (i.e., Print, Processed, or Hold) at this time by changing the choice in the Claim Status column.
Figure 8‐4 Update Open Claims After Making a Plan Inactive
For example, if claims were originally filed under ABC INSURANCE PLAN and the patient’s primary insurance changed to XYZ GROUP INSURANCE, then the staff can change the Claim Status to Print so those claims will be re‐filed automatically the next time the practice processes claims.
NOTE | When staff members change a patient’s plan, plan type, policy number, group number, and/or effective dates, the system records this information in the System Log. Deleting Insurance Plans
We recommend that staff members do not delete a plan if it is no longer effective. They should simply change the Effective From and To fields on the expired plan. If a staff member entered the incorrect plan and no activity has occurred with the plan in the patient’s account, then it can be deleted.
To remove an insurance plan from a plan set, right‐click on the plan and select Remove Plan from the pop‐up menu. Users can also select the plan and click the Delete icon on the Task Pane or press Delete on the keyboard to delete the plan.
If the staff member has decided to delete an insurance plan for the patient and there are open claims attached to that plan, MicroMD PM prompts them to delete the open claims. If the user clicks Yes, the system deletes the claim and transfers the responsibility of the sequence to the patient. Selecting No leaves the open claim in the system with the responsibility of the sequence still with insurance, but the sequence will have no plan associated with it.
NOTE | When a staff member removes or deletes a plan, the system records this information in the System Log. CREATE CASE INFORMATION FOR A PATIENT
The system provides a central area where the practice can maintain case information for patients. Patient cases can be used to separate patient illnesses or injuries that need to be billed to different insurance plans, such as worker’s compensation.
Create Case Information for a Patient
8.21
Patient Module
The Cases tab of the Patient Detail window allows staff members to enter chronic information and link each case to the Plan Set containing the insurance that covers the services rendered for the case. Staff members can also specify which case to link to the Default Plan Set. The system automatically uses the case associated with the Default Plan Set each time staff members post charges. They can change the case and plan set information if needed when posting charges.
For example, Mr. Smith has chronic back problems for which he regularly visits with the physician. The other day he was hurt at work, unrelated to his medical condition. Advanced Family Practice added an additional plan set to handle this situation. They now have two cases: a medical case linked to his MEDICAL plan set and a BWC1111 case linked to his WORKER’S COMP plan set.
Figure 8‐5 Cases Tab of the Patient Detail Window
The layout of the Cases tab is similar to the Plan Sets tab. There are two panes: the left pane, which displays the cases, and the right pane, which displays the information for the selected case. To display the information for a particular case, click on the case in the left pane.
NOTE | The majority of the fields of this tab set the default values for the Claim Transactions window that appears when posting charges for this patient. Staff members can always change these defaults as needed when posting.
8.22
Create Case Information for a Patient
Patient Module
Each patient starts with a “default” case. You can rename or delete this case if necessary. To change the name, simply make any necessary changes to the Case field.
To add a new case:
Procedure
Details
1. Click the New icon on the Task Pane.
2. Enter a name for the case in the Case field.
This could be the case number or other identifier for the case.
3. Enter a brief, useful description in the Desc field.
This could help staff members understand more about a case.
4. From the Default Plan Set drop‐down, select the plan set containing the insurance plan that covers services rendered for this case.
TIP | If you have no plan sets available in the drop‐down list, be sure you saved this patient after creating their plan sets. Then the plan sets should be available in this drop‐down list.
5. Check the Default box if this case should be used by default when staff members post charges to this patient’s account.
You could have two medical cases entered for a patient, but only one of them is their main case. You would check the Default box on the main case so MicroMD PM knows use that case by default when staff members post charges. They can change this to the other case if needed when posting.
6. Enter the rest of the information on this window as needed.
7. Click the Save icon on the Task Pane to save your changes.
You can also press the Ctrl + S key combination.
Other Fields on the Cases Tab of the Patient Detail Window:
Field
Description
Third Party
Case Category
The system allows you to categorize patient cases. To edit or create category names, refer to the Master Table Setup. Diagnosis 1, Diagnosis 2, Diagnosis 3, Diagnosis 4, Diagnosis 5, Diagnosis 6 and Diagnosis 8
The system allows you to enter up to eight diagnosis codes for which the patient most frequently comes into the office. This is usually a chronic diagnosis and you can leave these blank in most cases. The system already tracks the last eight diagnosis codes posted for the patient, unrelated to the eight fields on the Cases tab. The diagnosis fields on this tab are look‐up fields. If you specify a diagnosis for this case, it becomes the default diagnosis when entering a charge for the patient. Staff members can, however, change the diagnosis fields when posting.
Create Case Information for a Patient
8.23
Patient Module
Claim or Encounter
The option chosen in this field is the default value for the Claim Transactions window for this case. These two fields allow the practice to indicate if the practice expects payment for the claim or is sending the charges from this case for informational purposes only.
Select the Claim option if you are sending a claim to the insurance company for payment, whether it is paper or electronic. Select the Encounter option to inform the insurance company that the service rendered to the patient on this case is a capitated procedure. The charge is being sent for informational purposes, and payment is not expected.
Extra button
Click the Extra button to enter information for some special forms. Many of the fields in these forms default from information entered in the patient’s account. The system then transfers this information to the claim, and users can modify the information when posting or editing the claim.
You can set the defaults for new patient cases for some of the forms in this button. Set the defaults for the Extra button on the Cases tab on the Billing Preferences tab under Setup > Practice Preferences.
TIP | Your support team has additional documentation available for the form you need to use in this list.
Employment Related
Check this box to indicate that the patient’s condition is a result of an employment accident. This information prints in Box 10a of the CMS 1500 claim form.
Auto Accident
Check this box to indicate that the patient’s condition is a result of an auto accident. This information prints in Box 10b of the CMS 1500 claim form.
Other Accident
Check this box to indicate that patient’s condition is due to an accident other than auto or employment. This information prints in Box 10c of the CMS 1500 claim form.
State
Enter the state in which the patient’s auto accident occurred. For example, if the patient was in an auto accident in Oklahoma and lives in Ohio, the insurance company wants to be aware that the accident took place in Oklahoma.
Injury/LMP
Enter the date of the patient’s injury or illness. If the patient is pregnant, enter the date of her last menstrual period. The date entered in this field sets the default for the Injury/LMP field on the Claim Transactions window for this case and then prints in Box 14 of the CMS 1500 claim form.
Conslt/Illness
Enter the date the patient had a consultation for this injury or illness, or the date the patient had the same or similar illness previously. The date entered in this field sets the default for the Conslt/Illness field on the Claim Transactions window for this case and then prints in Box 15 of the CMS 1500 claim form.
8.24
Create Case Information for a Patient
Patient Module
Last Seen
The system updates this field when staff members post charges for this case. This field is used primarily by podiatry practices to record the date the patient had last seen their primary care physician. The system also enters this date in the Block 19 field on this tab. The entries in these two fields set the default values for the Last Seen and Block 19 fields on the Claim Transactions window. This date then prints in the Box 19 of the CMS 1500 claim form.
If there are changes to the referring physician and the Last Seen date (and the practice is a podiatry practice), the system enters the UPIN of the referring doctor followed by the date in the Last Seen field.
X‐RAY
Enter the date of the patient’s last x‐ray, if applicable. If there is a date in this field, MicroMD PM enters that date by default in the Block 19 field of the Claim Transactions window for this case. It then prints that date in Block 19 on the CMS 1500 claim form. Chiropractic practices typically use this field to track the patient’s last x‐rays.
Disability Frm and Disability To
Enter the date the patient began their period of disability in the Disability From field. Enter the date that the patient’s disability ended in the Disability To field. The system enters these dates by default on the Claim Transactions window for this case. These dates then print in Box 16 of the CMS 1500 claim form.
Admission and Discharge
Enter the dates on which the patient was admitted and then subsequently released from the hospital for this case. You can set the system to alert the staff member if they have forgotten to enter an admission date for certain place‐of‐
service codes. Prior Authorization #
Enter the prior authorization number provided for the services rendered to the patient for this case. The number entered here appears by default on the Claim Transactions window for this case and then prints in Box 23 of the CMS 1500 claim form each time staff members print a claim for this case.
Block 10d
Enter whatever information the carrier requires in Block 10d of the CMS 1500 claim form. The text entered in this field is the default value on the Claim Transactions window for this case and then prints in Box 10d of the claim.
Block 19
Enter whatever information the carrier requires in Block 19 of the CMS 1500 claim form. The text entered in this field is the default value on the Claim Transactions window for this case. If there is a date in the Last Seen field, MicroMD PM enters that date in the Block 19 field and on the claim.
Block 11b
Other Claim ID For Worker's Compensation or Property & Casualty. Enter the claim number assigned by the payer.
Supervising
Some ANSI claims require a supervising physician for chiropractic, podiatry, physical therapy, and occupational therapy claims. Enter the supervising physician for this case in the Supervising field, if applicable. The system enters this physician by default on the Claim Transactions window when staff members post charges for this case.
Create Case Information for a Patient
8.25
Patient Module
Referring MicroMD PM uses this entry if a user selects a case when he or she creates a new appointment or sequence. Otherwise, the system uses the referring doctor entered on the Detail tab of the Patient Detail window if you do not enter one here. Weight
Enter the patient’s weight (in pounds) for this case. This is the default value for the Claim Transactions window when posting for this case and is used mostly for newborns and for patients undergoing dialysis treatment. This weight also appears as the default for the Weight field in ambulance billing. The system enters this information as required by the carrier in the electronic claim file.
Pregnancy Indicator
Check this box to indicates that, for this case, the patient is pregnant. This is the default value for the Claim Transactions window for this case. The system enters the appropriate indicator in the electronic claim file when checked.
Fam Planning
Check this box to check the Family Planning checkbox by default on the Claim Transactions window for this case. When that box is checked, the system prints an “X” in Box 24H on the CMS 1500 claim form or includes the appropriate marker in the electronic claim file.
Emergency
Check this box to check the Emergency box by default on the Claim Transactions window for this case. When checked, this box indicates that services rendered to the patient were due to an emergency of some kind. The system marks Box 24C on the CMS 1500 claim form.
For example, Mr. Smith was out of town and needed to be rushed to the hospital for a heart attack. The insurance company needs to be aware of this so the practice checked this box for the case.
EPSDT
Check this box to set the default value on the Claim Transactions window. This indicates that this case is related to the Early and Periodic Windowing, Diagnosis and Treatment Program. The system marks Box 24H on CMS 1500 claim form.
Hospice Provider No
Enter the hospice‐provider number, if applicable, for this case. This is the default value for the Claim Transactions window for this case. The number entered prints in Box 23 of the CMS 1500 claim form.
Hospice Employed Provider
Check this box if the practice or provider on the case is employed by hospice for the services rendered. This is the default value for the Claim Transactions window for this case. The Hospice Employed Provider box, if checked, indicates to the insurance company that the doctor is a hospice provider.
8.26
Create Case Information for a Patient
Patient Module
Service Fac
Enter the default service facility for this case for the patient. This is the default value for the Claim Transactions window when posting charges for this case but staff members can change this when posting, if necessary.
For example, Mr. Jones is an Alzheimer’s patient who is being treated at the N.E.O. Alzheimer’s Treatment Center. Advanced Family Practice created an ALZHEIMER’S case for Mr. Jones and then entered this facility in the Service Fac field for this case so all insurance claims for the case print or go electronically with this service facility’s ID and address.
NOTE | To use the patient’s service facility by default when posting, the following drop‐down lists must be set to (Default):
 Default Service Facility on the Billing Preferences tab under Setup > Practice Preferences.
 Service Facility on the Batch Posting Options window (click the Batch Options icon on the Task Pane from the Charges/Payments window).
 Facility on the Batch Charge Posting window, if using this feature.
Unit/Section
The system displays this drop‐down list whenever you enter a facility in the Service Fac field. The system populates this drop‐down with the entries on the Unit tab of the Service Facility Detail window.
Load Address Click this button to replace the patient’s address with the address of the facility listed in the Service Fac field on this tab. This is especially helpful for patients that have been moved into a nursing home or other treatment center. One click of the mouse updates their address to that of the facility.
button
To activate this feature for your practice, check the Enable Load Address Button checkbox on the General Preferences tab under Setup > Practice Preferences.
Case Notes
You have the ability to enter notes specific to a case located on the Patient Detail window. Wherever you see the Floating Toolbar (e.g., appointments, charges/payments), you can click the Case Notes icon to open the Case Notes window and enter text for the selected case.
Create Case Information for a Patient
8.27
Patient Module
Figure 8‐6 Case Note Window To create a new note, click the Insert button. The system records today’s date, selects the default note category and tags the note with your user name. You can change the Date and Categry fields if necessary. The Categry drop‐down pulls from the list of note categories on the Notes Category tab under Setup > System Classes/Categories.
STOP | Once you save a note you cannot change the Categry drop‐down.
To delete a note, make sure your cursor is within the appropriate note and click the Delete button. If you want to print the list of notes, simply click the Print button.
PATIENT ACCOUNT NOTES
The system tracks a wealth of general information about each patient’s account on the Notes tab of the Patient Detail window (e.g., the date of the last bill or statement, the amount of the bill/statement, and the patient message number). Staff members can also enter notes regarding this patient. These notes are not associated with a specific claim or encounter and are meant for use by office personnel.
NOTE | Any patient‐sensitive information should be entered in this tab rather than the Remarks field. The system does not print these notes on patient statements or charge slips.
The staff can access and enter this information easily from within the Patient Detail window, from the Patient Sequences window, the appointment window, and the Billing Inquiry window for the patient using the Patient Note General icon. As a security precaution, whenever a staff member creates a note, only the user who creates the note and the supervisor have permission to delete or edit the note, unless there is a category assigned that allows others to alter the contents. 8.28
Patient Account Notes
Patient Module
Figure 8‐7 Patient Notes Tab on the Patient Detail Window
The system uses the very first note to keep track of the patient’s monthly billing. Staff members with User security rights cannot edit this note. The system adds to this note automatically it prints monthly statements. It also constantly updates this system note when subsequent billing is done or when the patient’s collection status changes. The system only keeps a record of the last 10 statements/bills.
TIP | If there is at least one note item on this tab, the Notes tab in the Patient Detail window turns red and the label changes to Notes Exist.
To add a new note to a patient’s account:
Procedure
Details
1. Click the New icon on the Task Pane.
The system creates a new entry underneath the last note created.
2. Change the Date field only if necessary.
The system defaults to the current system date.
3. Type the note in the large text area.
This is an open text field and staff members can enter an unlimited amount of text.
4. Select a Note Category from the Category drop‐ You can set the default notes category for the practice on the General Preferences tab under down list, if other than the default.
Setup > Practice Preferences.
5. If you want to add this note to your task list for Once you save this note, the Task List checkbox any reason, you must place a check mark in the disappears.
Task List box at this time.
6. Click the Save icon on the Task Pane to save the You can also press the Ctrl + S key combination.
new note.
Printing Notes
There may be instances where you need to print notes from a patient’s account. The Print checkbox on each note allows staff members to print any or all notes for this patient. Click the Print icon on the Task Pane to print all notes with a check mark in the Print box.
Patient Account Notes
8.29
Patient Module
TIP | Use the Select All and Deselect All buttons to make printing easier. If you want to print all of the notes except one, click the Select All button and uncheck the one you do not want to print. The same works for Deselect All if you only want to print one note.
Adding a Note to the Task List
When entering new notes, you can also add them to your task list to generate a future reminder or task. When you click the New icon to add a note, a Task List checkbox appears under the Print box for this new note. To add this note to the task list, place a check in this box. NOTE | You must add a note to the task list when you first create the note. Once you save the note, the Task List checkbox disappears.
CONTACTS TAB
The Contacts tab for the patient’s account in MicroMD PM allows practices to record a list of people they may contact regarding any number of aspects involved in serving the patient’s medical needs. This includes the patient’s emergency contact information, the patient’s other parent, etc. To add a new contact, click the New icon on the Task Pane, enter all appropriate details and save your changes.
Figure 8‐8 Contacts Tab on Patient Detail Window
8.30
Contacts Tab
Patient Module
The Type drop‐down allows you to indicate what kind of contact this is for the patient. You can choose Emergency, Misc, Parent, Legal Guardian, Care Giver, Grandparent, Next of Kin or Pharmacy. The system defaults to Emergency for each new entry.
NOTE | Once you save a contact, you cannot change their type. Be sure you associate the appropriate type when creating the contact.
Special Behaviors of Emergency and Pharmacy Types
The first contact that you tag as an Emergency contact in the patient’s list is the contact data that is available when you create patient mail merge letters. You can tag several contacts as Emergency contacts, but only the first one is available as mail merge data.
When you tag a contact as a Pharmacy contact, you also have the option to indicate that it is the patient’s preferred pharmacy. Simply place a check mark in the Preferred checkbox. This bolds the entry in the left side of the window.
Phone Number Fields on the Contacts Tab
The phone number fields provide staff members with the ability to indicate the type of phone number they want to enter for this contact. The labels for the Business, Cell, Home and Fax are drop‐down lists with additional labels you can choose to identify the phone number more precisely.
This feature also stores the numbers you enter under each label. Even if you do not have them displayed, the system has saved the number you entered under the selected label. For example, you can save the contact’s home phone number under the Home label but choose not display it.
Simply click to the right of the label to access the drop‐down list. The system displays a check mark next to the phone number field labels that you have already used to store a number for this contact. Any label without a check mark is an empty slot. Select the label you want to use and enter your number.
NOTE | Changing a label only changes the label for that contact.
CUSTOMIZE PATIENT SEARCH LIST
The system allows each user to customize the columns that appear on the Guarantor/Patient List window to suit their needs. Some users might need to find patient’s based on social security number for the tasks they perform, so they customize their list to display just the patient’s name and their social security number. Still another user’s tasks require them to see the patient’s name, social security, balance, and phone number when they search for patients.
To customize the patient search list:
Procedure
Details
1. Select Maint > Patient from the main menu.
You can also click the Patient button on the Launch Pane or press F5 on the keyboard.
The Guarantor/Patient List window appears.
2. Click the Display icon on the Task Pane.
Customize Patient Search List
The Guarantor/Patient List Options window appears.
8.31
Patient Module
3. Drag and drop the columns that you want to display from the Available For Selection side to the Selections Made side of the window.
4. To reorder the columns, drag and drop the column names into the appropriate order.
5. Click Accept to save your changes.
SEARCH FOR AN EXISTING PATIENT
Staff members can search for patients using a variety of information found in the patient’s account. Click the Based on drop‐down to choose the criteria by which you want to search for a patient. Staff members can search for patients using the following fields: Chart No, Phone, SS No, or DOB. There is a single Search for text box and you can select the type of information by which you want to search from the Based on drop‐down list.
NOTE | The system remembers the choice you make in the Based on drop‐down and chooses that automatically when you reopen the window.
Generally, this is a practice‐specific search. Staff from one practice cannot view or edit patients from another practice in the same database, unless the practices want them to have that ability. If practices in the same database want to share patients, they can check the Global Search checkbox on this window. To enable this feature, checkmark the Multi‐Practice checkbox on the System Preferences tab under Setup > System Preferences.
Figure 8‐9 Guarantor/Patient List Window
Staff members can search for patients by name or account number, responsible party, the insured’s name, the patient’s alias or any combination of these. The down arrow next to the drop‐down appears 8.32
Search for an Existing Patient
Patient Module
for the Pat.Name/No and Patient Name options. When you click this arrow, the system displays the types of names you want to search. Click the arrow again to return to the search field.
Figure 8‐10 Additional Name Fields to Search
To search for a patient:
Procedure
Details
1. Select Maint > Patient from the main menu.
You can also click the Patient button on the Launch Pane or press F5 on the keyboard.
The Guarantor/Patient List window opens.
2. Enter the search criteria
TIP | You can also use wildcard characters to search for patients when you are not sure of the spelling. 3. Press the Enter or Tab key.
The system displays the list of patients that match the criteria entered.
NOTE | If your practice uses the sub‐account feature, a name search also returns any sub‐
accounts that match. The name on the left side of the window could be different than the name on the sub‐account. Highlight the main account to view the patients that matched the criteria entered.
4. Double‐click the appropriate patient to open their Patient Detail window.
PATIENT UTILITIES
The Utility menu in MicroMD PM provides a number of useful tools for various situations. This includes a couple of patient utilities that you can use when entering new patients in the system or for promoting a patient from a sub‐account to a main account.
Copy Patients
The system provides an easy method for copying patients. Practices can copy patients within the same practice or copy a patient from one practice to another using the Patient Copy Utility. Use the following procedure to copy a patient.
NOTE | This utility does not copy any of the patient’s billing information.
Patient Utilities
8.33
Patient Module
For example, Anthony and Vanetta Smith are patients with Advanced Family Practice. Anthony has some back troubles, and the Chiropractic Clinic he visits happens to be a practice in the same database as Advanced Family Practice (the physicians are siblings, and they purchased the system together). The Chiropractic Clinic wants to copy Anthony’s patient details into their practice, rather than manually entering the information that Advanced Family Practice already has in the database.
Procedure
Details
1. Select Utility > Patient Utilities > Copy Patient from the main menu.
The Patient Copy Utility window opens.
2. In the Source Patient section, select the practice from which you want to copy a patient.
3. Enter the patient’s name or ID in the Patient ID field that you want to copy.
This is a search field where you can enter full or partial names to display a list of patients from which to choose.
4. In the Destination Patient section, select the practice to which you want to copy the patient.
5. Enter the patient’s ID number for the destination practice or check the Assign Next Number checkbox.
If you want to assign this patient as a sub‐
account in the destination practice, you can indicate the account number and the sub‐
account (*.x). Otherwise, the Assign Next Number box adds the patient as a separate main account.
6. In the Information Selection section, checkmark the tab(s) from which you want to copy data to the new patient.
When copying the plan set information, the system copies all of the plan sets created for the source patient, including any scanned insurance cards.
7. Click the Copy Patient icon on the Task Pane to save your new patient.
Renumbering Patients
Staff members can renumber patients in MicroMD PM. You might want to do this for a patient who was in a sub‐account under another patient, but now has his or her own insurance plan and needs to be an account holder. In order to change this patient from a sub‐account to a main account, the patient needs to be assigned a new patient ID number that ends in “.0”. All of the information contained in the original account remains in the renumbered account.
For example, Mario Smith is Anthony Smith’s son and has always been under his father’s insurance. He just graduated from college and has a job where he has his own insurance. Advanced Family Practice simply renumbered Mario’s sub‐account number (1001.2) to the next available account number ending in “.0” (2124.0).
NOTE | Patients can only be renumbered within the same practice.
8.34
Patient Utilities
Patient Module
To renumber a patient:
Procedure
Details
1. Select Utility > Patient Utilities > Renumber Patients from the main menu.
The Patient Renumbering Utility window opens.
2. Enter the current number for the patient in the Old Patient field.
3. Enter a new number for this patient in the New Patient field or check Assign Next Number to have the system assign the next available number in the practice.
4. Click the Renumber icon on the Task Pane.
The system changes the patient’s account number, retaining all billing information from the old account number.
Exporting Patient Data
You can export patient demographic information to your third‐party vendor through their interface with MicroMD PM. You can set the export to do so automatically at timed intervals, or you can export an individual patient’s information manually. Your support team can help with editing the export.ini file for setting an appropriate timer interval for automation.
To export data manually for a single patient:
Procedure
Details
1. While in the Patient Detail window, click the Pat Export icon on the floating toolbar.
The Patient Info Export window opens.
2. From the Export Type drop‐down, select the application to which you want to export the data.
Only those interfaces or additional modules you have purchased appear in this list. Once you select the interface or module, the system displays the export path for your reference.
3. Click Accept.
The system exports the patient’s data to the specified location and file.
PATIENT LOG
The system tracks a wealth of information regarding changes made to and actions taken on a patient’s account. Staff members can access the patient log if they have security privileges to do so. Click the Patient Log icon on the Task Pane from the Patient Detail window. Patient Log
8.35
Patient Module
Figure 8‐11 Patient Log Window
Along with other information, the system tracks the following information in this log:
 Deleting a transaction (a procedure that has been posted)
 Deleting a patient’s plan
 Changing a patient’s plan (plan ID, policy number, group number, plan type, effective dates)
 Deleting a sub‐account
 Editing a patient’s demographics
 Deleting or merging sequences
 Deleting or modifying a patient message
When you first enter the patient log, the entries in the window pertain only to the current patient. If you want to view log entries for all patients in all practices in this one window, place a check mark in the Show All box.
STOP | BE CAREFUL! When you check this box, the system displays all log entries in the database for all patients in all practices. This could result in a system slowdown as that information is retrieved in a large practice.
You have the ability to search the patient log for those entries that contain specific words or phrases. In the Note Text field, simply type the text you want to find and press Enter. The window sorts itself and displays only those log entries that contain the text you entered.
TIP | If you need to see log entries related to actions taken by a certain user, type their user name in the field as the text you want to find.
To view transactions deleted by users in the system for the current patient, click the Del Trans button. This opens the Deleted Transactions window that displays all line items deleted from a patient’s account. These deletions can happen for any number of reasons, including when staff members correct posting mistakes.
You can print either window if necessary. Click the Print button at the top of each window to print the displayed information.
8.36
Patient Log
Patient Module
PATIENT CHART
To help you keep dictation notes, you can click the Patient Chart Note icon on the Task Pane to access Microsoft® WordPad or Microsoft Word. The system uses the patient’s account number to name the *.doc file it creates for the patient’s chart.
PLANNED VISITS
For those patients who are only authorized by the insurance carrier for a limited number of visits, MicroMD PM provides an area where staff members can enter this information. Staff can then access this information from the Patient Detail, appointment, and Charges windows. The system also prints planned visit information on the patient’s charge slip, if you choose that option. The program keeps track of visits and displays the remaining number of visits and the date range.
Figure 8‐12 Planned Visits Window
NOTE | You can only enter planned visits from the Patient Module.
To enter a set of authorized visits: Procedure
Details
1. Click the Planned Visits icon on the Task Pane of The Planned Visits window opens.
the Patient Detail window.
2. Click the New icon on the Task Pane.
3. Enter the information for these visits.
4. Click the Save icon on the Task Pane to save your changes.
Patient Chart
8.37
Patient Module
Columns on the Planned Visits Window:
Field
Description
Proc. and ICD
Enter the procedure/diagnosis code combination for which this group of authorized visits apply. The system populates the Procedure and Diagnosis columns automatically when staff members enter the codes. The Proc. and ICD fields are search fields.
NOTE | For this combination to trigger the planned visits calculation, the ICD code entered must be the primary diagnosis for the indicated procedure.
To indicate that the system should use all procedure codes and/or all diagnosis codes, type the word ALL or the code 999999 in the Proc and/or ICD columns. If you choose all codes for the authorized procedures and diagnosis codes, the system deducts a visit from the R column whenever staff members post charges to the patient’s account, regardless of how many charges are posted.
For example, Mr. Smith has a set of approved office visits, no matter what the diagnosis. Advanced Family Practice created a row for Mr. Smith with 99213 in the Proc. column and ALL in the ICD column. Whenever staff members post 99213 and any diagnosis code, the system calculates the remaining visits accordingly.
Date From and Date To
Enter the effective dates for this set of authorized visits. When staff members post charges for the indicated procedure/diagnosis code combination where the posting date falls within that range, the system calculates the remaining visits appropriately.
V
Enter the number of visits allowed by the insurance plan for this procedure/ diagnosis combination within the date range specified.
R
This field displays the visits remaining within the date range for the specified procedure/diagnosis combination. The system automatically decrements this value as staff members post the specified procedure/diagnosis combination.
Unit
Check the Unit column to toggle the V and R columns to unit‐based fields. When posting charges, the system subtracts the number of units from the R column instead of subtracting the value of 1.
Authorization
Enter the authorization number provided by the insurance plan for this set of authorized visits, if applicable. The system takes this authorization number and enters it in the Prior Authorization # field on the Claim Transactions window, overriding any data entered for this field on the Cases tab.
The Authorization column can contain a maximum of 30 characters for paper claims and ANSI electronic claims. NSF claims, however, still only accept 15 characters.
Notes
8.38
Enter any information to communicate with other staff members about this set of authorized visits. The Notes column holds a maximum of 100 characters. When you position the mouse over the Notes field wherever you see the Planned Visits window, a pop‐up displaying the text appears. Planned Visits
Patient Module
PATIENT REGISTRATION (INFORMATION) SHEET
The system provides a standard information sheet that practices can print for their patients. Practices use this information sheet in a variety of ways:
 To verify the information that the practice has on file for the patient is accurate.
 To provide a release‐of‐information authorization form for the patients to sign.
 To gather survey information from new patients.
The system prints the patient demographic, insurance, emergency information, as well as the registration text entered on the Registration Text tab under Setup > System Preferences. This text controls how you use the registration sheet. TIP | You can also create a unique form for your practice’s needs using the mail merge feature, and then print that document using the Label/Mail Merge icon. You can also use the HIPAA features to create a set of standard documents each new patient must complete. PRINT LABELS OR DOCUMENT
There may be times that you need to print a letter for an individual patient, along with an address label for the envelope. Maybe this person referred someone to your office or they helped paint the outside of the office building, and you would like to send them a thank you letter.
From the Patient Detail window, click the Label/Mail Merge icon on the Task Pane. You can print labels and mail merge documents from this window. APPOINTMENT HISTORY
The system tracks actions taken against appointments by users in the system. It keeps this information, including copied, deleted, rescheduled, and moved appointments, in the Appointment Log. Click the Appointment History icon on the Task Pane of the Patient Detail window to display an appointment history for this patient, including the patient’s current appointments. When you double‐click an entry in the Appointments window, the system opens the appropriate provider’s appointment schedule to the date listed on the history entry. RESPONSIBLE PARTY
The Responsible Party icon on the Task Pane allows you to send a bill or statement to someone other than the patient (e.g., the patient is a minor, and you want the parents to receive the bills). Simply click this icon and fill in the information for the party who is responsible for the account. The system then uses the address entered in this window for the address on statements/bills.
BILLING INQUIRY
The system provides access to the Billing Inquiry window for individual patients while the staff member is in the Patient Detail window. Staff can click the Billing Inquiry icon on the Task Pane to display the Billing Inquiry window. Patient Registration (Information) Sheet
8.39
Patient Module
VIEW A PATIENT’S DIAGNOSIS HISTORY
The system tracks all of the diagnosis codes posted to a patient’s account. The system displays the posting date, service date and rendering provider on the sequence for the displayed code.
Figure 8‐13 Diagnosis History Window
Click the ICD Hist icon on the floating toolbar. You can filter the list of codes by Service Date and/or Posting Date of the sequence containing the diagnosis code. Click the Search button after you change any dates to retrieve just the diagnosis codes. You can also print the resulting list with the Print button at the top of the window.
VIEW A PATIENT’S PROCEDURE HISTORY
The system can track procedures posted to a patient’s account that are included in any Explosion Codes. The system displays the service date of the procedure line, along with any modifiers, the fee charged and the rendering provider for the procedure.
When a procedure is included in an Explosion Code that has the Track Code box checked, MicroMD PM tracks the posting of the procedures contained in that Explosion Code, even if the Explosion Code was not used to post the procedure.
Figure 8‐14 Procedure History Window
Click the Track Code Hist icon on the floating toolbar. You can search for the Explosion Code by Service Date and/or Posting Date of the procedure code line. From the drop‐down list, select the Explosion Code that contains the codes you want to view. Click the Search button to retrieve the information. You can also print the resulting list with the Print button at the top of the window.
8.40
View a Patient’s Diagnosis History
DAY SHEETS AND CHARGE SLIPS
To help practices be as efficient as possible, MicroMD PM has two modules that allow practices to prepare to enter charges quickly and then balance out the day accurately. The Day Sheet Module provides an audit log for all financial transactions posted in your practice and is the means by which a practice balances the day’s activity. The Charge Slip Module has the flexibility to meet your practice’s needs for creating unique charge slips (aka encounter forms, routing slips, super bills) for providers to indicate the procedures performed during the patient’s visit.
IN THIS CHAPTER
In this chapter, we cover how to:
 Create and work with day sheets
 Close/erase the day sheet, including balancing your day
 Create charge slips
 Print charge slips
 Identify missing charge slips
EXAMPLE PRACTICE
For the purposes of illustration for certain concepts in this chapter, we need a consistent example practice. Today is 08/01/10 and Advanced Family has an administrator with supervisor privileges. The three other users in this practice are Kim, Tom, and Jennifer. Kim enters charges for the practice and has a USER security level. Tom posts payments and also has a USER security level. Jennifer manages the overall financial duties, including opening/closing day sheets and reporting to the administrator. Sometimes she also jumps in occasionally to help the others when needed. She has a USER security level as well.
CREATING AND SELECTING A DAY SHEET
Day sheets are posting logs. A user creates a day sheet for each day’s activity, and it provides a temporary log or file of all financial transactions (charges, payments, write‐offs, and refunds) posted throughout the day. Once a user closes/erases a day sheet, the data becomes permanent, and the office has a paper trail of all transactions posted on a specific day and has data available for various reporting purposes. The totals of the charges and payments posted during the day should match the totals on the day sheet. Even adjusted transactions that may have been deleted from the patient’s record print on the day sheet, including which operator performed the transaction to protect the audit trail.
Security Options
The system has security settings to allow supervisors/equivalents to specify which users can erase, change settings, or view day sheets. The system houses all security options for the system under the Permissions tab on the Users and Groups window (Setup > Identity and Access Management). You can find the following security options in the user access security tree under Billing > Day Sheet.
 Delete: Allows the user to erase a day sheet once it’s printed (for those users at the User security level that perform some, but not many, supervisor functions in an office).
In This Chapter 9.1
Day Sheets and Charge Slips
NOTE | If a user with this privilege (including a supervisor/equivalent) has any selections made in the Provider, Location, Batch, or User drop‐
down lists, they will not have the option to close/erase the day sheet. All drop‐downs must be set to (ALL) before anyone can close/erase the day sheet.
 Change Settings: Allows the user to make changes to the Day Sheet Options window.  View: Allows the user to access the day sheet, but they can only see the items they posted.
 View All: Allows the user to see information posted by all users in the system by checking the Show By Operator checkbox on the Day Sheet Options window.
You can find the following options in the user access security tree under Misc > Day Sheet Date – Select:
 Add: Allows the user to create a new day sheet in the system.
 Add a Closed/Erased Day Sheet: Allows the user to create a new day sheet in the system with the same date as one that is already closed/erased.
 Delete: Allows the user to delete a day sheet from the Day Sheet Info window when accessed from the main menu (Misc > Day Sheet Date – Select).
 View: Allows the user to access the Day Sheet Date – Select menu item.
You can find the following option in the user access security tree under Utility > Billing and Claims Utilities:
 Day Sheet Date – Change: Allows the user to edit an existing day sheet’s date. For example, if you create a day sheet under 10/03/2010, users with this access right can change that date to 10/05/2010.
Creating a Day Sheet
Practices normally create day sheets prior to entering financial data for the day and then close/erase them according to office policies. You can have multiple day sheets open at any given time; however, staff members must make sure they have the appropriate day sheet active.
STOP | Since you are working with financial information, it is important to select the correct day sheet PRIOR to performing financial tasks. You must also close/erase day sheets in the appropriate order; otherwise, your accounts receivable totals will be inaccurate.
For example, today is 08/02/2010 and Advanced Family Practice has day sheets for 07/30/2010, 08/01/
2010, 08/02/2010 and 08/03/2010 open simultaneously because they have staff members performing various tasks. Jennifer can balance a previous day (07/30/2010) and generate charge slips for tomorrow (08/03/2010) while Tom and Kim post to yesterday and today’s day sheet (08/01/2010 and 08/02/2010). Each staff member also made sure they were working with the appropriate day sheet to ensure that the accounts receivable totals were as accurate as possible.
9.2
Creating and Selecting a Day Sheet
Day Sheets and Charge Slips
To create a new day sheet:
Procedure
Details
1. Select Misc > Day Sheet Date – Select from the main menu.
The Day Sheet Info window opens. This window also opens in any module where you post activity to the day sheet. If you have a New button on this window, you can create a day sheet from there.
2. Click the New button.
This creates a new row on the left side of the window with today’s system date already entered.
3. From the calendar on the right, choose the date you want for the new day sheet or leave the default value.
4. Click the Accept button.
The new day sheet is now your active day sheet.
The system alerts you if you are creating a day sheet for more than seven days in the future or if you are attempting to create a day sheet for a date that has been closed/erased (if the user does not have security access rights to do so).
You can also limit the number of days a day sheet can be open in your system. Once a day sheet reaches this time limit, the system prevents anyone from creating a new one until you close/erase the day sheet(s) that have reached that time limit. To limit the number of days a day sheet can be open, enter that number in the Day sheet open days field on the System Preferences tab (under Setup > System Preferences).
Selecting a Day Sheet
There are a couple of ways to select the day sheet with which you want to work. If there is no day sheet in the system or if you have not selected a day sheet with which to work, MicroMD PM prompts you to create or select a day sheet. This happens when a user enters the Posting Module, attempts to create charge slips, etc. and they have not selected the day sheet or there isn’t one in the system. When prompted, users can accept the current day for the day sheet or select a different day sheet (from the left part of the window).
Creating and Selecting a Day Sheet
9.3
Day Sheets and Charge Slips
Figure 9‐1 Day Sheet Info Window
TIP | When you are on the Charges/Payments window and the day sheet date is not the current system date, notice that the Day Sheet Date flashes in red as a reminder for you to verify that you are on the correct day sheet.
Changing a Day Sheet’s Date
If you want to edit an existing day sheet’s date, you must have security access rights to do so and you must use the Day Sheet Date – Change utility. For example, someone created a day sheet for the date 07/
03/2010 by mistake, and you need to change that date to 07/02/2010.
STOP | You must use this utility with caution and only if absolutely necessary.
Figure 9‐2 Utility to Change a Day Sheet’s Date
To use this utility, the day sheet that you want to change must be your active day sheet. If it is not, select Misc > Day Sheet Date – Select from the main menu and choose the appropriate day sheet. Then select Utility > Billing and Claims Utilities > Day Sheet Date – Change from the main menu and change the date to the correct one. Click Accept.
NOTE | Changing the day sheet date changes the posting date on sequences posted on the original day sheet, but it does not change the service date.
9.4
Creating and Selecting a Day Sheet
Day Sheets and Charge Slips
SETTING UP THE DAY SHEET DISPLAY
The day sheet provides a wealth of information about the posting activity throughout the day. Depending on the work flow of your practice and the security rights provided for each user, the system can streamline balancing out the day—for the practice as a whole, as well as each user posting information to the system. Practices can establish a specific set of day sheet options and then prevent users from changing them. When those users balance their totals with the activity they performed in MicroMD PM, they can display their own part of the day sheet.
Day Sheet Options
Practices can choose how to display and print their day sheets. These settings are practice‐specific, so all users with the security right to change settings can alter these options. The next time any user generates a day sheet, these are the options chosen.
TIP | As a supervisor/equivalent, remove the Change Settings security right for staff members. This allows supervisors to use the day sheet as a balance sheet that staff members turn in and allows supervisors to control the information that they want to appear on the balance sheet.
In our example practice, the administrator gave Jennifer the security option to change settings but removed that option from Tom and Kim. This way Jennifer can control how the day sheet prints.
Select Billing > Day Sheet from the main menu to open the Day Sheet Module. The Day Sheet Options window opens to allow users (with appropriate access rights) to change the type of information included in the day sheet.
Figure 9‐3 Day Sheet Options
Setting Up the Day Sheet Display
9.5
Day Sheets and Charge Slips
Options Available for the Day Sheet:
Field
Description
Sort Order
Select the order in which you want the patients displayed on the day sheet. There are three options:
 Posting: Displays patients in the order in which users posted charges/ payments to accounts in the system.
 Account: Displays patients in order by their account number. (The system uses this option by default.)
 Last Name: Displays patients in alphabetical order by the last name on the account.
Show Operator Summary
Check this box to display a summary section at the bottom of the day sheet that includes a breakdown per user of all charges, payments, write‐offs, and refunds they posted to the day sheet.
Show Plan Summary
Check this box to display a summary section at the bottom of the day sheet that includes a breakdown of charges, payments, write‐offs, and refunds posted per insurance plan and grand totals per Insurance Class.
Show Payment Summary
Check this box to display a summary section at the bottom of the day sheet that includes a breakdown of all payment codes posted for that day: cash, personal checks, insurance checks, etc.
Show Day Summary
Check this box to display a summary underneath the day sheet’s totals (near the bottom of the day sheet) that includes a breakdown of all charges, payments, write‐offs, and refunds posted for the day.
TIP | The View All security option allows a user to view the grand total of all posting activity for the practice. If your staff members do not need to see each other’s activity, you can remove this security option for each user. When the Show Day Summary box is checked, the system only shows the individual user’s totals to help them balance out their day’s activity.
In our example practice, the administrator gave Jennifer the View All security option but removed it from Tom and Kim. Jennifer makes sure the Show Day Summary box is checked. Now when Tom and Kim balance their day, they only have to click Accept when they run the day sheet. The totals displayed are only their individual totals.
Show Accounts Receivable
Check this box to display the practice’s current accounts receivable information on the day sheet in the totals section near the bottom of the day sheet. The system displays the total accounts receivable on the last day sheet date closed (on the Previous Total line), the total amounts of the current day sheet (on the Day’s Total line). Then MicroMD PMadds/subtracts the Day’s Total to/from the Previous Total line to display your current accounts receivable total (on the Current Total line).
STOP | Remember, if you close your day sheets out of order, your accounts receivable totals will be off.
9.6
Setting Up the Day Sheet Display
Day Sheets and Charge Slips
Show Appointment Changes
Check this box to display a summary section at the bottom of the day sheet that includes any appointment changes made in the system on the system date of the day sheet. For example, today is 03/12/2009 and your active day sheet is 03/11/2009 (perhaps you were balancing yesterday’s day sheet). If you make changes to appointments today, those changes would appear on the your 03/12/2009 day sheet (even if you haven’t created it yet), not the 03/11/2009 day sheet.
The terms you see in the Status column of this section reflect the last action performed on that appointment. Once the appointment is removed from that time slot (deleted, cancelled, rescheduled, cut, etc.), the system starts a new entry for the new time slot.
Show Allowed Exceptions
Check this box to display a summary section at the bottom of the day sheet that includes a list of those instances where the posted allowed amount was smaller than the stored allowed amount for a procedure. The section displays the patient and plan, as well as the contracted, allowed, and entered amounts for those procedures. Show Batch Summary
Check this box to display a summary section at the bottom of the day sheet that includes a breakdown of payment activity (excluding write‐offs) associated with batch numbers entered in the system. This breakdown also includes adjustments made to those sequences associated with the batch, as well as refunds. Show By Operator
Check this box to enable the User drop‐down list and display an Operator Summary section on the day sheet. This allows a supervisor (or those users with the View All security option) to generate a posting log for specific users (or all users) in the system and to display a breakdown of all users’ day totals.
Provider
If you want to view posting activity for specific provider, select that provider from this drop‐down list.
Location
If you want to view posting activity for a specific practice location, select that location from this drop‐down list.
Batch Number
If you want to see information for a single batch, select that batch from the Batch Number drop‐down list. The system displays the batch number at the top of the day sheet and provides only the information attached to that batch number. User
The system enables this drop‐down list when you check the Show By Operator box. Select a user from this drop‐down list to display a day sheet report for that user’s posting activity on that day sheet. Select (ALL) to view all activity and the breakdown of each user’s totals.
Overview of the Day Sheet Display
When you generate a day sheet, MicroMD PM displays the report on the screen for you to review, compare with your totals, print, and erase, thus closing the day. In addition to the posting log and the summary reports selected, this report provides you with a breakdown of your Accounts Receivable Information and a Day’s Summary. Any deleted or voided transactions appear in bold on the day sheet.
Setting Up the Day Sheet Display
9.7
Day Sheets and Charge Slips
Posting Details Section
In the top portion of the day sheet, the system displays the posting log—all of the posting activity performed by your staff members throughout the day under that day sheet date. This includes charges, payments, adjustments, etc.
Figure 9‐4 Posting Log Portion of the Day Sheet
Totals Section
The day sheet report lists the total charges, payment, write‐offs, refunds, and adjustments posted for that date. The system then subdivides the payment information into the type of payment posted (cash, check, etc.). If your practice has a specific co‐pay payment code (where the Co‐Pay box is checked on the payment code’s Procedure Detail window), then the system also displays how much of the total payment amounts were co‐pays.
9.8
Setting Up the Day Sheet Display
Day Sheets and Charge Slips
Figure 9‐5 Totals Section of the Day Sheet
TIP | The system can only separate your co‐pay amounts if you use separate co‐pay codes. For example, you should create separate co‐pay codes for cash, check, and credit card payments and use those codes when the patient’s payment is their co‐pay. Following these totals is a breakdown of the total adjustments that staff members posted for that day sheet date. These figures should be reviewed to make sure the proper adjustment codes were posted prior to closing/erasing the day sheet.
Provider Summary Section
The Provider Summary Section breaks up the day’s totals per provider per location. If you chose a specific provider from the Provider drop‐down and/or a specific location from the Location drop‐down list on the Day Sheet Options window, MicroMD PM only includes that provider’s totals in this section.
Optional Summary Sections
Depending on the choices you make in the Day Sheet Options window, the system displays a variety of summary sections at the bottom of the day sheet. Setting Up the Day Sheet Display
9.9
Day Sheets and Charge Slips
CLOSING/ERASING THE DAY SHEET
After everyone has finished posting financial transactions against a day sheet and has balanced their totals with the totals on the day sheet, the day sheet can be printed and closed/erased. Once the day sheet is closed/erased, the total charges, payments, write‐offs and refunds are entered into a database table and used to calculate your accounts receivable.
STOP | If you have multiple day sheets open in the system, you MUST remember to close/erase them in the correct order. Your AR totals could be extremely distorted if day sheets are closed/
erased out of order. Balancing the Day Sheet
The Day’s Summary section of the day sheet is a key element in balancing the day sheet—for each user, as well as the practice as a whole. (The system displays this section if you have the Show Day Summary option checked on the Day Sheet Options window). It displays a single total amount at the end of the totals section, with all adjustments already taken into account, that users can easily match with their totals and the practice can match with the grand total.
For example, remember our example practice? In that scenario, Kim was posting charges, Tom was posting payments, and Jennifer closed/erased the day sheets. To help Kim and Tom out, the administrator removed the View All security option for the Day Sheet and removed the Change Settings security option from Kim and Tom. Then the administrator made the day sheet option choices she wanted chosen, including Show Day Summary. Jennifer has the security rights to view all and change settings because she needs to be able to research if something is off.
Now, when Tom selects Billing > Day Sheet from the main menu, the Day Sheet Options have already been chosen for him. All he has to do is click Accept and scroll down to the Day’s Summary section. The totals displayed relate only to his posting activity. He can simply match the totals in MicroMD PM with his totals. If something is off, he can review the breakdown to help narrow down where he made his mistake.
Erasing the Day Sheet
Once a day sheet balances, it is time to close/erase it. Once a day sheet is closed/erased, staff members can no longer post against that day. Only users with the appropriate security rights can create a new day sheet with the same date as an closed/erased day sheet, but doing so is not recommended as this action adversely affects your accounts receivable totals. NOTE | If you have a specific operator, provider, or location chosen, the system does not allow you to close/erase the day sheet. You must set those choices to all before you have the option to delete the day sheet.
9.10
Closing/Erasing the Day Sheet
Day Sheets and Charge Slips
The basic steps to erasing your day sheet:
Procedure
Details
1. Select Billing > Day Sheet from the main menu.
The Day Sheet Options window opens.
2. Select the appropriate selections for printing the day sheet.
3. Click Accept.
The system saves these options for the next time.
4. Review the day sheet one final time.
5. Click the Print icon on the Task Pane.
The system sends your day sheet to the printer so you have a hard copy for your records. Then the Day Sheet pop‐up appears. This allows you to perform various closing activities, including to close/erase the day sheet.
6. Check the Erase Day Sheet box, along with any other activities you want to perform.
7. Click Accept.
The system sends the appropriate reports to your default printer.
When there is only one day sheet in the system, and it is printed and closed/erased, the batch totals automatically reset. If there are multiple day sheets in the system, the program asks you if the batch total should be reset. Retrieving Day Sheet Totals
You can retrieve the day sheet totals in a couple of ways in the future, depending on your needs:
 Day Sheet Summary report: This is a comprehensive monthly summary of all the day sheets you have created for a specified month. It reflects total monthly charges, payments, write‐
offs, and refunds. Select Reports > Summary > Day Sheet Summary from the main menu. Please refer to the MicroMD PM Reports Guide for more in‐depth information.
 Posting Details by Patient Report: This report can provide transaction activity posted against an individual patient’s account. Select Reports > Management > Posting Details By Patient from the main menu.
 Review Most Recent utility: If you clicked Yes to the prompt to save the day sheet for later viewing, the system created a PDF for you and stored it. Select Utility > Review Most Recent > Day Sheet from the main menu. Activities Available with the Day Sheet
When closing/erasing your day sheet, there are several activities that the system can perform quickly for you based on the work you and your staff have already done. The system can take payment data and create a deposit slip for you to take with you to the bank, so you don’t have to take precious time to write Closing/Erasing the Day Sheet
9.11
Day Sheets and Charge Slips
everything by hand. If you post charges from the charge slip in the system, you can view a list of charge slips that were printed for patients but had no charges posted from them. The system can also tell you if those charge slips were a result of a missed appointment.
Figure 9‐6 Activities Available for the Day Sheet
Print Deposit Slip
The deposit slip in MicroMD PM is a list of payments posted on that day sheet. The system lists those payments in posting order and separates them into cash and non‐cash (checks, money orders) items. Any adjustments posted to those payments appear in the Adjustments column.
To provide a HIPAA‐compliant deposit slip, the system provides the option to prohibit patient names from printing on the deposit slip. Uncheck the Print patient names checkbox (under the Print Deposit Slip checkbox) if you want to prevent the names from appearing on the deposit slip.
Print a Charge Slip Report
Check this box to print a list of all of the patients who had a charge slip—encounter forms, routing slips, super bills—printed but had no charges posted to them on that particular day sheet. Since each charge slip is assigned an individual number, that number also prints on this report, as well as the total number of charge slips printed for the day. If a staff member marks a patient’s appointment as cancelled or rescheduled, the system highlights those charge slips on the report in yellow.
NOTE | Temporary patients do not appear on this report.
Erase Day Sheet
Check this box to permanently delete this day sheet. Print Missed Appointments (Based on Charge Slips)
The system automatically compares the patients listed on the Charge Slip Report with the appointment schedule for the day and then displays the Missed Appointment Report for those patients with no charges posted. If there are no missed appointments after this comparison, the system displays a message to that effect and does not display a report window.
9.12
Closing/Erasing the Day Sheet
Day Sheets and Charge Slips
Figure 9‐7 Missed Appointment Report This report window provides you with three options:
 Print: Click the Print button to print this list (as displayed on the screen) to your default printer.
 Update: Click the Update button to mark the status of the scheduled appointment(s) for the selected patient(s) as “Missed.” If there are specific appointments you do not want to update, uncheck the box next to those appointments.
 Close: Click Close to exit the window without making any changes to the status of the appointments.
You can track missed appointments using the Appointment Status Report or in the patient’s appointment history.
Print Missed Appointments (Based on Check In/Check Out Module)
If you use the Check In/Check Out Module and you want to see a report of all missed appointments based on whether the patients checked in and had charges posted to their account, you can check the Missed Appt Report box on the Day Sheet pop‐up window. This checkbox is available if there is a check mark in the Use CheckIn for Missed Appts box on the System Preferences tab (under Setup > System Preferences).
NOTE | The system automatically displays a missed appointment report based on charge slips.
This report window provides you with three options:
 Print: Click the Print button to print this list (as displayed on the screen) to your default printer.
 Update: Click the Update button to mark the status of the scheduled appointment(s) for the selected patient(s) as “Missed.” If there are specific appointments you do not want to update, uncheck the box next to those appointments.
NOTE | Updating an appointment’s status does not delete that appointment from the schedule.
 Close: Click Close to exit the window without making any changes to the status of the appointments.
Closing/Erasing the Day Sheet
9.13
Day Sheets and Charge Slips
You can track missed appointments using the Appointment Status Report or in the patient’s appointment history.
CHARGE SLIPS
Charge slips—encounter forms, routing slips, super bills—are the documents that the office staff and provider complete to indicate the services rendered to a patient for that visit to the office. They usually contain procedure codes and may include diagnosis codes. Once the provider completes the charge slip and turns it over to the billing department, those staff members can post charges directly from the Charge Slip List in the system.
As charge slips should coincide with the appointment date or date of service, you should make sure you are on the appropriate day sheet when printing charge slips. The system automatically numbers each charge slip printed to help staff members post charges and balance their posting activity at the end of the day. This also helps you to check which charge slips were printed but had no activity posted from them. Were the appointments cancelled? Were the services performed and the charge slip mistakenly put into the chart? And so on. Designing a Charge Slip
When you create charge slip documents, you must do so through the Charge Slip Module. There are three formats for creating charges slips to use in your practice: text, word‐processing document, or a mail merge document.
NOTE | If there are already charge slips in your system, the system uses the format of the currently active charge slip as your new format when adding a new one.
For example, if you have an OBGYN charge slip displayed in the Charge Slip window with Word as its format, the system assumes any new charge slips are also going to be word‐
processing documents.
Many staff members responsible for creating charge slips (mostly those created with Microsoft Word) tend to create those documents outside of the system first . These users then copy from their document and paste the contents into a new document within MicroMD PM. A myriad of problems could arise from this simple task. Here are some suggestions. Compare the original Word file with the new one created in the system.
 Are the margins the same between the original and the new one?
 Are the font sizes in the document the same? Microsoft Word uses the Normal.dot file, which houses many different properties and can be different across computers.
 Did you use a table in the original document? Make sure the column widths and row heights are the same in the new document as they are in the original.
 Did you create columns in the original? Make sure you have the same columns created in the new document.
The above tests should remedy some of the most common problems people encounter when using Word to create charge slips outside of the system.
9.14
Charge Slips
Day Sheets and Charge Slips
Text-Based Charge Slip
This is a text‐based charge slip created within the Charge Slip window. The system automatically includes a 3½‐inch header block at the top of the charge slip containing information related to the patient and the patient’s appointment, including the charge slip number.
To create a text‐based charge slip:
Procedure
Details
1. Select Billing > Charge Slips from the main menu.
The Charge Slips window opens. (You can also press the F8 key to open this window.)
If there are no charge slips created, the system automatically begins the process for you and prompts for a charge slip description (skip to step 3).
2. Click the New icon on the Task Pane.
If the system prompts you to save changes to the currently displayed charge slip, click the appropriate answer.
The Charge Slip Description dialog pops up.
3. Type in the name for the charge slip that makes it easily identifiable to staff members in the practice.
4. Click Accept.
The system creates a new entry in the Charge Slip Description drop‐down list, including the internal ID number for the charge slip.
5. Verify that Text appears in the drop‐down list below the Charge Slip Description list.
6. Select the point size for the text of the charge slip from the 8, 10, and 12 font size options.
7. Click inside the large text area at the bottom Remember that the system automatically includes a header block at the top of the charge slip with of the Charge Slip window and design the patient and appointment information.
bottom portion of your charge slip.
TIP | As a rule of thumb, leave the bottom 3½ inches of the text document empty.
8. When you are finished, click the Save icon on You can also press the Ctrl + S key combination.
the Task Pane to save your changes.
That’s it! You’re done with your text‐based charge slip.
Word-Processing Charge Slip
This is a Microsoft Word or WordPad document that you create and edit directly through MicroMD PM. The system automatically includes a 3½‐inch header block at the top of the charge Charge Slips
9.15
Day Sheets and Charge Slips
slip containing information related to the patient and the patient’s appointment, including the charge slip number. The application the system uses depends on the program listed in the Word Processing Program field on the Documentation Paths window (under Utility > Workstation Setup > Documentation Paths). NOTE | Staff members do not need to have Microsoft Word or WordPad to print this type of charge slip. They only need the appropriate program on their workstation if they need to edit the charge slip design.
To create a charge slip using a commercial word processor:
Procedure
Details
1. Select Billing > Charge Slips from the main menu.
The Charge Slips window opens. (You can also press F8 to open this window.)
If there are no charge slips created, the system automatically begins the process for you and prompts for a charge slip description (skip to step 3).
2. Click the New icon on the Task Pane.
If the system prompts you to save changes to the currently displayed charge slip, click the appropriate answer.
The Charge Slip Description dialog pops up.
3. Type in the name for the charge slip that makes it easily identifiable to staff members in the practice.
4. Click Accept.
The system creates a new entry in the Charge Slip Description drop‐down list, including the internal ID number for the charge slip.
5. Verify that Word appears in the drop‐down list below the Charge Slip Description list.
6. Double‐click large blank grey area under the This launches a new blank document in Microsoft Word.
drop‐down lists.
7. Design the bottom portion of your charge slip as needed.
Remember that the system automatically includes a header block at the top of the charge slip with patient and appointment information.
TIP | Set the bottom margin of your Word document to about 3½ inches. This will help when you’re designing.
8. Save your document and close Word.
9.16
The system should now be your active window, and you should see a preview of your document in the grey area you double‐clicked earlier.
Charge Slips
Day Sheets and Charge Slips
Microsoft Word Mail Merge Charge Slip
With the help of the mail merge feature in Word, practices can fully customize their charge slips and the information that appears in them. On this type of charge slip, MicroMD PM does not include a header block on the document. The system provides a completely blank canvas and the flexibility to design a charge slip to fit the needs of your practice.
NOTE | Staff members who print mail merge charge slips MUST have Microsoft Word installed on their workstations since the system opens the application to print those documents.
STOP | You should not edit a mail merge charge slip document from outside the system. You must edit the document through the Charge Slip Module. Serious issues could arise that can corrupt your charge slip file if you attempt to edit the document outside of the system.
To create a mail merge charge slip:
Procedure
Details
1. Select Billing > Charge Slips from the main menu.
The Charge Slip window opens. (You can also press F8 to open this window.)
If there are no charge slips created, the system automatically begins the process for you and prompts for a charge slip description (skip to step 3).
2. Click the New icon on the Task Pane.
If the system prompts you to save changes to the currently displayed charge slip, click the appropriate answer.
The Charge Slip Description dialog pops up.
3. Type in the name for the charge slip that makes it easily identifiable to staff members in the practice.
4. Click Accept.
The system creates a new entry in the Charge Slip Description drop‐down list, including the internal ID number for the charge slip.
5. Verify that Mail Merge appears in the drop‐down list below the Charge Slip Description list.
6. Click the Open button.
Charge Slips
This launches a new Superbill document in Microsoft Word and links the document to the information in your database.
9.17
Day Sheets and Charge Slips
7. The document is all yours. Design the charge slip as needed, using the mail merge fields you need.
8. Close the document and exit Word.
If you are prompted to save the document, click Yes. The system might prompt you again to save the document.
9. Click the Save icon on the Task Pane to save the charge slip.
This finalizes the link between the document and the database.
That’s it! You’re done with your mail merge charge slip.
Editing the Charge Slip
Once you have created your charge slip, you can edit it whenever necessary. However, the method you use to edit the charge slip depends on how you created it:
 Text: If you created the charge slip using the text option, you can edit the charge slip in the Charge Slip window. Simply select the charge slip from the Charge Slip Description drop‐down list, edit it directly in the text area, and save the changes.
 Word: If you created the charge slip in Word, select the charge slip from the Charge Slip Description drop‐down list and double‐click the text area. This opens the charge slip in Word, where you can edit the document as needed. NOTE | Remember to save your changes, even if you save them while still in the Word application.
 Mail Merge: If you created a mail merge charge slip, select the charge slip from the Charge Slip Description drop‐down list and click the Open button. This opens the charge slip in Word, where you can edit the document as needed.
CHARGE SLIP OPTIONS
The Charge Slip Options window allows practices to customize some of the information that appears in the header block on text‐based or Word‐based charge slips. These options do not apply to mail merge charge slips; however, the bottom portion of the window involves some printing preferences that pertain to all charge slips.
9.18
Charge Slip Options
Day Sheets and Charge Slips
Figure 9‐8 Charge Slip Options Window
Customize Header Block
The system provides a header block with text‐ and Word‐based charge slips. Practices can customize much of this information to suit their needs. To customize the information included on the charge slip, click the Charge Slip Options icon on the Task Pane. Options Available for Customizing the Charge Slip Header:
Field
Description
Print Insurance Info
Check this box to print the insurance plan and policy number, along with other basic insurance information. The system prints insurance information for up to three active insurance plans listed on the patient’s Plan Sets tab.
Print Last Payment Date
Check this box to print the date of the last patient payment and the last insurance payment posted to the account.
Print Last Payment Amount
Check this box to print the amount of the last patient payment and the last insurance payment posted to the account. (The system notes credit amounts in red.)
Print Medical Alerts
Check this box to print the information from the Medical Alerts field (on the Patient Detail window) on the charge slips.
Charge Slip Options
9.19
Day Sheets and Charge Slips
Pat Category or Appt Class
Check the Pat Category box to print the category indicated in the patient’s Category drop‐down list (on the Patient Detail window), or check the Appt Class box to print the Appointment Class of the visit for which the charge slip was printed.
Patient Aging or Planned Visits
Check the Patient Aging box to print a complete aging of the account, based on personal and insurance responsibility. If your practice uses Family Billing (i.e., sub‐accounts), the aging‐bucket display includes totals for the entire family. The system also displays a Patient Billing area for the individual patient on the charge slip.
Alternatively, you can check the Planned Visits box to print the list of pre‐
authorized visits on each patient’s charge slip.
Remarks or Appt Note
Check the Remarks box to print the information from the patient’s Remarks field (available on the Patient Detail, Billing Inquiry, or appointment detail windows), or check the Appt Note box to print the information from the Note field on the appointment detail window.
Chronic Diag or Last Diag
Check the Chronic Diag box to print the four diagnosis codes on the Cases tab for the case associated with each patient’s appointment, or check the Last Diag box to print the last four diagnosis codes posted to each patient’s account.
Employer or PCP
Check the Employer box to print each patient’s employer on their charge slip, or check the PCP box to print each patient’s primary care physician on their charge slip (listed on their appointment detail and Patient Detail windows).
Creation Date or PostOp Date
Check the Creation Date box to print the date the patient’s account was created in the database, or check the PostOp Date box to print each patient’s post‐op date, if any, on their charge slip.
Home Phone or Cell Phone Check the corresponding box to print the appropriate patient phone number on their charge slip. These fields on the Charge Slip Options window correspond to the appropriate fields on the Detail tab of the Patient Detail window.
Work Phone or Alt. Phone
Printing Options Available for All Charge Slips
There are several additional options for printing charge slips, other than “what” to print on the charge slip. The Charge Slip Options window, accessed through the Charge Slip Options icon on the Task Pane, is the main default control for these print options. Staff members can change these options on a case‐by‐
case basis on the Charge Slip Autoload window.
9.20
Charge Slip Options
Day Sheets and Charge Slips
Additional Charge Slip Print Options:
Field
Description
Print a Charge Slip for Set the default value for the Print a Charge Slip for Every Appt checkbox found Every Appt
on the Charge Slip Autoload window. When this box is checked on the Charge Slip Autoload window, MicroMD PM prints a charge slip for every appointment loaded, regardless if several appointments are for the same patient. With this box unchecked, the system prints one charge slip for every patient, regardless if they have multiple appointments.
For example, Anthony Smith has two appointments scheduled for tomorrow—one with Dr. Kumar and for a lab test. With this box checked, the system prints two charge slips for Mr. Smith. With this box unchecked, the system prints a single charge slip based on Mr. Smith’s first appointment and only includes information from the first appointment.
Show Print Option
Check this box to enable the ability to print multiple copies of each charge slip. The system then displays the Copies field on the Charge Slip window that allows users to indicate how many copies to print of each charge slip.
Print Charge Slip For Temp Patient
Check this box to include temporary patients when printing charge slips. You must use the Autoload feature to print charge slips for temporary patients.
Exclude Already Printed
Choose the default value for the Exclude Already Printed checkbox on the Charge Slip Autoload window. When this box is checked on the Charge Slip Autoload window, MicroMD PM verifies if it has printed a charge slip for that appointment and only prints it if it has not done so already.
For example, if you need to print charge slips for appointments that were scheduled after you had already printed everything for the next day, you can choose to print only those charge slips.
Exclude SSN
When you check this box, the system does not print the patient’s social security number on the charge slip.
DEFAULT CHARGE SLIPS
By default, the system prints the charge slip currently selected in the Charge Slip window. The system also allows practices to associate a charge slip to a provider and an Appointment Class. The system checks for a charge slip in the following order. (If there are no charge slips specified, the system prints the charge slip chosen in the Charge Slip window.)
 Provider: If the provider’s Charge Slip drop‐down is set to (Default), the system checks the appointment’s Charge Slip Description drop‐down.  Appointment: If the appointment’s Charge Slip Description drop‐down is set to (Default), then the system uses the charge slip chosen in the Charge Slip window.
Default Charge Slips
9.21
Day Sheets and Charge Slips
Associate a Charge Slip with a Provider
Practices can tell MicroMD PM to always use a specific charge slip for patients seen by a particular physician. Choosing a charge slip for a provider prints this charge slip for all of this provider’s appointments if the charge slip for the Appointment Class is set to (Default).
NOTE | The charge slip associated with an Appointment Class overrides the provider’s charge slip.
For example, in Advanced Family Practice, Dr. Kumar is an OBGYN and Dr. Davidson is a cardiologist. The diagnosis and procedure codes these physicians use are different from the other (plus Dr. Davidson is a little far‐sighted and sometimes forgets his glasses). Advanced Family Practice created two separate charge slips with appropriate codes for the physician’s specialty (plus a little larger font size for Dr. Davidson) and associated them accordingly. Whenever patients are seen by either physician, the correct charge slip prints automatically. To associate a charge slip with a provider:
Procedure
Details
1. Select Maint > Practice from the main menu.
The Practice List window opens.
2. Double‐click the appropriate practice name from the list.
3. Click the Provider tab.
4. Highlight the provider for whom you want to specify a charge slip.
5. Select the charge slip you want to use for this provider’s appointments from the Charge Slip drop‐down list on the right side of the window.
Select (Default) to use the charge slip specified for the Appointment Class.
6. Click the Save icon on the Task Pane and exit the window.
Associate a Charge Slip for an Appointment Class
If you want to create a charge slip for specific Appointment Classes (e.g., a well visit, sports physical, labs), you can create the unique charge slip and then associate that charge slip with the appropriate Appointment Class.
TIP | Remember that a charge slip associated with an Appointment Class overrides the charge slip associated with a provider. If you use provider‐specific charge slips, you should keep the Appointment Class at (Default).
9.22
Default Charge Slips
Day Sheets and Charge Slips
NOTE | You can force the system to print the charge slip selected in the Charge Slip window by placing a check mark in the Force box.
To associate a charge slip with an Appointment Class:
Procedure
Details
1. Select Appt > Setup > Classification from the main menu.
2. Select the appropriate charge slip from the Default Charge Slip drop‐down list next to the Appointment Class for which you want to specify a charge slip.
Select (Default) to use the charge slip specified for the provider. If the provider is set to (Default), the system uses the charge slip chosen in the Charge Slip window.
3. Continue for all Appointment Classes as needed.
4. lick the Save icon on the Task Pane and exit the window.
PRINTING CHARGE SLIPS
Printing charge slips is almost the same, regardless of whether it is text‐based, Word‐based or a mail merge document. There are a couple of ways to print charge slips in the system. You can automatically load those patients with a scheduled appointment, or you can pick and choose the patient(s) for whom you want to print a charge slip.
When you print charge slips, MicroMD PM displays the list of charge slips in the Posting Module. Staff members can post directly from the charge slip entries. This list appears if you have the Charge Slip List box checked on the Display Properties window (under Workstation Setup > Display Properties).
Print Under the Appropriate Day Sheet
You should print charge slips under the appropriate day sheet. If you have not selected a day sheet yet, the system prompts you to select the day sheet for which you want to print charge slips. However, if you have been working with another day sheet, you must remember to switch if you want to print charge slips for another day sheet date.
For our Example Practice, Jennifer is finished balancing 07/30/2009 and is ready to prepare for tomorrow’s patients. Since there are still day sheets open in the system for08/01/2009, 08/02/2009, and 08/03/2009, she made sure that she selected 08/03/2009 before she prints her charge slips.
Printing Charge Slips
9.23
Day Sheets and Charge Slips
STOP | It is extremely important to make sure you make sure your active day sheet is the day sheet for which you want to print charge slips. If the person closing/erasing the day sheet chooses to print a Charge Slip Report, the system lists any patient who had a charge slip printed but did not have any charges posted.
Select Misc > Day Sheet Date – Select and select the appropriate day sheet or create a new one. Charge Slip Print Order
With the many changes to the Charge Slip Module over the last two years, there has been some confusion about the order in which MicroMD PM now prints charge slips and about printing charge slips for temporary patients.
Charge Slips for Temporary Patients
You cannot print mail merge charge slips for temporary patients. You can still, however, print text or Word (without merge fields) charge slips for temporary patients just as you can for permanent patients. Mail merge fields can only pull information from data committed to the database, and temporary patients (by design) are new patients that have not been committed to the database. If you want to print mail merge charge slips for all of your patients, you can create a separate text charge slip or a Word charge slip (i.e., one without merge fields) for your temporary patients. After you autoload appointments and print your mail merge charge slips, you can use the Exclude Already Printed option on the Charge Slip Autoload window and the Force checkbox on the main window to grab your temporary patients for that day and print charge slips for them. Figure 9‐9 Charge Slip Autoload Window
The combination of these options allows you to load the same appointments you loaded the first time but without the appointments for which you already printed a mail merge charge slip. The Force checkbox forces the system to print the charge slip you have selected in the main window for the patients selected (i.e., your temporary patients).
9.24
Printing Charge Slips
Day Sheets and Charge Slips
NOTE | When you attempt to autoload the same patients, you must make sure that the options you choose on the Charge Slip Autoload window match the options chosen when the charge slips were originally printed in order for the system to exclude the appropriate patients.
When Autoloading Patients
If you autoload patients from the appointment schedule and you HAVE NOT assigned different charge slips to different providers and appointment classes, the Charge Slip Module prints charge slips for you in the order the patients appear in the Patient Selection window. (The system displays the patients grouped by provider and then by appointment time by default.) If you sort the window by one of the columns, the system prints charge slips in order by that column, rather than by any other order. For example, if you sort the window by the SS No column after you autoload them, the system prints the charge slips in order by the patient’s social security number.
When Picking and Choosing Individual Patients
When you do not use the autoload feature, you enter the patients individually and you HAVE NOT assigned different charge slips to different providers and appointment classes, the Charge Slip Module prints charge slips for you in the order the patients appear in the Patient Selection window. If you sort by a column in this window, the system prints charge slips in that order.
When Using Multiple Charge Slips
You have the ability in the system to associate charge slips to appointment classes and providers. Whether you autoload patients or select them individually, the system prints charge slips in an order depending on the charge slip it needs to print. The system prints all appointments with (Default) chosen on the appointment detail window first. Those charge slips are in order by provider and appointment time. Then the system prints charge slips for appointments that have a specific charge slip chosen on the appointment detail, and those charge slips are in order by provider and appointment time. The system then prints all of the next specified charge slips, and those charge slips are in order by provider and appointment time. And so on for each different charge slip.
NOTE | If each of a provider’s appointments uses a different charge slip, the charge slips for those appointments are printed with their appropriate charge slip group.
TIP | If you want to print the same charge slip for the patients listed in the Patient Selection window, use the Force checkbox. When you check this box, the system prints the charge slip selected in the main window for all patients listed and in the order they are listed.
Printing Charge Slips
9.25
Day Sheets and Charge Slips
Figure 9‐10 Appointment Detail – Associated Charge Slip
For example, Advanced Family Practice uses a different charge slip for appointments associated with the LAB Appointment Class. They have three providers, and Dr. Kumar needs a special charge slip for all of his appointments, regardless of class. When Advanced Family uses the Autoload feature to print charge slips for tomorrow, MicroMD PM prints all of the charge slips with (Default) selected in the Charge Slip Description drop‐down on the appointment. The charge slips in that group print in order by provider and appointment time. Then the system prints all of the LAB charge slips in order by provider and appointment time. Then the system prints all of Dr. Kumar’s charge slips in order by appointment time. If one of the other providers used the same charge slip as Dr. Kumar, their patients would be included in that group of charge slips.
Print Charge Slips for Patients with a Scheduled Appointment
The best way to print charge slips every day is to use the Autoload feature. The Autoload feature in the Charge Slip Module allows practices to print charge slips quickly for all patients with an appointment scheduled on a given day. This is helpful when preparing for the next day of business. Once you print charge slips this way, you can use the Exclude Already Printed checkbox to print only those charge slips that haven’t been printed yet.
NOTE | You must use the Autoload feature to print charge slips for temporary patients and verify that there is a check mark in the Print Charge Slip for Temp Patient checkbox on the Charge Slip Autoload window.
To print charge slips using the Autoload feature:
Procedure
Details
1. Select Billing > Charge Slip from the main menu.
The Charge Slip and Patient Selection windows open. (You can also press the F8 key to open this module.)
If the system prompts you to select a day sheet, be sure to select the day sheet for which you want to print the charge slips.
9.26
Printing Charge Slips
Day Sheets and Charge Slips
2. Click the Autoload Patients icon on the Task Pane.
The Charge Slip Autoload window opens.
TIP | Both the title bar of the Charge Slip window and the Day Sheet Date field on the Charge Slip Autoload window should correspond to your active day sheet.
3. From the Appt Date field, choose the appointment date for which you want to print charge slips, if different from the default.
This field defaults to the current system date.
If you choose a date in the future, the system automatically changes the Day Sheet Date field to match for the purposes of printing the charge slips and makes that your active day sheet while in the Charge Slip Module, even if there is no day sheet created for that day.
TIP | Be sure to tab off the Appt Date or Day Sheet Date field if you make a change.
When you exit the Charge Slip Module, the day sheet date with which you were working before printing charge slips remains in effect.
4. To print charge slips for a specific provider, select the provider(s) from the Provider drop‐down list.
When you autoload a list of patients from the Appointment Module, the system prevents staff members from adding additional patients (or another provider’s patients if you select a specific provider from the Charge Slip Autoload window).
5. To print charge slips for a specific location, select the location(s) from the Location drop‐down list.
6. If you want to print charge slips for appointments within a specific time frame, enter that time range in the Appointment Time Range fields.
7. If necessary, change the print options for this batch of charge slips.
Printing Charge Slips
Set the defaults for these options in the Charge Slip Options window.
9.27
Day Sheets and Charge Slips
8. Click Accept to load the patients that meet this criteria into the Patient Selection window.
If you already have patients in the Patient Selection window, the system clears those patients from the list before autoloading another set of patients from the Appointment Module. 9. Click the Print icon on the Task Pane.
The system prints charge slips for the patients listed in the Patient Selection window and numbers those charge slips in the order it prints them. TIP | Remember, the system first prints charge slips for those patients whose appointment calls for the (Default) charge slip. Then the people prints the remaining charge slips by charge slip ID, then appointment time.
Pick and Choose Patients for Whom to Print Charge Slips
There may be times when you need to print a charge slip for an individual patient (e.g., a walk‐in patient). For whatever reason, you can select specific patients using the Patient Selection window. Each patient for whom you want to print a charge slip must appear in the top portion of the Patient Selection window. If you do not need to print a charge slip for a patient’s name that appears in this window, simply double‐
click on the name and it disappears from the list.
Figure 9‐11 Patient Selection Window
TIP | Press the Ctrl + F8 key combination anywhere in MicroMD PM to launch the Charge Slip Module with your current patient already selected in the Patient Selection window.
If the patients for whom you print charge slips have an appointment scheduled on the day sheet date for which you are printing charge slips, their appointment date/time display in the upper right‐hand corner of the charge slip and the provider for that appointment displays underneath. 9.28
Printing Charge Slips
Day Sheets and Charge Slips
To pick and choose patients for whom to print charge slips:
Procedure
Details
1. Select Billing > Charge Slip from the main menu.
The Charge Slip and Patient Selection windows open with the focus of your cursor already in the Patient Name/No field to begin typing right away. (You can also press the F8 key to launch the Charge Slip Module.)
2. In the Patient Selection window, enter the patients for whom you would like to print charge slips.
TIP | If you do not see the Patient Selection window, click the Patient Select icon on the Task Pane to display the window.
3. Click the Print icon on the Task Pane.
The system prints all the charge slips at once. The system automatically populates patient information according to the type of charge slip and the charge slip options chosen.
TIP | Remember, the system first prints charge slips for those patients whose appointment calls for the (Default) charge slip. Then the system prints the remaining charge slips by charge slip ID, then appointment time.
Reprinting Charge Slips
If you printed charge slips for tomorrow only to find out that the printer jammed part way through the job, you have the ability to print those charge slips again without changing the charge slip’s ID.
Simply repopulate the Patient Selection window with the same patients, place a check mark in the Reprint checkbox on the Charge Slip window, and print your charge slips. The system sends the charge slips to the printer again.
Re‐printing a mail merge change slip and superbill will include the updated and accurate information based on the updated appointment plan info.
Figure 9‐12 Option to Reprint Charge Slips
NOTE | When you choose Reprint, this overrides the Exclude Already Printed option on both the Charge Slip Options window and the Charge Slip Autoload window.
Printing Charge Slips
9.29
Day Sheets and Charge Slips
Missing Charge Slip Report
The Missing Charge Slip Report provides a way for those practices that post charges from the charge slip to account for all charge slips printed in the system that had no charges posted to them by the time a staff member closed/erased the day sheet. If you’re researching why your totals didn’t balance, this can help. You can print this report without printing the day sheet first. Temporary patients do not appear on this report.
Figure 9‐13 Missing Charge Slip Report
Select Misc > Missing Charge Slip Report from the main menu to access this report. Report Options Available for the Missing Charge Slip Report:
Field
Description
Day Sheet Date
Select the day sheet date or range of day sheets for which you want to find all charge slips from which there have been no charges posted.
Pat ID
To view missing charge slips for specific patients by ID, enter the ID or range of IDs here. Leave the default value if you want to include all patients. For a single patient, enter the patient’s ID in both the From and the To field.
Pat Name
To view missing charge slips for specific patients by name, enter the name or name range here. For a single patient, enter the patient’s last name in both the From and the To field. For a range of patient names (e.g., patients from Abercrombie to Connor or all patients from N through T), enter the range here.
Provider
To view the missing charge slips printed for a specific provider (but had no charges posted from the charge slip), select the provider(s) from this list.
Location
To view the missing charge slips printed for specific locations, select the location(s) from this list.
Show All
Check this box to display all charge slips that have been printed for the day sheet date or range indicated, including on open day sheets, whether or not charges have been posted to them.
Group By
You can organize the information in the report by Provider and/or Location.
TIP | Don’t forget that you can use the Group Options icon to create page breaks, renumber pages, etc. based on the grouping you select.
Deleting Charge Slips
Once the day sheet has been closed/erased, the missing charge slips can only be deleted or left in the system. They are no longer available for posting charges since their associated day sheet is no longer 9.30
Printing Charge Slips
Day Sheets and Charge Slips
available. If you locate a charge slip on this report and then post the charges, or the charge slip is related to a missed/rescheduled appointment, you should remove the charge slip from MicroMD PM.
To remove a charge slip from the system for a closed/erased day sheet:
Procedure
Details
1. Select Misc > Missing Charge Slip Report from the main menu.
2. Select the appropriate report options.
3. Place a check mark in the Delete column next to the charge slip(s) you want to remove.
4. Click the Delete icon on the Task Pane.
This removes the selected charge slip(s) from the system, and they no longer appear on the report.
Highlighted Entries on the Report
On the Missing Charge Slip Report, the system highlights the charge slips (in yellow) for those patients whose appointments were removed from the schedule.
Printing Charge Slips
9.31
APPOINTMENTS
MicroMD PM combines sophisticated scheduling and management tools to help you and your staff be more productive while improving service to your patients. The Appointment Module lets you manage all aspects of providers’ and patients’ schedules from a central location in the system, accessible from each workstation. Support staff can easily schedule, reschedule, or cancel appointments using simple point‐
and‐click and drag‐and‐drop operations with this intuitive module, as well as print mail merge documents and labels.
IN THIS CHAPTER
In this chapter, we cover how to:
 Set up the Appointment Module
 View appointments
 Schedule, copy, delete and reschedule appointments
 Find an open appointment slot
 Access a list of patient appointments when they call
 Use the Appointment Clipboard
 Access and use the Appointment Log
 Remove old appointments from the database
 Use the Check‐In/Check‐Out Module
 Add patients to a Waiting List
 Keep track of hospital rounds
 Generate appointment reports
 Print appointment‐related mail merge documents
SET UP APPOINTMENT MODULE
Since you can tailor the system to meet your specific practice requirements, you must first set up your database for appointments prior to scheduling. By doing the preliminary work, your appointment management remains consistent, and the staff can perform other appointment operations—scheduling, inquiry, and reporting—more efficiently.
Once you create your Appointment Classes and establish preferences, you can then create your schedules. You must first create a day template. This tells the system how you schedule appointments, what time you set aside for consultations, lunch, drug reps, etc. Then you tell the system your normal week schedule, including the days that your practice is closed. After you have those established, you can tell the system all about provider schedules in your practice.
Schedules you create are practice‐specific. Templates created in a practice are only available in that particular practice, but you can copy those templates from practice to practice and to providers within the same practice.
In This Chapter 10.1
Appointments
Set Up Appointment Classifications
Appointment classification allows you to assign a background color, text color, description, and time allotment for each appointment type for your practice. This makes it easy to identify types of appointments in the schedule at a glance. To create an Appointment Class:
Procedure
Details
1. Select Appt > Setup > Classification from the main menu.
The Classification window opens.
2. Click the New icon on the Task Pane.
3. In the Desc column, enter a useful, short description (up to 10 characters) to identify this type of appointment on the schedule.
4. In the Slots column, designate the default For example, a practice has their time slots in 15‐
number of time slots this type of appointment minute increments. Lab work typically takes 30 minutes. When they create their LAB WORK covers.
Appointment Class, they indicate that it takes up two slots when scheduling this type of appointment.
5. If appointments with this classification need a specific charge slip, select that charge slip from the Default Charge Slip drop‐down list.
6. If you want or need appointments with this Appointment Class to display in the Check‐In/Check‐Out Module or on any reports involving a count of appointments, verify that the Suppress checkbox for this class is not checked.
10.2
Some practices use appointments as reminders and not as actual appointments. The checkbox for the Appointment Class sets the default for the appointment entry screen.
Set up Appointment Module
Appointments
7. Select a color from the Background Color and Text Color drop‐down lists to color code this Appointment Class.
These colors display in the appointment schedule to help staff members quickly see what type of appointment is scheduled.
If you need to create new colors that are not in the list, select Custom from a color list, click one of the Custom colors squares, and click the Define Select Custom from either list and select a color from the Custom colors squares. Click OK Custom Colors button.
to use that color.
OR
Create your color by clicking anywhere in the color matrix. You can change the hue (Hue field) by moving the pointer horizontally, the saturation (Sat field) by moving the pointer vertically or adjust the luminosity (Lum field) by moving the slider at the right of the matrix. You can also choose to change the color by typing numerical values.
Click the Add to Custom Colors button and click OK.
Click the Save icon on the Task Pane and exit the window.
Deleting a Classification
You can delete appointment classifications if needed. A warning system activates when a staff member attempts to delete an Appointment Class (Appt > Setup > Classification). When they highlight a classification and click the Delete icon on the Task Pane, the system displays a warning about any associations with the classification that exist, including recall reasons and waiting list entries.
Staff members must reassign all of the associations before the system deletes the classification, even for past appointments. If the appointment classification has no associations with any other area of the system, the user simply has to confirm that they want to delete the record when prompted.
To reassign a classification:
Procedure
Details
1. Click Accept when prompted to reassign classifications.
Set up Appointment Module
10.3
Appointments
1. Select the new classification from the Reassign Classification drop‐down list.
You can print this list for your records by clicking the Print button.
2. Select the items you want to reassign to the selected Appointment Class.
NOTE | Remember that you must reassign all of the items in this list before you can delete the classification from the system.
OR
Deselect the items you do not want to reassign to the selected Appointment Class.
3. Click the Reassign button.
STOP | You cannot undo this action. Be sure you mean to delete this classification before you click the Reassign button.
4. Click OK to confirm that you want to delete the selected appointment classification.
5. Click the Save icon on the Task Pane to commit your changes.
Establish Appointment Preferences
There are some general display and interactivity preferences you can set for your Appointment Module. The Appointment Setup window allows you to establish several preferences including how your appointment views appear, as well as how the Appointment Schedule Report prints. You can also turn on (or off) the Appointment Confirmation feature.
Select Appt > Setup > General Setup from the main menu to access the Appointment Setup window. Click the Save icon on the Task Pane (or press the Ctrl + S key combination) to save your changes.
Figure 10‐1 General Appointment Setup Window
Setup Options Available for the Appointment Module:
Field
Description
Display Columns, Col 1 Text, Col 2 Text, and Col 3 Text
From the Display Columns field, choose how many columns of appointments you want to use when scheduling your providers in all appointment views. These columns allow your practice to single book, double book, or even triple book the physician(s). The Col 1 Text, Col 2 Text, and Col 3 Text fields allow you to label each column appropriately.
For example, a practice labeled their columns simply APPT 1, APPT 2, and APPT 3 so they could easily identify the columns.
10.4
Set up Appointment Module
Appointments
Appts
Select the number of columns you want the system to search when generating the Appointment Schedule Report or when searching for open slots: the first display column (1), both the first and second display columns (2), or all three display columns (3).
Show Confirm and Show Confirm Popup
Check the Show Confirm box to enable the confirmation indicator on the Appointments window and on the Appointment Schedule Report. Staff members can then check those boxes as they confirm patient appointments for a given day, using the appointment schedule window or using the Appointment Schedule Report.
Check the Show Confirm Popup box to enable a pop‐up information box when the mouse hovers over the confirmation checkbox on the Appointments window. This pop‐up displays the user who confirmed the appointment and the date/time they confirmed it.
Print View in Color
Check this box to print the appointment schedule views in color instead of black and white. This box sets the default to always print the schedule in color if you print to a color printer.
Double Space Report
Check this box to display and print the Appointment Schedule Report with extra space between each appointment entry. This provides a useful space for writing notes on the print out.
Show Eligible and Show Eligible Popup
These checkboxes apply to the MicroMD ECM module. They can only be set by a user with a Supervisor role.
Force Template Class
Check this box to prevent staff members (without the appropriate security privilege) from changing the appointment class assigned to a time slot when they attempt to schedule an appointment. The system displays the lock image ( ) on the schedule view when you have this box checked.
To change an appointment class pre‐assigned to a time slot, the user must have permission to modify Day Setup and/or to customize a day. Set up Appointment Module
10.5
Appointments
Tab 1 Text and Tab 1 Days
Tab 2 Text and Tab 2 Days
Tab 3 Text and Tab 3 Days
These fields allow each practice in the database to customize the shortcut tabs in the Daily View to fit their scheduling needs. You can customize the number of days forward staff members jump in the appointment schedule when they click one of the tabs, and you can label the tabs however you want.
 The Tab 1 Text field allows you to label the first tab on the left. This tab brings the staff back to the current day’s schedule. The Tab 1 Days field is permanently set to “0”.
 The Tab 2 Text field allows you to label the second tab. This tab takes the staff forward in the appointment schedule by the number of days indicated by the Tab 2 Days field.
 The Tab 3 Text field allows you to label the third tab from the left. This tab takes the staff forward in the appointment schedule by the number of days indicated by the Tab 3 Days field.
For example, a practice uses the Daily View when scheduling and established their tabs as follows:
 Tab 1 Text: TODAY
 Tab 2 Text: 3 MONTHS and Tab 2 Days: 90
 Tab 3 Text: 6 MONTHS and Tab 3 Days: 180
When their staff members need to schedule a follow‐up appointment for three months from now, they can click the 3 MONTHS tab and work with the patient from that point.
Display Chronic Diag
Check this box to display the chronic diagnosis codes from the patient’s Cases tab for the case selected on the appointment window in the Case drop‐down, instead of displaying the patient’s last eight diagnoses.
Verify Plan Set Place a check mark in this checkbox to allow users to select a patient’s plan set when checking them in through the Check‐In/Check‐Out window. Provider Difference Warning
Check this box to display a warning if users add an appointment to a provider’s schedule when they are not designated as the patient’s provider on the Detail tab of the Patient Detail window.
Warn if Unchecking Arrivals
Check this box to warn users if they uncheck a patient’s status in the Check‐In/
Check‐Out window. Verify Plan Set:
The options are “N/A”, “Arrival” and “Checkin.” This tells the PM when to activate the Verify Plan Set pop‐up window.
Create Day Templates
Before you can schedule appointments, the system needs to know what your typical appointment day looks like. How long are you appointment increments? Do you set aside specific times of the day for certain kinds of appointments? Do your providers have different schedules for different days?
The Appointment Day Setup window allows you to design day templates for each day of the week that the provider has a different schedule and then use those days to create a week template. Once you have 10.6
Set up Appointment Module
Appointments
your week templates, you can then assign those weeks to your providers, thus creating an appointment schedule.
NOTE | The system also provides the ability to customize the layout of a day’s appointment schedule quickly without changing the templates; however, use this feature prudently as it removes the link between the day’s template and the appointment schedule. Figure 10‐2 Appointment Day Setup Window
Each day has three appointment columns, allowing staff members to single book, double book, or even triple book a provider. The versatility of the system allows all three columns to have the same appointment classification, or staff members can schedule a different appointment classification in each of the columns.
For example, at Advanced Family Practice, Dr. Kumar works a normal work day on Mondays, Tuesdays, Thursdays, and Fridays. However, he works a half day on Wednesdays and Saturdays. This practice created the following day templates: NORMAL DAY (which is 8 am to 4 pm) and HALF DAY – MORNING (which is 8 am to noon).
To create appointment day templates:
Procedure
Details
1. Select Appt > Setup > Day Setup from the main menu.
The Day List window opens.
2. Click the New icon on the Task Pane.
The Appointment Day Setup – Detail window opens.
3. Enter a useful name for this day template in the The system automatically assigns an ID when you save this day.
Description field.
4. From the Start Time and End Time drop‐down lists, select the times that the practice begins and ends its day of business.
Set up Appointment Module
When selecting these times, take into consideration that you need to include the earliest and latest times that an appointment or meeting may need to be scheduled.
10.7
Appointments
5. In the Time column, place a check mark next to The Time column displays the times throughout the day that the provider sees patients. Only the the time slots available to create the checked times appear on the appointment appointment time schedule for the provider(s).
schedule. For example, if Dr. Kumar sees patients every 15 minutes, you want to make sure to check mark each 15‐minute slot.
TIP | Select the time interval you want to use from the text field next to the Auto Interval button, and then click the button. The system places a check mark in the appropriate time slots for you automatically. You can make any adjustments accordingly.
6. If you want to designate the type of appointment that staff members should schedule for a specific time slot, select that Appointment Class from the Description column.
7. If you do not want staff members to schedule appointments during a particular time period for this type of day, click in the P column for the time slot(s).
Click in the area under the description column to access the drop‐down list.
For example, Dr. Kumar does all of his consultations in the morning between 8 am and 10 am. Advanced Family Practice created their day template and selected their CONSULT Appointment Class for those time periods. When a staff member wanted to schedule a new patient, they knew that the blue CONSULT appointment slots were off limits for a new patient appointment.
A lock image appears on both the template and the schedule view when you protect an appointment slot. To prevent staff members from scheduling an appointment in this slot, you need to remove the Protect Slots security right from their user name. TIP | This function is useful if you are unsure of the provider’s availability for certain times and you do not want to schedule appointments until the day’s schedule is confirmed.
8. If this day’s template requires the provider(s) to be at specific practice locations, you can select these from the Location column.
When you select a location from the drop‐down list, all of the subsequent appointment slots for the rest of the day default to that location. You can then go to the next time slot where the practice location should change, change that location, and all of the subsequent locations from that point forward change.
The appointment views display a bar across the column(s) to signify the appointments at a location. 10.8
Set up Appointment Module
Appointments
9. Click the Save icon on the Task Pane to save your new day template.
10. Repeat these procedures for each of the day templates you need to create.
All of the day templates you create make up the week templates used to establish a provider’s schedule.
Create Week Templates
Once you have your typical days set up in the system, you can then create week templates that you will assign to your provider(s). The Appointment Week Setup – Detail window allows you to design a week template, specifying the day template to use for Sunday, Monday, Tuesday, etc. If your practice is not open on a particular day, there is a CLOSED option you can select.
Figure 10‐3 Appointment Setup Week Window
Each day of the week has a drop‐down list. You can choose one of the day templates you created, or you can choose the CLOSED option. The CLOSED option prevents staff members from scheduling any appointments on this day of the week when this week template is assigned to a calendar period.
To create a week template:
Procedure
Details
1. Select Appt > Setup > Week Setup from the main menu.
The Week List window opens.
2. Click the New icon on the Task Pane.
The Appointment Setup Week – Detail window opens.
3. Enter a useful name for this week template For example, Dr. Kumar has a monthly schedule where the hours/days are different per week but the in the Description field.
same every four weeks. Advanced Family Practice created WEEK 1, WEEK 2, WEEK 3, and WEEK 4.
You may also want to specify week templates per provider (e.g., KUMAR WEEK 1, WEBB WEEK 1).
The system automatically assigns an ID when you save this week.
Set up Appointment Module
10.9
Appointments
Procedure
Details
4. From the drop‐down lists, select the day template you want to use for each day of this week template.
TIP | Double‐click the day template selected in the drop‐down list to open a display window for that day template. For example, if you double‐click the selection for Monday, a window displaying the selected template for Monday appears.
5. Click the Save icon on the Task Pane to save You can also press the Ctrl + S key combination.
this template.
Provider Week Setup
Once you have created day templates and week templates, you can now create provider schedules. The Provider Week Setup window allows you to assign, view, or change the week template associated with a particular provider for the selected date range or week. Figure 10‐4 Provider Week Setup
To establish a provider’s schedule:
Procedure
Details
1. Select Appt > Setup > Provider Week Setup from the main menu.
The Provider Week Setup window opens.
2. Double‐click the provider for whom you want to establish a schedule.
The Provider Week Setup Detail window opens.
3. From the Description drop‐down list, choose the week template you want to apply to the provider’s schedule.
10.10
Set up Appointment Module
Appointments
4. Select the date range that you want this week template to cover. You can do this one of two ways:
Select a date range using the From and To fields.
OR
Use the Recurrence button to target specific weeks of the month for the selected template.
The Recurrence window allows you to indicate the specific weeks of the month to which you want to apply the selected week template and the date range you want the template to cover.
Set up the recurrence using the fields in the Weekly section of the window. Then set the duration of the recurrence using the appropriate selections in the Range section of the window. You can choose to end the recurrence after a certain number of occurrences or on a specific date. Once the selections have been made, click Accept to return to the Provider Week Setup Detail window.
5. Click Apply to add the selected weeks to the bottom portion of the window.
The new weeks appear in the window.
If a week already exists for the dates you chose, the system prompts you to replace the week, allowing you to override an existing schedule.
Default Provider Week
If a provider uses the same schedule most of the time, you set that week template as their default appointment week. When you try to schedule an appointment for provider whose schedule has not been created out that far yet, the system displays a message and allows you to assign a week template. If you set a week template as the provider’s default, that week appears in this window, but you can change this if needed. Click Accept to apply the chosen template.
Figure 10‐5 Assign a Week Template from the Appointment View
Select Maint > Provider and then double‐click the provider to whom you want to assign a default week. On the Provider Detail window, select the week you want to use for this provider from the Default Appt Week drop‐down list.
Copying Appointment Templates
You can copy a day template or a week template from one practice to another or within the same practice. This is helpful if you have a detailed day template, for example, with multiple practice locations and providers, with Appointment Classes chosen for certain time slots that are protected so staff members . . . in other words, you don’t want to have to go through that again if you can help it. The system makes it easy to just copy the template and change only what needs to change for the new day template. Set up Appointment Module
10.11
Appointments
The same procedure applies for both the daily appointment templates and the weekly appointment templates. The procedure discusses copying the day template. Simply access the Week Setup to copy a week template. To copy a day or week template: Procedure
Details
1. Select Appt > Setup > Day Setup (or Appt > Setup The Day List (or Week List) window opens.
> Week Setup) from the main menu.
2. Click the Copy Setup icon on the Task Pane.
The Appointment Day Setup Copy (or Appointment Week Setup Copy) window opens.
3. From the Source section, select the practice from which you want to copy the day or week template.
4. From the drop‐down list to the right of the source practice, select the existing day or week template you want to copy.
5. From the Destination section, select the practice to which you want to copy the day or week template.
6. In the drop‐down list to the right of the destination practice, type the description of the new day or week template in the empty field.
7. Click the Copy button.
8. When the system prompts you that the copy was successful, click OK.
9. Click the Close button on the Appointment Day To see the new day or week template, exit the Setup Copy (or Appointment Week Setup Copy) Day List (or Week List) window and enter it again to refresh the window. Your new template window.
should now appear in the list.
Holiday/Vacation
When providers go on vacation, the office closes for a holiday, or any other countless reasons the office might close, you can avoid changing your day templates and close the office using the Holiday/Vacation 10.12
Set up Appointment Module
Appointments
feature. From here, you can select days that you do not want to schedule patients for an individual provider because of a holiday, the provider’s vacation, or another demand on the provider’s schedule.
Figure 10‐6 Holiday/Vacation Detail Window
Schedule a Holiday/Vacation Period
Once you schedule the holiday/vacation or other downtime, the system prevents staff members from scheduling appointments for that day. On the pop‐up calendar, the system displays that date in red and when staff members click the date to try to schedule an appointment, the appointment window for that day appears with the description you entered. If there were already appointments scheduled for that day when you created the holiday/vacation entry, a window opens listing the appointments so you can reschedule them. Procedure
Details
1. Select Appt > Holiday / Vacation from the main menu.
The Vacation / Holiday – Provider window opens.
2. Double‐click the provider for whom you want to enter a holiday/vacation schedule.
The Holiday/Vacation Detail window opens.
3. In the From and To fields, select the date or date range for the holiday or vacation.
TIP | Remember you can also choose dates with the pop‐up calendar. Click the down arrow next to the field to access it.
4. In the Description field, enter a useful name or reason the office is closed.
Some examples: TRIP TO MEXICO, DALLAS CONVENTION, FOURTH OF JULY.
Set up Appointment Module
10.13
Appointments
5. Click Apply to add those dates to the provider’s schedule.
6. Click the Save icon on the Task Pane and exit the windows.
Copy Holiday/Vacation Days
Once a holiday/vacation day is established for one of the providers, you can copy it to other providers if needed. For example, you created a holiday schedule for the coming year for Dr. Kumar, and now you want to copy that same schedule to the other four physicians in your practice, so you don’t have to take the time to redo your work four more times.
To copy a holiday/vacation schedule:
Procedure
Details
1. Select Appt > Holiday / Vacation from The Vacation / Holiday – Provider window opens.
the main menu.
2. Click the Copy Setup icon on the Task The Vacation / Holiday – Copy window opens.
Pane.
3. From the lists of providers on this window, highlight the providers whose schedules you want to view.
Neither side is specifically designed for Copy To or Copy From. Just be sure to pick the two providers’ schedules that you want to share.
4. In the View Dates From and To This date range defaults to today’s date in the From fields, select the range of dates that selection and a year from now in the To selection. You can change this if needed.
contain the days you want to copy.
10.14
Set up Appointment Module
Appointments
5. Click the Copy button.
A new window opens with the holiday/vacation days of both providers displayed.
6. Highlight the day(s) you want to copy and click the appropriate Transfer button.
Single click each day to select that day.
7. Click the Save button and exit the window.
TIP | You can add more holiday/vacation days to the providers using the Add button. This opens the Vacation / Holiday ‐ Add window. Enter the date and description of the day you want to add. Click the appropriate Add button and click Exit when finished.
If there were already appointments scheduled for the day(s) you just copied, a window opens listing the appointments so you can reschedule them. APPOINTMENT VIEWS
Once you have all of the provider schedules established and you have chosen how you want your appointment view displayed, you can begin scheduling appointments in the view that is most convenient for you. There are five options for viewing appointments:
 Daily View
 Location Day View
 Provider Day View
 Resource Allocation View
 Weekly View
The look of the schedules in these windows (e.g., labels on the tabs, number of columns displayed) are established on the General Setup window (under Appt > Setup > General Setup). Appointment Views
10.15
Appointments
You can have different appointment views open at the same time, allowing you to drag and drop appointments from one view to another. This allows you to easily reschedule appointments from one day, provider, or location to another. TIP | Resize the windows to make it easier to see the different aspects of the Appointment Module. On higher resolution screens, you can stretch the view so that it displays more appointments, including the classification and patient name for the appointment.
Next to each column header in all appointment schedule views (if the window is large enough), the system shows the user the total number of appointments in that column.
NOTE | This number reflects only those appointments without a check mark in the Suppressed box on the appointment’s detail window.
Provider Display Options
Each of the appointment views allows the user to specify which providers appear in the Provider drop‐
down list (Daily View and Weekly View), as windows in the appointment window (Location Day View and Provider Day View), or displayed in the selection window of the Resource Allocation View. This ability also allows you to specify the order in which they appear in the list or window. This display order is user‐
specific and used throughout the Appointment Module.
For example, Advanced Family Practice has 20 providers, and Kim only schedules appointments for Dr. Kumar and Dr. Davidson. She can choose only to show those two providers in her appointment views and which provider appears first.
10.16
Appointment Views
Appointments
To specify a provider display order while in any of the appointment views (select Appt > Appointments from the main menu to access the appointment view you want): Procedure
Details
1. Click the Provider Order icon on the task bar.
The Select Provider Order window opens.
If you are in the Location Day View, there is also a Location drop‐down list added to this window.
A location filter has been added to the Pending Charges provider order settings. This will narrow the pending charges lists displayed when based on this setting. If the location is not identified in pending data, the pending charge will be shown regardless of filter settings.
In the Daily View and the Weekly View, only the 2. Drag the appropriate provider(s) from the providers in the Selections Made side of the Available for Selection side of the window to window appear in the Provider drop‐down list.
the Selections Made side.
In the Location Day View and the Provider Day View, only the providers in the Selections Made side of the window appear in the appointment display window.
TIP | You can change provider selections at any time. To rearrange the order of the providers, drag and drop the appropriate provider to the selected position in the Selections Made side of the window.
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3. If you want to view only a certain number of providers on the screen at one time, enter the number of providers in the Max Providers Per Screen field.
For example, Tom schedules appointments for 10 providers. He can fit three providers on his computer screen comfortably and still view enough detail to work efficiently. Because Tom entered 3 in his Max Providers Per Screen field, only three providers always appear in the window at one time. Even if he resizes the window, a maximum of three providers display in the window.
TIP | A scrollbar appears at the bottom of the appointment view windows when there are more providers than will fit on the screen.
4. In the Location Day View, select location(s) from the Location list if you want to see schedules for providers at a specific practice location(s).
5. Click the Accept button.
The system arranges the appointment window or Provider list according to your selections.
Customize Day Setup
If you or staff members need to change a day’s schedule, you can do so without creating a new day template and modifying the week template assigned to the provider. This could alter other provider schedules based on the same template.
STOP | Use this feature judiciously and set up appropriate security rights for your staff members. Many offices run into problems where one person changes a day and then another person changes it back.
For example, Dr. Kumar has appointments scheduled for the afternoon. He calls in to Advanced Family Practice and talks with Kim. There has been an emergency with one of his patients so he won’t make it back to the office for those appointments. Kim doesn’t have access rights to change an appointment schedule. She informs Jennifer, who uses the Customize Day Setup to change the ending time of the day. Then Kim can reschedule patients as needed.
TIP | Only users with the Customize Setup security right can use this feature. You should remove this security right from all users unless they have the authority to change provider schedule and reschedule patients as a result of the change.
Modify a Day’s Schedule
To change the layout of a day’s schedule:
Procedure
Details
1. From any of the Appointment Views, click the Customize Setup icon on the Task Pane.
The Appointment Day Setup Change window opens.
2. Make the necessary edits to the day.
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Appointments
3. Once the day has been modified, click Accept to apply your changes.
The system only modifies the selected day with your changes and breaks the link to the day template. Therefore, if you make changes to the day template this modified day was based on, those changes do not affect the modified day.
TIP | If a user has modified the layout of this day using the Customize Setup icon, the Daily View displays a message in red text: “This day has been customized”.
Reschedule Patients from a Customized Day
If there are appointments scheduled during the time period you adjust, MicroMD PM displays those appointments in a new window. You or your staff members need to reschedule these patients. To reschedule these patients, you will move them to the clipboard when needed and then drag them to their new day and time slot. The system displays a Patient icon on the Daily View to indicate if there are still patients who need to be rescheduled. You can also print this list of appointments if needed. Figure 10‐7 Appointments to Reschedule
Reset a Customized Day
You can reset a customized day back to the original day template if needed. Click the Customize Setup icon on the Task Pane and click the Reset button. Confirm that you want to reset the day. The system automatically replaces any appointments that needed to be rescheduled. These appointments appear back in their original time slots for this day, unless those appointments were already saved to the clipboard. You will need to replace those appointments manually.
NOTE | If the appointments are sent to the clipboard, they have to be manually rescheduled if the day is reset to the template.
Daily View
This view allows you to see an individual provider’s daily schedule. To access this view, select Appt > Appointments > Daily View from the main menu, click the Daily View button on the Launch Pane if Appointment Views
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available, or press the F4 key. Select the appropriate provider from the drop‐down to view their daily schedule. The location(s) specified in the day’s template display as horizontal bars.
Figure 10‐8 Daily Appointment View
The Scroll section allows you to view just morning appointments (AM) or jump to the afternoon appointments (PM) quickly. The system displays the number of appointments scheduled in each half of the day. The total number of appointments on the schedule that begin prior to 12:00 noon displays next to the AM radio button. The total number of appointments on the schedule that begin at or after 12:00 noon displays next to the PM radio button.
For example, if a patient’s appointment begins at 11:45 am and ends at 12:30 pm, the system includes that appointment in the total count for the AM appointments. If the appointment starts at 12:00 noon, the system includes that appointment in the total count for the PM appointments.
TIP | When you click the Open Legend icon in the Task Pane to view the color coding associated with the appointments on the schedule, you can also see the number of appointments for each classification scheduled for the selected provider.
Click each of the tabs below the Scroll fields to take you ahead in the calendar by the value indicated on the tab. This helps when you need to schedule return visits. Establish the value for those tabs on the General Setup window (under Appt > Setup > General Setup). TIP | Next to the Today tab on the Daily View, the system shows the user the total number of appointments in the schedule for that day, unless the appointment has the Suppress checkbox marked.
Next to the label for each appointment column, the system displays the total number of appointments scheduled in that column, unless the appointment is suppressed.
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Weekly View
This view allows you to see an individual provider’s entire weekly schedule. To access this view, select Appt > Appointments > Weekly View from the main menu or click the Weekly View button on the Launch Pane if available. Select the appropriate provider from the drop‐down to view their weekly schedule. The location(s) specified in the week’s template display as horizontal bars.
Figure 10‐9 Weekly Appointment View
The appointments are sorted by columns, just like the Daily View. Moving the mouse pointer over any scheduled slot displays the patient’s name and phone number. If appointments have been color‐coded, those colors also appear in the appropriate time slots in this view. The first slot for a scheduled appointment shows a plus sign ( + ). For those appointments that take up more than one slot, the additional slots for that appointment appear under the plus sign with a vertical line ( | ).
Provider Day View
This selection allows you to quickly view the appointments of the providers for a specific date all at the same time. This view may be useful in a multi‐provider practice so that it is easier to schedule appointments for several providers without having to keep switching between provider schedules. To access this view, select Appt > Appointments > Provider Day View from the main menu or click the Provider Day View button on the Launch Pane.
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Figure 10‐10 Provider Day View
The providers to be viewed as well as the order in which they appear are user‐specified, using the Provider Order icon on the Task Pane. From this view you have the option of moving appointments from one provider to another. Simply click and hold the desired appointment for one provider and drag and drop the appointment in the desired time slot for another provider.
Location Day View
The Location Day View allows you to view the appointments for all providers at a specific practice location. The view is identical to the Provider Day View; however, you can use the Provider Order icon on the Task Pane to limit the view to the provider schedules for certain location(s). Select the provider(s) and the location(s) from the Provider Display order window.
Figure 10‐11 Select Provider Order Window
Schedule appointments just like you do with any other appointment view, with the added ability to drag and drop an appointment from one provider’s schedule to another provider’s schedule. To access this view, select Appt > Appointments > Location Day View from the main menu or click the Location Day View button on the Launch Pane if available.
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Resource Allocation View
The Resource Allocation View provides users the ability to schedule the same patient for multiple providers. With this view, you can select the provider schedules in which you want to search for future open slots within a certain date/time range. Select Appt > Appointments > Resource Allocation View from the main menu or click the Resource Allocation View button on the Launch Pane (if available) to access this tool.
For example, Jennifer at Advanced Family Practice needs to schedule Anthony Smith with Dr. Kumar first, then for a CT scan, and then have him meet with Dr. Davidson afterward. She can use the Resource Allocation View to do this.
Search For Open Slots
Resource Allocation allows you to include any number of providers in this search but only allows you to schedule if every provider included in the search has an open time slot that meets the search criteria you entered. To use the Resource Allocation View:
Procedure
Details
1. Select Appt > Appointments > Resource Allocation View from the main menu.
The Select Provider Order window opens.
2. Drag and drop the providers from the Available For Selection side to the Selections Made side to search their schedules.
The providers available were determined from the provider order you chose using the Provider Order icon on the Task Pane in one of the other appointment views. 3. From the Starting Search Date and the Ending Search Date fields, select the date range for which a patient is available for an appointment.
This date search can be no longer than a week. This allows for faster queries to the database, especially for several provider schedules. If the search returns no results, try another week range.
4. From the Starting Search Time and Ending Search Time fields, select the time range the patient is available for an appointment.
Remember that the more open you make your search ranges, the more slots the system has to search. To speed up the search, we recommend that you limit your time range to within one to six hours if possible, instead of all day.
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5. If you want to search only appointments available at a certain practice location, select that office from the Location drop‐down.
6. To search only slots assigned to a specific Appointment Class, choose it from the Class drop‐down.
7. From the Columns to Search field, select the appointment columns you want to search for open slots.
The Columns to Search option defaults from the Appts field on the Appointment Setup window, but you can change it here if needed.
The system provides a horizontal scrollbar to view 8. In the Max Providers per Screen field, enter the number of providers you want to multiple providers that do not fit on the screen.
display on the screen at a time 9. Click Accept.
All schedules must have open slots that meet the criteria you established. If the system finds them, it displays the provider schedules in the order you chose in the Selections Made section, and it only displays the open slots, unless there is an overlapping appointment with an open slot. Then the system has to display that overlapping appointment.
To show all slots, simply click the Show/Hide Empty Slots icon on the Task Pane. In the Resource Allocation View, the system hides slots with appointments by default.
If the system informs you that no results meet your criteria, you can continue changing your criteria until you find the slots you need.
When you find open slots available for the providers you selected, you can begin scheduling appointments.
Scheduling and Navigating with Resource Allocation
Once you have the provider schedules with the appropriate open slots displayed on your screen, you can make appointments for the patient as you would any appointment. The system knows that you are typically making multiple appointments for the same patient when you use this view, so when you create the second appointment, the system automatically completes the patient information in the entry window for you. You just have to finish with other details about the specific appointment.
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Figure 10‐12 Resource Allocation View
If you cannot find the right arrangement of appointments for the day displayed, you can switch days one of two ways.
 You can select the specific day from the pop‐up calendar.
 You can click through the displayed week of the selected provider schedules. Use the black arrow icons to move to the next day or to view the schedules for the previous day.
You can also search again with the same providers and/or different criteria. Click the Provider Order icon on the Task Pane to display the Select Provider Order window again.
SCHEDULING APPOINTMENTS
Once you have all of your providers’ schedules established and your display just how you want it, you can begin to schedule patients. Scheduling an appointment is generally the same for every view. The Resource Allocation view has some additional steps to perform before you get to the view and schedule an appointment, but at that point, it is the same procedure. Once you make an appointment, you can see the patient’s name, telephone number, chart number and appointment notes if you hover the mouse pointer over the appointment.
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Figure 10‐13 Appointment Entry Window
When you double‐click in a time slot of an appointment view, the system displays a blank appointment entry window or one with any defaults you’ve set. You have a few options at this point:
 You can create an appointment for an existing patient
 You can create an appointment for a new patient NOTE | When scheduling a new/temporary patient, the system only provides some basic fields. You may not see all of the fields or buttons listed when you schedule a temporary patient.
Fields and Buttons Available on the Appointment Entry Window:
Field
Description
Fields Available
Patient Status
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Click the type of patient for whom you want to schedule an appointment. The system selects Existing by default. Simply enter the patient’s name, account number, or date of birth in the Name/DOB field. If you click the New option, the system enables the Registration icon so you can create a temporary patient. Scheduling Appointments
Appointments
Appointment Class and If the appointment slot had a predefined Appointment Class, the system Recall Reason
selects that class in the Appointment Class drop‐down list by default. Otherwise, select an Appointment Class for the patient. This indicates the main reason for the patient’s appointment.
If the Appointment Class chosen has a recall reason associated with it, that reason displays under the toolbar on this window. Slots
This field displays the default number of time slots specified for the Appointment Class chosen. You can change the number of slots for this patient if needed. Charge Slip Description The system defaults the charge slip specified for the provider on the appointment. If the Appointment Class has a charge slip associated with it, that charge slip overrides the one selected for the provider. If the charge slip for both the Appointment Class and the provider are set to (Default), MicroMD PM prints the charge slip chosen in the Charge Slip window. Name/DOB
Enter an existing patient using their name (last name, first name or a portion of either), date of birth (MM/DD/CCYY), or their account number. The patient information from the patient’s Patient Detail window appears in this appointment window.
When the user enters a deceased patient’s name or account number, the word “Deceased” flashes in red above the Name/DOB label. If a user attempts to schedule an appointment for a deceased patient, the system alerts them and provides the user the option to save anyway or to close without saving.
Main Phone, Work Phone, Alt Phone, Cell Phone
This field displays the phone numbers entered in the patient’s Patient Detail window.
Co‐Pay
This field displays the amount listed for the primary carrier on the patient’s Plan Sets tab for the set selected in the Plan Set drop‐down on this appointment entry window.
Bal and Due columns
This section displays the amount due from the patient’s account. The Bal column indicates the individual patient’s total balance due (Patient line) and the entire account balance due (Account line), including any amounts due from the insurance companies. The Due column indicates how much of those balances is patient‐responsible.
Case and Plan Set
Select the appropriate case related to this appointment from the Case drop‐
down list. The system defaults to the case with a check mark in the Default box on the patient’s Cases tab. The system switches the Plan Set drop‐down list automatically to the plan set associated with this case. When staff members post charges from the Check‐In/Check‐Out Module or from the Charge Slip List window, the system keeps these case and plan set selections.
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Last Diagnosis or Chronic Diagnosis
This section displays the last twelve diagnosis codes posted to the patient. If you have the Display Chronic Diag checked on the Appointment Setup window (under Appt > Setup > General Setup), then the system displays the Chronic Diagnosis section instead. This section displays the diagnoses entered on the Cases tab for the patient’s case you select from the Case drop‐
down on this window. Each diagnosis will be accompanied by its corresponding ICD‐9 or ICD‐10 code.
Plan
This field displays the primary insurance plan associated with the case and plan set selected on this window.
Procedure
If applicable, enter the procedure for which the patient is scheduling an appointment. You can enter either the code or the description. The system then copies the code and description into the Note field.
If the procedure requires pre‐certification by the insurance plan, a message flashes and displays the contact information at the insurance company (if it was entered in the PreCert Contact and PreCert Phone fields on the Plan Detail window).
Diagnosis
If applicable, enter the diagnosis for which the patient is scheduling an appointment. You can enter either the code or the description. The system then copies the code and description into the Note field.
Referral
This field displays the physician who referred the patient to your practice. Click the Referral button to insert that physician’s name in the Notes field. The Notes field prints on the Appointment Schedule Report.
Prim Care
This field displays the patient’s primary care physician (listed in the PCP field on the Patient Detail). Click the Prim Care button to insert that physician’s name in the Note field. The Note field prints on the Appointment Schedule Report.
Remarks
The system displays any text entered in this Remarks field on the Patient Detail window or on the Charges window in their respective Remarks fields. This information prints on the patient’s charge slip (if selected) and should not contain any sensitive information.
Note
This is a free‐form text area that allows you to add any notes pertaining to this patient’s appointment. You can use Quick Text in this field to help quickly enter information. Remember that MicroMD PM prints these notes on the Appointment Schedule Report. This field has a limit of 250 characters. The entire note up to this limit will be visible on hover.
Protected
Check this box to prevent others from editing the appointment. Only those users with the Protect Appointment security right can edit a protected appointment.
Suppress
Check this box to prevent the appointment from appearing on the Appointment Schedule Report and any appointment counts. If you use appointments for something other than a patient (e.g., an appointment with a drug rep or a meeting with the board), you might not want that to appear in the schedule report or count as an actual patient appointment.
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Appointments
Created by
This field displays the user name of the staff member who created the appointment and when they created it.
Provider on File
This field displays the provider listed on the Patient Detail window for this patient in the Provider drop‐down list, even if the provider for the appointment is different.
Floating Toolbar Icons
Patient Notes
If this patient has notes listed on the Notes tab of their Patient Detail window, the system activates this icon. Click the icon to open a window that enables you to view these notes. Appointment History
Click this icon to open the Appointment History window for this patient. The window lists the patient’s current and previous appointments, including rescheduled or cancelled appointments. Planned Visits
Click this icon to open the Planned Visits window for this patient, which displays the number of pre‐authorized visits allowed for this patient and the number of those visits remaining. You cannot edit visits from this area. Case Info
Recurrence
Click this icon to view the details of the case selected in the Case drop‐down list on this window. This information was entered on the patient’s Cases tab on the Patient Detail window. You cannot edit this from the appointment area.
Click this button to make this appointment a recurring appointment. This is helpful for scheduling routine appointments for the patient that need to occur in a short period of time (e.g., dialysis patients, physical therapy). The icons on this toolbar provide detailed information about the patient’s appointment history, prescriptions, etc. Floating Toolbar
Eligibility
Click this icon to send a real‐time eligibility request to the insurance carrier. If the patient does not have a plan that accepts eligibility requests, the icon is disabled. This feature is available with the MicroMD ECM module. Scheduling Existing Patients
From any of the appointment views in MicroMD PM, staff members can add appointments to a provider’s schedule. To schedule an existing patient:
Procedure
Details
1. Open the Appointments window for the appropriate view.
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2. Choose the provider for whom you want to schedule an appointment.
In the Daily View and the Weekly View, choose from the drop‐down list. In the other views, scroll the window horizontally until the provider’s schedule appears on your screen.
3. On the pop‐up calendar, click the appropriate calendar date for the appointment.
If you do not see this calendar, click the Calendar icon on the Task Pane.
The calendar defaults to today’s date, which appears in the schedule window’s title bar. You can drag this calendar anywhere on the screen.
The appointment clipboard also appears automatically and contains those appointments that require rescheduling. 4. Click once inside the time slot that you want to If the appointment takes up two time slots (e.g., 30 minutes instead of 15 minutes), click in the schedule with an appointment to make that time
slot for which the appointment begins.
slot your focus.
5. Click the New icon on the Task Pane or double‐
click inside the time slot.
A blank appointment window opens.
6. From the Patient Status options, select Existing The system selects Existing by default, but if you know this is a new patient, click the New option. as the type of patient for whom you want to When you click the New option, the system schedule an appointment.
enables the Registration icon. 7. Select the appropriate patient.
Enter the patient using their name (last name, first name or a portion of either), date of birth (MM/DD/CCYY), or their account number in the Name/DOB field. The patient information from this patient’s Patient Detail window appears in this appointment window. When a staff member enters a deceased patient’s name or account number, the word “Deceased” flashes in red above the Name/DOB label.
Information that appears in red is system‐
generated (such as the patient’s balance), and you cannot change this from the appointment area.
The system will also display a warning message if someone has indicated that this patient should not be seen. 8. Complete the appropriate information for this appointment.
9. Click Accept to save the new appointment.
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Appointments
Scheduling a New Patient
The Temporary Patient feature provides the option to add new patients to a temporary holding area, with the ability to make them permanent with arrival/check‐in or in the Patient Module and schedule them for future appointments before their account makes it to the database.
NOTE | If you create an appointment for a new patient and do not use the Registration icon, the system adds the patient to the schedule, but you cannot print charge slips for the new patient.
Registering new patients in the system BEFORE they arrive makes your check‐in process as smooth as possible.
To create and schedule a temporary patient:
Procedure
Details
1. Open the Appointments window for the appropriate view.
2. Choose the provider for whom you want to schedule an appointment.
In the Daily View and the Weekly View, choose from the drop‐down list. In the other views, scroll the window horizontally until the provider’s schedule appears on your screen.
3. On the pop‐up calendar, click the appropriate calendar date for the appointment.
If you do not see this calendar, click the Calendar icon on the Task Pane.
The calendar defaults to today’s date, which appears in the schedule window’s title bar. You can drag this calendar anywhere on the screen.
The appointment clipboard also appears automatically and contains those appointments that require rescheduling. 4. Click once inside the time slot that you want to schedule with an appointment to make that slot your focus.
If the appointment takes up two time slots (e.g., 30 minutes instead of 15 minutes), click in the time slot for which the appointment begins.
5. Click the New icon on the Task Pane or double‐click inside the time slot.
A blank appointment window opens. Information that appears in red is system‐generated, and you cannot change this manually.
6. From the Patient Status options, select New as the type of patient for whom you want to schedule an appointment.
When you click the New option, the system enables the Registration icon.
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7. Click the Registration icon next to the Name/DOB field.
The Temporary Patient Information window opens.
8. Complete as much information about this patient as you can.
9. Click Next.
At this point, the system performs a search for you automatically for any existing temporary or permanent patients to help you avoid duplicate entries in the temporary holding area. If the system does not find any matches in the system, you can continue with the next step.
10. Complete any insurance information you can gather for this patient when scheduling the appointment.
The top half of this screen is for the patient’s primary insurance, and the bottom half is for the patient’s secondary insurance.
11. Click Finish.
This adds your new patient to the Temporary Patient List and takes you back to the appointment entry window where you can select additional appointment information for this patient if you want, including Appointment Class and Procedure.
12. Click Accept.
This adds your new patient to the appointment schedule. You can now print charge slips for your temporary patients and schedule another appointment if necessary.
TIP | Remember: You cannot print mail merge charge slips for temporary patients. Scheduling an Existing Temporary Patient
You begin scheduling an existing temporary patient as you would a new one. The system looks at four fields to match patients in the system to the temporary patient you want to create: First Name, Last Name, Social Sec, and DOB. With each criteria you specify, the system narrows the search to only those entries that match all of those fields literally.
If the system finds any matches to existing temporary or permanent patients, an Existing Patients Found window opens.
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Appointments
Figure 10‐14 Existing Patients Found Window
Temporary patients are listed in red text. Existing patients in the database are in black. The Display icon on the window allows you to choose the columns and their order in this window.
If you see your patient in the list, highlight the patient’s entry and click the green check mark to accept your choice. Then click the Accept button to schedule the patient’s appointment.
Making a Patient Permanent
The system holds this patient in a holding area until a staff member converts the patient into a permanent entry in the database. When your staff is ready to make the patient permanent, they can do so through the Check‐In/Check‐Out Module or the Patient Module. Recurring Appointments
Staff members have the ability to create recurring appointments when creating new or existing appointments for existing patients. Recurring appointments are useful for those patients who need to schedule a series of visits within a specific amount of time.
NOTE | This feature is only available when scheduling existing patients.
For example, Anthony Smith hurt his shoulder at work and needs to visit Advanced Family Practice every day for four weeks for therapy, and today is 08/01/2010. Jennifer at the front desk uses the Recurring Appointments feature to schedule Mr. Smith’s appointments quickly, print him a list of those appointments, print some information sheets and then send him on his way.
To schedule a recurring appointment for a patient:
Procedure
Details
1. Create an appointment entry as you would normally but do not click Accept yet.
2. Click the Recurrence icon on the appointment’s The Recurrence window opens.
toolbar.
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3. Select the frequency of the appointment from The right section changes with the Pattern choice to let you further customize the recurrence.
the Pattern section of the window.
TIP | If you need to see a patient every day for the next few weeks, use the Weekly option instead of the Daily option.
In our example, Jennifer chose Weekly from the Pattern section, entered 1 in the text box, and checked every day of the week except Saturday and Sunday.
4. From the Range section, select the start/end dates and the time range for the recurring appointments you want to schedule.
The Start On field defaults to date of the appointment slot in which you created this new appointment.
The Time Range fields specify the time period during which the patient is available. The system searches only those appointment slots within that time period.
TIP | To keep your patient coming in near the same time for each visit, set the From and To fields within a hour or two of each other.
You can select to end the recurrence after a certain number of appointments or by a certain date.
5. Click Accept to return to the appointment entry window.
If you want to make any final adjustments to the appointment itself, you can do so now.
6. Click Accept on the appointment entry window.
The system scans the schedule for appointments available during the date and time period specified. Once the scan is complete, the Recurrence Appointments window opens, showing those appointments that can be scheduled and those that cannot, due to some conflict.
The Scheduled option lists those appointments where the requested slot is available. The Conflicting option lists those instances where the requested slot is unavailable.
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Appointments
7. Decide what to do with any entries on the Conflicting list.
When staff members select the Conflicting option button, MicroMD PM enables the Wait List and Re‐Try buttons and displays the appointment dates with conflicts. Staff can then widen the time range columns and change the date range columns to resolve the conflicting entries and schedule a patient. Click the Re‐Try button to use the new parameters. To place the appointments on the waiting list for the specified date/time period, click the Wait List button.
TIP | To print a list of the scheduled recurring 8. To print a mail merge document for the scheduled appointments, select the document appointments to hand to the patient, select (None) from the mail merge drop down list and and click the Print button.
click the Print button. (You could also print a list of the patient’s future appointments from the Appointment History window.)
9. Close the Recurrence Appointments window when finished. The system automatically adds the entries in the Scheduled list to the appointment schedule. It also adds any entries to the Waiting List for which you clicked the Wait List button while on the Conflicting list in the Recurrence Appointments window.
Changing an Appointment with a Recurrence
When a staff member changes an appointment in a recurrence series, the system prompts them with the option to change all future appointments linked to this recurrence (click Yes) or to change just the current appointment (click No).
Removing a Recurrence
To remove a recurrence link from an appointment in a series:
Procedure
Details
1. Open the appointment and click the Recurrence icon on the appointment’s toolbar.
2. Click the Remove Recurrence button.
Scheduling Appointments
The system prompts the option to delete all future appointments linked to this recurrence (click Yes) or to delete just the link between the appointments in the recurrence (click No). If the user clicks Yes, the system verifies if they also want to delete the appointment from which you are removing the recurrence.
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3. Click Accept on the appointment entry window.
The system removes the appointments and records the deleted appointments with the proper status and note in the Appointment Log.
Copy an Appointment
You can create multiple appointments for a patient using the Copy button on the Appointment Move window. This is available when you drag and drop an appointment into the clipboard or into a new slot, or when you click the Change Appointment icon on the Task Pane.
Figure 10‐15 Copy Appointment Button
TIP | When you copy an appointment into the clipboard, that appointment remains even after you drag and drop it into a new slot. This allows you to schedule the appointment multiple times for the patient.
Just remember to delete the entry from the clipboard when finished.
Here’s an example of one way to schedule a recurring appointment for a patient:
Procedure
Details
1. Click inside the appointment slot so that the focus of your mouse is the appointment.
2. Click the Change Appointment icon on the Task Pane.
The Appointment Move window opens.
3. Click the Copy button.
4. Enter an explanation for the action in the Log field, if necessary.
This text appears in the Note area of the Appointment Log.
5. Click the OK button.
6. Click a new day on the calendar.
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Appointments
7. From the Appointment Clipboard, select the patient appointment you want to reschedule.
If you do not see the appointment clipboard, click the Open Clipboard icon on the Task Pane.
8. Drag and drop that appointment into the new time slot.
The system copies the appointment into the new time slot, leaving the original copy on the clipboard.
9. Repeat steps 6 through 9 for each new appointment you want to create for the patient.
10. Remember to delete the appointment from the clipboard when finished.
Delete an Appointment
The system provides the ability to delete a single appointment from the schedule. Procedure
Details
1. Place your cursor in the appointment you want to delete.
2. Click the Delete icon on the Task Pane.
The Appointment Delete window opens.
3. Select Deleted from the Set Appointment Status as section.
4. In the Note field, add any text you want to display in the appointment log as the reason the appointment was deleted.
5. Click Accept.
RESCHEDULING APPOINTMENTS
When you reschedule an appointment, the system displays a window that allows you to indicate what you want to do to the appointment (e.g., cancel, reschedule, delete) and then enter any notes pertaining to that action (e.g., “Mr. Smith’s car broke down, and he needed to reschedule his appointment.”). Marking cancelled, missed, and rescheduled appointments helps you keep an appointment history for a patient, which staff members can retrieve with the Appt Hx icon in the appointment entry window and the Patient Detail window.
You can reschedule appointments in several ways:
 Drag and drop the appointment into the new slot.
 Drag and drop the appointment into the appointment clipboard and then into a time slot on a new day and/or provider.
 Click the Change Appointment icon on the Task Pane to move the appointment into the clipboard and then the Paste Appointment icon to move it out of the clipboard into a time slot.
Rescheduling Appointments
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Here’s an example of one way to reschedule an appointment: Procedure
Details
1. Click and hold the desired appointment slot.
2. Click the Change Appointment icon on the Task Pane.
The Appointment Move window opens.
3. Click the appropriate appointment status.
TIP | You can also copy the appointment, leaving the existing appointment in its current slot.
4. Enter an explanation for the appointment change in the Log field, if necessary.
This text appears in the note area at the bottom of the Appointment Log window.
5. Click the OK button.
If there is a waiting list entry for the time slot just vacated, the Waiting List window opens. 6. Click a new day on the calendar.
7. From the Appointment Clipboard, select the patient appointment you want to reschedule.
If you do not see the appointment clipboard, click the Open Clipboard icon on the Task Pane.
8. Click in the time slot you want to schedule with the patient’s appointment.
9. Click the Paste Appointment icon on the Task Pane.
If the provider and/or location are different than original appointment, MicroMD PM alerts you and provides the opportunity to cancel the action.
SEARCH FOR OPEN SLOTS
When you need to schedule an appointment but are having a tough time finding any open slots, let the system do the search for you. From any of the appointment views, click the Open Slots icon on the Task Pane to search for available appointment times quickly.
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Search for Open Slots
Appointments
Figure 10‐16 Appointments – Open Slots
To search for open slots and schedule an appointment:
Procedure
Details
1. From any view, click the Open Slots icon on the The Appointments – Open Slots window opens. Task Pane.
2. From the Starting Search Date and the Ending Search Date fields, select the date range during which the patient is available for an appointment.
3. From the Starting Search Time and the Ending Search Time fields, select the time range during those days that the patient is available for an appointment.
These fields represent the start time of an appointment. For example, a search containing 8:00 am as the Starting Search Time and 10:00 am as the Ending Search Time produces a list of available appointments that begin at 8:00 am to appointments that begin at 10:00 am.
4. To limit the search to those open slots with a specific provider, select the provider(s) from the Provider drop‐down list.
5. To limit the search to those open slots labeled as a certain Appointment Class, select the class(es) from the Class drop‐down list.
6. To limit the search to those open slots at a specific practice location, select the location(s) from the Location drop‐down list.
Search for Open Slots
NOTE | You cannot make a selection if you are in Location Day view when you clicked on Open Slots. This is set by the Provider order in Location Day view.
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7. To limit the search to those open slots on specific days, select the day(s) in the Day(s) section.
8. To exclude protected slots from the search, UNCHECK the Include Protected Slots checkbox.
When you execute your search the system skips any protected slots.
9. Click the Search button.
The open slots that meet the selected criteria appear in the lower portion of the window. If no open slots are available for the selected dates or times, you can add the patient to the Waiting List.
10. Highlight the slot you want to schedule and click the Goto button.
You can also double‐click the entry row.
The system takes you to the appointment view for the selected day and places the cursor in the time slot indicated by the Start Time column.
11. Schedule the appointment.
APPOINTMENT INQUIRY
Appointment Inquiry allows practices to view a list of appointments for specific patients, dates, and/or providers. Select Appt > Appointment Inquiry from the main menu to view the Appointment Inquiry window.
Staff members can search for existing appointments by the patient’s ID or name, as well as by the provider on the appointment. To view all patients who have had (or will have) appointments with a provider since a specific date (e.g., since November 2009), type the date into the lookup fields. Double‐
click an entry to open the Daily View for the day of that patient’s appointment. The system places the cursor in that appointment’s slot automatically.
Figure 10‐17 Appointment Inquiry Window
TIP | For a printable list of a patient’s current appointments, open the Patient Detail window for that patient and click the Appt Hist icon on the Task Pane. 10.40
Appointment Inquiry
Appointments
APPOINTMENT REQUESTS
For use with the MicroMD EMR application, or any other third‐party application with this capability, users have the ability to receive appointment requests from the MicroMD EMR application.
Figure 10‐18 Appointment Requests List
NOTE | If there are no appointment requests, the system does not display the Appointment Requests window.
You can view appointment requests that you have waiting while you are in either the Check In/Check Out Module or in the Appointment Module. The list in the Check In/Check Out Module is view‐only and only displays if you have the Appointment Request List checkbox marked under Utility > Workstation Setup > Display Properties.
In the Appointments Module, click the Appointment Requests icon on the Task Pane to display the list of requests. You can drag and drop each request into an appropriate time slot to schedule the appointment. A little red note triangle on an entry contains request instructions (e.g., when to schedule the appointment, who made the request, when it was made).
APPOINTMENT CLIPBOARD
The Appointment Clipboard is a global clipboard across the practice. When one user places an appointment on the clipboard, all users in the practice can view those entries, unless security privileges are set otherwise. The clipboard floats on top of the appointment windows so that you can move it around the screen.
The clipboard can hold more than one appointment at a time. Any appointments placed in the clipboard remain in the clipboard even after shutting down MicroMD PM. When the program restarts and you open one of the appointment views, the clipboard displays the appointments that need to be rescheduled.
NOTE | If you do not see the clipboard, click the Open Clipboard icon on the Task Pane.
Figure 10‐19 Appointment Clipboard
Appointment Requests
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To select one of the appointments from the drop‐down list, open the list and click an item. When the list closes, the selection appears as the primary selection in the clipboard window. You can then drag and drop the item into an open slot. You can also click the Paste Appointment icon to paste this appointment in the selected slot.
When you move the mouse over the drop‐down list, a pop‐up for the selected entry displays appointment information for that appointment. We have added two new fields the pop‐up display: the user who originally created the appointment and the user who added the appointment to the clipboard.
Security Options
The appointment clipboard has some security access rights to it. This allows supervisors control how their staff members use this feature. You can find the following access rights in the security tree under Appt > Clipboard:
 Edit Notes: Allows each user to view and edit notes entered in the clipboard.
 View All: Allows each user to view entries in the clipboard for all users. Remove the check mark from this option to allow the user to view only their entries in the clipboard.
Add Notes
When staff members reschedule appointments, the system displays the Appointment Move window. They can then add an entry in the Log field regarding the action they are taking with the appointment. The system displays this note when you click the Notes icon on the clipboard toolbar.
This allows multiple users to record information about the appointment on the clipboard (see figure below). For example, elderly Mr. Smith’s car broke down and he needed to reschedule his appointment. He doesn’t know when he can reschedule it, he’ll call back later in the day when he can get to his calendar, and he knows whether or not he has a ride. Jennifer took the call and moved the appointment to the clipboard. She entered a note in the Log field, “Mr. Smith’s car broke down and he needed to reschedule. JW 08/01/2010”.
Well, Mr. Smith didn’t call back that day, and Jennifer was going to be off the next day. She sent a message to Kim using the MicroMD PM Mail feature before she left: “Please give Mr. Smith (1001.0) a call this morning and see how he’s doing. Try to reschedule his appointment.” So Kim calls but had to leave a message. She opened the clipboard and added her note under Jennifer’s: “Called and left message. Waiting to hear back. KT 08/02/2010.” All of this information is added to the appointment log.
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Appointment Clipboard
Appointments
Figure 10‐20 Notes Area of Clipboard
Tom answered the phone later that afternoon and was able to just drag and drop the appointment from the clipboard and handle the transaction seamlessly for Mr. Smith thanks to the notes left by his coworkers.
Delete Entries
Users can also delete entries from the clipboard with ease. Simply select the appointment entry from the drop‐down list and click the Delete icon next to it. This removes the appointment entry from the clipboard without rescheduling it.
Filter Entries
To display only the appointment entries you added to the clipboard or to filter entries by location, click the Filter icon on the clipboard’s toolbar. The Filter Options window opens. NOTE | Only users with the View All security option can use the Filter icon.
Figure 10‐21 Filter Options window
Appointment Clipboard
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You have the following options on the Filter Options window:  User: To filter the results to only entries you added to the clipboard (User), place a check mark in the User checkbox and click Accept. To see the appointments added to the clipboard by all users (Global), remove the check mark from the User field and click the Accept button.
 Location: To filter the results by practice location in the clipboard, click the Location drop‐
down and select the appropriate location(s). Click Accept.
NOTE | You can select multiple locations in this drop‐down by pressing the Ctrl key while you highlight each location.
APPOINTMENT LOG
The system tracks actions taken against appointments by users in the system. It keeps this information, including copied, deleted, rescheduled, and moved appointments, in the Appointment Log. Click the Appt Hist icon on the Task Pane of the Patient Detail window to display an appointment history for this patient, including the patient’s current appointments. You can also click the Appt Hx icon on the Waiting List Detail window and the appointment entry window to view the appointment log.
If a corresponding note was entered for the appointment change, it appears in the bottom of the window when you highlight the appointment line.
Figure 10‐22 Appointment History Window
Staff members can choose the date range for the appointments they want to see. They can choose to see only those appointments that the patient had (or currently has) scheduled with specific provider(s). The user can also filter the display to view only the patient’s currently scheduled appointments, only the appointment log, or all information.
They can also double‐click an entry to open the Appointments window and view appointment detail for the selected day. Adding a Note to a Log Entry
Staff members can add notes to log entries when they perform the action against the appointment or through the Appointment History window. The white pane at the bottom of the window is a free‐form text field. This allows users to enter as much information as needed regarding the appointment, provided they have the appropriate security rights.
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Appointment Log
Appointments
STOP | Only a supervisor or equivalent position can perform the tasks described in this section.
Printing the Appointment History
Users can print the information currently displayed in the Appointment History window to the default printer. Click the Print button at the top of the window to print the information.
NOTE | Click the Current Appointments option and print the list displayed. This is a helpful list of appointments to hand to a patient if they ask for a list of their remaining scheduled appointments.
Make Changes to the Appointment Log
When staff members copy, reschedule, delete, or move appointments, they have the opportunity to enter any notes that pertain to the action they are taking. For example, Mr. Smith needs to reschedule his appointment because his car broke down. The staff member rescheduling the appointment can type this in the Log text area when rescheduling. Those notes appear in the white area at the bottom of the Appointment History window.
NOTE | You can only add or edit appointment log entries. Current appointment are for informational purposes only.
View, Add, Change Notes
To view any notes made to a log entry, simply highlight the log entry. Any notes made for this entry appear in the white area at the bottom of the window. To make changes to any notes or to add any notes to a log entry, highlight the log entry, click inside that text box, and add your note. Click the Save button at the top of the window to save your changes. Delete Log Entries
If you need to delete appointment log entries for any reason, highlight the entries and click the Delete button at the top of the Appointment History window. Then click the Save button to save your changes to the patient’s appointment history.
DELETE OLD APPOINTMENTS FROM THE DATABASE
To clean your database of old appointments that you no longer need to track, you can permanently delete them from all patients’ records by date and/or provider.
STOP | This option should not be confused with deleting a single appointment from the daily schedule. Delete Old Appointments from the Database
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To delete appointments from the database:
Procedure
Details
1. Select Appt > Setup > Delete Appointments from the main menu.
2. In the From and To fields, select the date range STOP | Make sure that the date range is correct. Once you click the Delete button, you cannot of appointments you want to remove.
recover the lost appointments.
3. To delete appointments for a specific provider, select the provider(s) from the Provider drop‐
down list.
4. Click the Delete button.
The system displays a message with the dates/ providers entered.
5. Verify that this is the action you want to perform for the dates/providers listed.
Since this action results in a permanent removal from the database, the system displays a second confirmation message with the dates/providers entered.
6. Confirm your providers and dates for the appointments you want to delete.
The system removes the appointments from the database permanently.
CHECK-IN/CHECK-OUT MODULE
The Check‐In/Check‐Out Module is one of the most effective ways to manage your front‐desk duties. It provides a central console to manage the day’s visits. It allows you to measure the duration of every visit, from waiting room to examination to check out. You can mark the time the patient arrives in the office, as well as when the patient actually checks in for their exam. When the patient’s appointment is over, the front desk personnel can check the patient out and receive their co‐payment right away. This entire process allows for the calculation of the length of time that the patients are spending in the office, as well as their wait times.
To access the Check‐In/Check‐Out Module, select Appt > Check‐In/Check‐Out from the main menu or click the Check‐In/Check‐Out button on the Launch Pane if available. The entries on the Check‐In/Check Out window are color‐coded according to the classification of the appointment.
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Check‐In/Check‐Out Module
Appointments
Figure 10‐23 Check‐In/Check‐Out Window
TIP | Click the Legend icon on the Task Pane to display a reference chart for the colors associated with Appointment Classes.
Checking a Patient “In”
Depending on the policies and tracking needs of your practice, you can check the Arrival column when the patient arrives in the office and comes up to the window to sign in. When you call them back to the exam room, you mark the Checkin column. Both actions record the time you marked the checkbox. This simple habit can provide your practice an insight into the average length of time your patients spend in the waiting room. You can use the Check‐In/Check‐Out report (under Appt > Appointment Reports) to review this information.
NOTE | To verify that the patient you have in front of you is the patient you want to check in, click the patient picture icon at the beginning of the patient’s row. When you mark the Arrival column, the system displays an up arrow on the appointment schedule view. The system displays an arrow pointing to the left when you mark the Checkin column. Selecting a Plan Set When Checking “In”
You can select a patient’s plan set when you check the Arrival or Checkin column for their appointment. This can be helpful when the patient does not have all their information while making an appointment. To activate this feature, place a check mark in the Verify Plan Set checkbox on the Appointment Setup window. When the patient comes in and you place a check mark in the Arrival or Checkin column, the system displays the Plan Set Select window. Once you double‐click the correct plan set, the Appointment Detail window updates to reflect the appropriate information. This then defaults correctly for the billers when they prepare the claim.
NOTE | If the patient has only one plan set, the system automatically chooses that plan set for you and does not display the Plan Set Select window.
Check‐In/Check‐Out Module
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Figure 10‐24 Plan Set Select Window
The Set Name and the Description columns pull from the Plan Set tab of the Patient Detail window. The Plan Set Type field reflects the information in the Set Type drop‐down for the plan set in the CHC Module. From the main menu, select Aux > MicroMD CHC > Setup > Plan Sets and choose the appropriate plan set to access the window.
Checking a Patient “Out”
When your patient’s visit is complete, staff members should mark the Checkout column. The system records the time they check this box, which provides you the average length of time your patients spend in the actual exam.
NOTE | You cannot place a check mark in the Checkout column until there is a check mark in the Checkin column.
Once the staff members mark the Checkout column, MicroMD PM displays an arrow pointing down. The Check In/Check Out window refreshes based on the Refresh Rates set on the General Preferences tab (under Setup > Practice Preferences) so that changes made by one user display on every user’s computer.
The system can launch the Posting Module for this patient when the Checkout column is marked. This eliminates steps for the front office, allowing them to post the patient’s charges and collect any payment due before the patient even leaves the office. If the staff member’s active day sheet date does not match the appointment date, the system prompts them if they want to continue.
 If they click Yes, the system continues to the Patient Sequences window with their active day sheet, even though it is different than the patient’s date of service.  If they click No, the system does not open the Posting Module. Staff members can then change their day sheet date, open the Posting Module on their own, and press the F12 function key to bring up the patient they checked out (provided that was the last patient with whom they performed an action).
Check the Check‐In/Check‐Out Posting Toggle box on the System Preferences tab (under Setup > System Preferences) to activate this feature.
Checked In/Checked Out Indicator
The system displays an indicator in the appointment slot when a patient has checked in for their appointment and when they check out. When a staff member places a check mark in the Checkin column, 10.48
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MicroMD PM displays an up arrow to the left of the patient’s name on the appointment view. When a staff member places a check mark in the Checkout column, the system displays a down arrow to the left of the patient’s name in the schedule. To view the time the patient checked in and when they checked out, hover over either arrow with your mouse. The system displays that information in a pop‐up.
Figure 10‐25 Indicator for a Patient Check in
Display Only Certain Provider/Location Appointments
If a staff member only needs to see appointments for specific provider(s) or location(s), they can use the Provider Order icon on the Task Pane. Any provider included in the Selections Made side of the Select Provider Order window appears in the Check In/Check Out window. If you only need to see appointments for a specific practice location, select them from the Location drop‐down list. Only appointments for the selected location appear in the window. Checking in a Temporary Patient
When a staff member checks the Arrival or Check‐In column for a temporary patient, the system prompts them to create a patient account. Click Yes to bring up a Patient Detail window for the new patient with information from the temporary patient registration already completed. NOTE | You cannot enter charges or payments until the patient is in the database as a permanent patient.
Display Appointment Detail or Patient Detail
If you typically need additional information about a patient’s account when they come in, or if you typically need additional information about the patient’s appointment when they come in, you have the ability to access the Appointment Detail or the Patient Detail window when you double‐click an entry in the Check In/Check Out Module.
Set the Default
By default, this module displays the Patient Detail window when you double‐click an entry. If you would like to always view the Appointment Detail window when you double‐click an entry, place a check mark in the Display Appt Details checkbox on the Display Properties window (under Utility > Workstation Setup > Display Properties) and click Accept to save that change.
Now when you double‐click the check‐in/out entry, the Appointment Detail window appears instead of the Patient Detail window. Staff members cannot make changes to the appointment from this window, but they can view the information about the appointment.
Check‐In/Check‐Out Module
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Right-Click Option
There is a quick way to override the default on a case‐by‐case basis if needed. Simply right‐click a check‐in/out entry. The system displays a menu that allows you to select the window you would like to display for that entry.
Print Charge Slip from the Check-in/Check-Out Module
For those clients that need to print charge slips when the patient arrives, the system provides a right‐click option in the Check‐in/Check‐out Module to print a charge slip for the selected patient. Right‐click the patient’s entry on the Check‐In/Check‐Out window and select Charge Slip from the context menu.
Figure 10‐26 Print Charge Slip from Check‐in/Check‐out
When you select Charge Slip from the context menu, the system launches the Charge Slip Module with the patient already selected. WAITING LIST
When staff members need to schedule patients for an appointment and the patient is only available for certain days and times, there will be times when you need to add the patient to the Waiting List. If an appointment slot within the specified date/time ranges opens, MicroMD PM automatically alerts the staff member who freed up the slot. To access the Waiting List, select Appt > Appointments > Waiting List from the main menu. This window displays a list of patients waiting for specific date/time slots to open. Double‐click an entry to view the details of their request. Staff members can also search for a patient in the list by name or ID.
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Waiting List
Appointments
Figure 10‐27 Waiting List Window
The system highlights the Patient Name column according to Appointment Class. Click the Legend icon on the Task Pane to view a color reference chart.
Add Patients to the Waiting List
You can add patients to the Waiting List in a few ways:
 Add them using the Waiting List window
 Add them to the Waiting List from the Recurrence Appointments window
 Add them to the list when moving or rescheduling an appointment The procedure, however, is the same once you get to the Waiting List Detail window. The fields and icons on the Waiting List Detail window are identical to those available when scheduling an appointment. There are some unique fields, however, that allow you to create a waiting list.
One way to create a waiting list entry:
Procedure
Details
1. Select Appt > Waiting List from the main menu.
2. Click the New icon on the Task Pane.
The Waiting List window opens.
3. Enter the patient’s name or ID.
4. Select the appropriate physician from the Provider drop‐down list.
Staff members are only notified when a slot becomes available on the schedule of the provider listed.
5. Select the appropriate practice location from the Location drop‐down list.
Staff members are only notified when a slot becomes available on the schedule of the provider listed for the location listed.
6. In the Day(s) section, place check marks in the boxes for the specific days of the week the patient is available for an appointment.
By default, the system marks all of the weekdays for you.
7. In the Date section, specify the date range for which the patient is available for an appointment.
Waiting List
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8. You can also indicate the Time range throughout the days selected that the patient is available for an appointment.
9. Complete the remaining fields on this window as necessary.
10. Click Accept.
The system adds this patient to the list and when a slot opens that meets the criteria, MicroMD PM alerts the staff member who freed the slot so they can contact the patient to schedule the appointment.
Expired Waiting List Entries
If a patient has an expired waiting list entry in the system when they arrive for a scheduled appointment and a staff member checks the Arrival box on the Check In / Check Out window, the system prompts them to remove the patient from the Waiting List. If they click Yes, the system removes the patient from the waiting list.
For example, Anthony Smith scheduled an appointment for October 12, 2010, at 10:00 am; however, he would rather come in the afternoon of October 11 because it is easier for him to leave work early than it is for him to take off in the middle of the day. Kim at Advanced Family Practice scheduled Mr. Smith for the October 12 appointment, but she also added him to the Waiting List for October 11. Unfortunately, since no appointments on October 11 became available, Mr. Smith’s waiting list request could not be filled. When Jennifer checked the Arrival box for Mr. Smith on October 12, the system checked for any expired waiting list requests, found one, and notified her so she could delete it.
Schedule from the Waiting List
To schedule an appointment from the Waiting List, select Appt > Waiting List from the main menu, then drag and drop the selection into the appropriate date/time slot for the appropriate provider. The system adds the appointment to the schedule exactly the way it is set up on the Waiting List Detail window. If a staff member performs an action that leaves a time slot open matching entries on the Waiting List, such as cancelling, cutting, rescheduling, or marking an appointment as missed, MicroMD PM displays the Waiting List window automatically. Only those entries that match the time slot just vacated appear in the list. (Click the Show All checkbox on the Waiting List to view all the entries in the list.) You can still drag and drop an entry from here to the appointment schedule.
HOSPITAL ROUNDS
Practices use the Hospital Rounds Module to track the patients in various service facilities. Users can print a list of patients with room for notes from the main application so the physician can take it with him/her to the facility.
The first window you see when you open the Hospital Rounds Module in the system (Appt > Hospital Rounds) is the list of service facilities you have entered in your system. This list is common to all practices in the database. You create this list under Maint > Service Facility.
Double‐click the facility to view the list of patients being treated at that facility. You can filter the list by selecting the appropriate physician from the Provider drop‐down list. To view only those patients that are 10.52
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still currently admitted at the facility, click the Show/Hide Discharged Patients icon on the Task Pane.
Figure 10‐28 List of Patients at a Facility
Click the New icon on the Task Pane to add a new hospital round entry. Double‐click an existing entry to modify it or discharge a patient. When you create a new hospital round, the system creates that hospital round for the physician selected in the Provider drop‐down list. If you have (ALL) selected in the drop‐
down, the system provides a drop‐down list on the patient’s Hospital Round detail window.
Figure 10‐29 Hospital Round Detail Window
To keep up with the charges incurred from a patient at a service facility, you can use the Hold feature for the claim until you are ready to release it and submit to the insurance carrier. Fields Available on the Hospital Round Detail Window:
Field
Description
Provider
When you add a new round, the system creates the round for the provider you chose from the Provider drop‐down list on the facility’s patient list. If you selected (ALL) from that drop‐down list, the system displays a list of providers on the new hospital round and defaults to the first one in the list.
Patient Status
Select whether you want to add a hospital round for an existing patient in your database (Existing) or you need to create a new temporary patient (New). The system defaults to Existing.
Diagnosis
The system displays the last eight diagnosis codes posted to the patient’s account.
Hospital Rounds
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Name
Enter the existing patient’s name, partial name, or ID number. This is a search field where you can use the wildcard characters (& or _) to search for the patient’s account. DOB
The system displays the birth date listed on the Patient Detail window for this patient.
Phone
The system displays the contact number found in the Phone Number field of the Patient Detail window.
Room
Enter the room number at the service facility where the provider can find the patient.
Note
Enter any information useful for the purposes of performing the hospital round. These notes appear on the Hospital Rounds report.
Chart No
The system displays the number from the patient’s Chart No field on the Patient Detail window.
Patient Category
Next to the Chart No field, the system displays the entry from the patient’s Category drop‐down on the Patient Detail window.
Referring Doctor
For an existing patient, the system pulls the physician listed in the Referring Dr field on the Patient Detail window. If there is no one listed for the patient, you can search using the Referring Doctor field on the Hospital Round detail window.
Consulting Doctor
For an existing patient, MicroMD PM pulls the physician initially from the PCP field on the Patient Detail window. When a user changes this field on either window, it does not update the other.
Shift
Select how often the provider should visit this patient.
Unit
Indicate in which unit of the service facility the physician can find the patient. Create the Unit list on the Unit tab for each service facility as needed (Maint > Service Facility). Admit Date
Enter the date the patient was admitted to the service facility. The system defaults to the current system date.
Discharged and Discharged Date
When the patient has been discharged from the service facility, check the Discharged box. Once checked, MicroMD PM automatically completes the Discharged Date field with the current system date. You can change this date manually, if necessary. When there is a check mark in the Discharged box for a patient, an icon appears in the Discharged column of the Hospital Rounds list for the facility.
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To add a Hospital Round:
Procedure
Details
1. Click the New icon on the Task Pane.
The Hospital Rounds window opens. 2. Click the Existing or the New option in the Patient Status section.
3. If the patient is an existing patient, enter the For an existing patient, the system automatically displays information from the patient’s Patient patient’s name or ID in the Name field.
Detail window.
or
New patients are temporary patients until a staff If the patient is a new patient, click the member creates a new patient account for them.
Registration icon.
4. Complete all necessary fields on this window.
5. Click the Save icon on the Task Pane.
The system adds the patient to the list of patients at the facility.
Print a List of Hospital Rounds
You can print a list of hospital rounds from two places for the physician to take with them to the facility: from the Hospital Rounds report or from the list of patients at the facility. These are essentially the same report. To print from the facility’s patient list, click the Print icon on the Task Pane. Choose a physician from the list when the system prompts you to choose a provider and click Accept. The report prints with extra space for the physician to write any notes while at the facility.
EXPORT APPOINTMENTS
You can export appointments from MicroMD PM into other programs. Typically, these are automated telephony programs that call the patients to remind them of their appointments. The third‐party interface that you have purchased must be activated in the system. You do this on the Additional Modules tab under Setup > Practice Preferences.
NOTE | Please contact your local authorized reseller for more information about editing your export.ini file for automating the export if possible.
The system exports the data to the path indicated on the Additional Modules tab in the Export Path column. Users can export appointment information from:
 Daily View: From the Daily View, you can export appointments one day at a time for one provider at a time.
 Weekly View: From the Weekly View, you can export appointments for an entire week for one provider at a time.
 Appointment Schedule Report: From the Appointment Schedule Report, you can export appointments for any provider or multiple providers for any date range you want.
Export Appointments
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Appointments
To export appointments:
Procedure
Details
1. Open the Daily View or the Weekly View.
or
Generate the Appointment Schedule Report for the appropriate day(s).
2. Click the Export icon on the Task Pane.
The Export window opens.
3. From the Export Type drop‐down list, select The system displays the path and file name that the third‐party application to which you want was entered in the Export Path column for that application. The system also displays the provider to export appointments.
for whom you are exporting appointments.
4. From the Appt Date fields, select the date range of appointments that you want to export to the application.
From the Daily View, these fields default to the day of the currently displayed day. From the Weekly View, these fields default to the date range of the currently displayed week. You can change them if necessary.
5. Click the Export button.
6. When notified that the export is complete, click OK.
APPOINTMENT REPORTS
There are several reports you can generate to mine a wealth of data about the appointment schedules of the providers in your practice. From managing the time your patients spend at your office to tracking the activity performed on every appointment, the reports are flexible and robust. For more information about generating reports, please refer to the MicroMD PM Reports Guide.
Select Appt > Appointment Reports from the main menu to access any of the appointment reports.
Check-In/Check-Out Report
This report provides concise, valuable time data for your practice. If your practice uses the Check‐In/
Check‐Out Module consistently, these figures may be useful in determining an average per Appointment Class of how long patients are sitting in the waiting room, how long it takes providers to complete various types of visits, and how much time patients spend in the office overall.
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Appointment Reports
Appointments
This report provides the number of appointments (not patients) for the indicated Appointment Class during the given date range. The Total column in each section indicates the sum of all time for the appointments in that class. The Avg column in each section is the average of amount of time per appointment in that class.
The Wait Time is the amount of time between the patient’s arrival (when staff members checked the Arrival checkbox) and check‐in time (when staff members marked the Checkin box). The Exam Time represents the amount of time between the check‐in (marking the Checkin box) and check‐out times (when staff members marked the Checkout box). The Total Visit section lists the amount of time between the arrival and check‐out for each Appointment Class.
Report Options Available for the Check‐In/Check‐Out Report:
Field
Description
Date
Enter the date range of the appointments for which you want to report the amount of time between arrival to check‐out.
Class
To gather information regarding those appointments with check‐in/check‐out information for a specific Appointment Class, select the class(es) from this list.
Provider
To generate a report for those appointments with check‐in/check‐out information and scheduled for a specific physician during the date range given, select the physician(s) from this list.
Location
For a report for those appointments with check‐in/check‐out information and scheduled at a specific practice location during the date range given, select the location(s) from this list.
Group By
You can organize the information in the report by Provider and/or Location.
Classification Report
This simple report provides the number of appointments scheduled (during the date range provided) per Appointment Class and the percentage of the overall appointments represented by that Appointment Class. The report also provides this information in a graph format. Click the Graph icon on the Task Pane to display the graph. Click the icon again to return to the text format.
Report Options Available for the Appointment Classification Report:
Field
Description
Date
Enter the date range of the appointments for which you want to view data.
User
To gather information about appointments scheduled by a specific user, select the user(s) from this list.
Class
To gather information regarding those appointments scheduled for a specific Appointment Class, select the class(es) from this list.
Provider
To generate a report for those appointments scheduled for a specific physician during the date range given, select the physician(s) from this list.
Location
For a report for those appointments scheduled at a specific practice location during the date range given, select the location(s) from this list.
Appointment Reports
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Appointments
Group By
You can organize the information in the report by User, Provider and/or Location.
Day of Week Report
This report classifies all appointments by the day of the week, allowing you to view how many and what percentage of appointments were scheduled on Mondays, Tuesdays, Wednesdays, Thursdays, and Fridays within your date range. The report also provides this information in a graph format. Click the Graph icon on the Task Pane to display the graph. Click the icon again to return to the text format.
For example, if you want to see a report for the days of the week for just one week, type in a date range of that week. Advanced Family Practice wanted to know how many appointments were actually scheduled for each day during the last week of the year so they can determine their staff requirements. They chose 12/26/2009 through 12/30/2009 as their date range. This provided a look at the work load for that week, and they could grant as many vacation requests as they can for this year.
Report Options Available for the Day of Week Report:
Field
Description
Date
Enter the date range of the appointments for which you want to view data.
User
To gather information about appointments scheduled by a specific user, select the user(s) from this list.
Class
To gather information regarding those appointments scheduled for a specific Appointment Class, select the class(es) from this list.
Provider
To generate a report for those appointments scheduled for a specific physician during the date range given, select the physician(s) from this list.
Location
For a report for those appointments scheduled at a specific practice location during the date range given, select the location(s) from this list.
Group By
You can organize the information in the report by User, Provider and/or Location.
Hospital Rounds Report
This basic report provides a list of patients at the different service facilities for your physicians. This allows the practice to review the patients’ situations that are at the various facilities or to print a list of patients for the physician to take with them on their rounds.
Report Options Available for the Hospital Rounds Report:
Field
Description
Admission Date
To generate a report for only those patients admitted during a specific date range, enter that date range in these fields. This is based on the date in their Admit Date field on the Hospital Round window.
Provider
To generate a report for a specific provider’s patients admitted during the date range given, select the physician(s) from this list.
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Appointment Reports
Appointments
Service Facility
For a list of hospital rounds in the system for a certain facility, select the facility(ies) from this list.
Show Hospital Notes
Check this box to include any notes on the report that were entered on the patient’s Hospital Round window in the Notes field.
Extra Room For Notes
Check this box to include extra space between patients on the report to allow physicians to write notes while they are at the facility.
Include Discharged Patients
Check this box to display to include discharged patients in the report. The system looks at the Discharged checkbox on the Hospital Rounds window for that patient.
Group By
You can organize the information in the report by Provider, Service Facility and/or Location.
Pre-certification Report
This appointment report provides the ability to generate a report for all appointments that require Pre‐
certification. You can specify the type of list the system returns by the criteria you set on the report options window. Only those appointments for plans that have specific procedures listed on the PreCert Procs tab of the Plan Detail window appear in this report. Staff members must also indicate that the appointment is for one of those procedures or the report won’t see the appointment as needing a referral. They do this using the Procedure field on the appointment entry window. This report lists the phone number entered in the PreCert Phone field and the contact name entered in the PreCert Contact field on the Plan Detail window. If these fields are empty on the Plan Detail window, the system uses the name and phone number from the Plan Name and Phone fields on the window.
TIP | Use the drill‐down feature on this report to access the patient’s personal information as you contact the insurance company for certification.
Report Options Available for the Pre‐certification Report:
Field
Description
Date
Enter the date range of the appointments for which you want to verify Pre‐
certification.
User
To gather information about appointments scheduled by a specific user, select the user(s) from this list.
Location
For a report of those appointments scheduled at a specific practice location during the date range given and that require Pre‐certification, select the location(s) from this list.
Provider
To generate a report for those appointments scheduled for a specific physician during the date range given and that require Pre‐certification, select the physician(s) from this list.
Plan
To generate a report for those appointments scheduled for patients with a specific insurance plan and that require Pre‐certification, select the plan(s) from this list.
Group By
You can organize the information in the report by Location, Provider and/or Plan.
Appointment Reports
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Appointments
Referral Report
When a patient is referred to the practice, some insurance plans require the referring physician’s information on claims to this plan before it can be processed properly. This report allows you to verify that you have referral information on record for patients on the appointment schedule—before you render services and have to bill to the insurance company. If the Referral field is checked on the Plan Detail window for the patient’s plan, those are the appointments that appear on this report.
TIP | Use the drill‐down feature on this report to access the patient’s personal information when needed.
Report Options Available for the Referral Report:
Field
Description
Date
Enter the date range of the appointments for which you want to verify that you have referral information.
User
To gather information about appointments scheduled by a specific user, select the user(s) from this list.
Provider
To generate a report for those appointments scheduled for a specific physician during the date range given and that require a referral, select the physician(s) from this list.
Location
For a report of those appointments scheduled at a specific practice location during the date range given and that require a referral, select the location(s) from this list.
Group By
You can organize the information in the report by Plan, Provider and/or Plan.
Appointment Schedule
Practices can use the Appointment Schedule Report is any number of ways. Practices can use this report to export the data to a third‐party telephony program or to provide the physicians with their schedule for the day. For those practices with MicroMD ECM, they can use the Appointment Schedule Report to verify patient plan eligibility. Practices can also confirm appointments with this report if they choose to use the Confirmation feature.
TIP | At the bottom of the Appointment Schedule Report, the system displays the number of appointments on the schedule for that day.
This report allows you to display appointments by date and times. Given the date range, the system creates a new page for each day in the report.
Unlike the Classification and Day of Week reports, this report also lists chart numbers, patient names, patient phone numbers, and any notes staff members entered when scheduling the appointment. It will also show you the total number of appointments in the schedule for that day (those without a check mark in the Suppressed box on the appointment detail window).
For example, Advanced Family Practice wanted a schedule report for 01/03/2010 through 01/08/2010. They entered those dates in the Appointment Date fields. Their report had all of the appointments for 01/03/2010 that met their criteria displayed on the first page, the appointments for 01/04/2010 displayed on a new page, the appointments for 01/05/2010 began on a new page after that, etc.
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Appointment Reports
Appointments
Report Options Available for the Appointment Schedule Report:
Field
Description
Appointment Date
Enter the date range of the appointments that you want to see on the schedule.
Appointment Time
Enter the time range of appointments that you want to see on the schedule for the given date range. To change between AM or PM, type a capital “A” or “P” next to the time.
Class
To display only those appointments scheduled for a specific Appointment Class, select the class(es) from this list.
Provider
To generate a report for those appointments scheduled for a specific physician during the date and time range given, select the physician(s) from this list.
Location
For a report of those appointments scheduled at a specific practice location during the date and time range given, select the location(s) from this list.
Order By
The system sorts the appointments on this report based on your choice in this Order By section. If you choose Show All Slots in the Display Options section, your only choice to sort the appointments is by Time.
Group By
You can organize the information in the report by Provider, Location and/or Plan. Appointment Reports
10.61
Appointments
Display Options
The options in this section determine a little about how MicroMD PM displays the Appointment Schedule Report for you.
 Show All Slots: Check this box to display the open slots in the appointment schedule (and their related Appointment Class) on the Schedule Report. If you check Show All Slots, only Time in the Sort By section is available.
 Show Landscaped: Check this box to display the report in the landscape page orientation (i.e., 11 in. x 8‐1/2 in.). This allows the system to include more information on each line. This option also automatically double‐spaces the report, regardless of the settings in the general appointment setup (under Appt > Setup > General Setup).
 Show Provider: This box is available when you check the Show Landscaped checkbox. Check this box to list all the appointments with the name of the provider at the end of each line.
 Show Insurance: Check this box the system displays the plan name, policy number, name of the insured party and the telephone number of the insurance company for each scheduled patient in the report. Additionally, when you place a check mark in the Show Landscape field as well, the system displays the patient’s balance, insurance balance, and the total balance.
 Show Balances: This box is available when you place a check mark in the Show Landscaped field. Placing a check mark in this field activates the Balance Type section.
 Show Loc, Separator: This will only be available when Time is selected in the Order By section by itself, or when in addition to Group By Provider. When Show Loc. Separator is checked, a location separator is inserted between appointment times based on the schedule setup, but the time order for each location is kept. If you check the Provider checkbox in the Group By section, the system disables the Show Provider box since the report automatically displays the provider(s) when you group.
Balance Type
This section is available when you select the Show Balances option in the Display Options section. You can choose to show Account Based or Patent Based balances when you create the report. Status Report
This report is unique from the other appointment reports in that it classifies appointments by the action performed on them (their “status”). It allows you to see, according to the parameters you set in the Appointment Status Options window, the status of all appointments in the specified date range: Standard, Deleted, Cancelled, Missed, and Rescheduled. With this report, you can also view the log entries and appointment notes entered by the staff members working with the appointments.
10.62
Appointment Reports
Appointments
Report Options Available for the Status Report:
Field
Description
Date
Enter the date range of the appointments for which you want to view the status.
User
To gather information about actions performed on appointments by a specific user, select the user(s) from this list.
Class
To view the appointment status of those appointments scheduled for a specific Appointment Class, select the class(es) from this list.
Provider
To review the status for those appointments scheduled for a specific physician during the date range given, select the physician(s) from this list.
Location
For a report on the status of those appointments scheduled at a specific practice location during the date range given, select the location(s) from this list.
Status
Place a check mark next to each of the status indicators that you want to see in the report. Remove the check mark from each status that you do not want to see.
NOTE | If a staff member chooses to place the patient on the Waiting List when they modify the patient’s appointment, the system marks the original appointment as “Cancelled.” If they choose to cut the appointment, the system marks the original as “Deleted.”
Display Options
The options in this section determine a little about how MicroMD PM displays the Status Report for you.
 Show Appt. Notes: Check this box to display on the report any text entered in the Note field on the appointment entry window.
 Show Log Entries: Check this box to display on the report any text entered in the Log field of the Appointment Move or Appointment Delete windows.
 Show Landscaped: Check this box to display the report in the landscape page orientation (i.e., 11 in. x 8‐1/2 in.). This allows the system to include more information on each line.
Group By
You can organize the information in the report by User, Class, Provider and/or Location.
APPOINTMENT MAIL MERGE DOCUMENTS
You can print any kind of mail merge document from the Appointment Module that uses the appointment mail merge fields. Some practices like to send cards or letters to remind patients of their upcoming appointments, and then print address labels for those same patients. The system provides the tools to do this and do it quickly.
Create a Mail Merge Document
With the Create Mail Merge Document utility, create your reminder card/letter or any other appointment‐related document you want to print from the Appointment Module (e.g., a thank‐you note, Appointment Mail Merge Documents
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Appointments
a survey of their experience). Set the default document that you most often print from the Appointment Module (e.g., your reminder card or letter).
Print an Appointment Document – Individual Patient
Staff members can print appointment‐related mail merge documents for a patient directly from any of the appointment view windows.
To print a document for a single patient:
Procedure
Details
1. From any of the appointment view windows, place your cursor in the patient’s appointment time slot.
2. Click the Label/Mail Merge icon on the Task Pane.
The Appointment Documents window opens.
3. Select Mail Merge Documents from the Print Options section.
Your default document appears in the Mail Merge Documents drop‐down.
4. If you want to print a document different than the default, select it from the Mail Merge Documents drop‐down.
5. Click the Print button.
The system opens the mail merge document to merge the patient’s data and then prints the document to your system’s default printer.
Print an Appointment Document – Multiple Patients
Use the Appointment Schedule Report to print an appointment document for multiple patients:
Procedure
Details
1. Select Appt > Appointment Reports > Schedule from the main menu.
2. Generate the report to return all of the appointments for which you want print a mail merge document.
3. Click the Mail Merge Export icon on the Task Pane.
The Appt Select window opens with all of the appointments from the report listed. The system will print the document in the order the appointments are listed. Sort the columns to print the documents in a specific order.
To remove an appointment from the list, simply highlight it and click the Delete icon on the Task Pane.
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Appointment Mail Merge Documents
Appointments
4. Click the Open Letter icon on the Task Pane.
The system opens the mail merge document to merge all of the appointment data and then prints the document to your system’s default printer.
TIP | To print this list of appointments, click the Print icon on the Task Pane.
5. You can close all windows when finished.
Appointment Mail Merge Documents
10.65
POSTING CHARGES
The system has the flexibility to provide various ways for your practice to post charges to the database. Depending on the needs of your practice, you can post charges for an individual patient using the search engine to locate that patient. You can post from the Charge Slips list window. Or you can post the same charges for multiple patients in a batch—excellent for those days when your practice performs many immunizations and allergy shots. You can also import charges from a third‐party application—excellent for downloading a text file from another facility, such as a hospital.
In previous chapters, we discussed how to create charge codes, payment codes, MicroMD PM adjustment codes, Explosion Codes, etc. You also learned about the preferences and defaults you can establish to make your posting activities as efficient and accurate as possible. Now we can put all of that together and start posting charges to patient accounts and prepare to send claims.
IN THIS CHAPTER
In this chapter, we cover how to:
 Post charges in a variety of ways
 Perform various edits and modifications to a sequence
 Correct charge posting mistakes
 Prepare for submitting claims
 Merge patient‐responsible sequences
 Split transactions into two sequences
 Reorder items in a sequence
OVERVIEW OF CHARGES/PAYMENTS WINDOW
The Charges/Payments window is generally the first window you access in the Charges/Payments Module. Click the Charges/Payments icon on the Launch Pane, select Billing > Charges/Payments from the main menu, or press the F6 function key on the keyboard to access the window. From this window, you can search for any patient in your practice and post charges or payments. NOTE | Two other windows could pop up, depending how your practice is set up: the Charge Slips list and the Pending Charges list. In This Chapter 11.1
Posting Charges
Figure 11‐1 Charges/Payments Window
The top portion of the Charges window acts just like the Guarantor/Patient List window when searching for a patient’s account. However, you have some additional information displayed relating to posting charges/payments:
 The Day Sheet Date field displays your currently selected day sheet and flashes red if this date differs from your current system date.  The Entries field displays the total number of line items posted to that day sheet date. This includes charges, payments, write‐off, refunds, MicroMD PM adjustments, etc.  The Batch Payments and Global Payments fields relate to using Batch Payment Posting. The middle section of the window contains the list of patients that met the criteria you entered in the top portion. The bottom section of the window displays information about any sub accounts for the highlighted patient, including the patient.
OVERVIEW OF PATIENT SEQUENCES WINDOW
Once you search for a patient and double‐click their name in the Charges / Payments window, you access the Patient Sequences window. The Patient Sequences window is the central area where you can access all activity posted to the patient’s account. 11.2
Overview of Patient Sequences Window
Posting Charges
Figure 11‐2 Patient Sequences Window
The top portion of the window displays the patient’s account number, name and chart number. You can also see the patient’s category and whether any notes exist. The floating toolbar appears on this window to provide quick access to a wealth of information for the patient. The system also presents two text fields in the top portion of the window that are linked to the Patient Detail window: Alerts/Remarks and Notes. Any change to these fields is reflected on the Patient Detail window, the appointment detail, and Billing Inquiry window.
The rest of this window displays the patient’s sequences in MicroMD PM, with the balance due and responsibility. It also displays those sequences that are paid and have a balance of zero. These paid sequences appear on the window if the date in the Posting column is within the number of days indicated by the Cutoff days field in the top section of the window. (This field defaults from the Cutoff Days field on the Billing Preferences tab under Setup > Practice Preferences.)
Columns on the Patient Sequences Window:
Field
Description
P
Users check this box to access additional icons on the Task Pane. These additional icons are actions you can perform specific to the sequence checked.
Red bar ( )
A red bar next to a sequence indicates that user‐generated notes exist that are specific to that sequence. To view the note(s), place a check mark in the P column for the sequence and click the Sequence Note icon that appears on the Task Pane. Overview of Patient Sequences Window
11.3
Posting Charges
Blue bar ( )
A blue bar next to a sequence indicates that the patient has a co‐pay amount still due for the services posted on that sequence. When you hover the mouse over the blue bar, the system displays a pop‐up with the dollar amount of the co‐pay due.
The system only tracks co‐pay balances if there is a check mark in the Track Co‐pay box on the Billing Preferences tab (under Setup > Practice Preferences). Green bar ( )
A green bar next to a sequence indicates that there are unapplied payment amounts associated with the sequence. This happens when staff members do not use line‐
item payment posting (i.e., using the green and blue Payment Calculation windows). If you do not use line‐item posting in your system, you can turn off this green bar indicator. Remove the check mark from the Show Sequence Applied Flag box on the System Preferences tab (under Setup > System Preferences). Purple bar ( )
When the system imports extended CPT codes from the MicroMD EMR software, MicroMD PM displays a purple bar indicator next to the sequence. This bar indicates that the user can select either a five or a six‐digit code to associate with the sequence. To view the extended codes, click the purple bar to open the Procedures window. Then, double‐click the appropriate code for claims submission.
NOTE | If you select a six‐digit code from the Procedures window, the system removes the purple bar indicator. If you keep the five‐digit code, the system retains the bar to remind you that additional codes are available.
Posting
This column displays the date that the first item on the sequence was posted. Typically, this is the day sheet under which the biller posted charges. The other items in the sequence could have different posting dates.
Service
This column displays the date the services listed in the first item of the sequence was rendered. Typically, the service date and posting date are the same. The other items in the sequence could have different service dates.
SEQ
This column displays each sequence’s number. The system does not duplicate a patient’s sequence number over the life of their account. Each patient will only ever have a sequence 1. They will only ever have a sequence 2. And so on. For dental practices, however, sequence 0 is always the pre‐estimate sequence. Once that sequence is empty, these practices can create a new sequence 0 when needed.
Entries
This column indicates how many line items are listed on the sequence, including charges, payments, write‐offs, refunds, MicroMD PM adjustments, note lines, etc.
Rend. Provider
This column indicates the provider who rendered the services listed on the sequence for the first line item. Other services in the sequence could have other providers listed, but the system displays the first rendering provider.
Balance
This column displays the total balance remaining on each sequence, including both insurance‐responsible and patient‐responsible items.
OVERVIEW OF CHARGES WINDOW
There are many ways in MicroMD PM to post charges. Most practices post charges manually. The Charges window opens when you click the New icon on the Task Pane or press the Ctrl + N key 11.4
Overview of Charges Window
Posting Charges
combination while in the Patient Sequences window. (You can also double‐click the sequence to view the items it contains.) This window provides staff members with access to everything they need to enter charge data for the services rendered by the provider(s) in the practice.
Figure 11‐3 Charges Window
The top portion of the window contains the case and plan information for this patient. It also displays the practice location and service facility associated with this sequence. You enter any diagnosis codes for the sequence in this area. The bottom portion of the window is where you enter the transaction lines for the sequence. NOTE | This icon, located near the top‐right corner of the charges window, is an indicator that the practice is using ICD‐9 only. Several windows can pop up when you access this window and post charges, depending on the modules you use and other set up options chosen by the practice. Some of the possible windows that can pop up include:
 HIPAA alerts
 Planned visits
 Payment calculation display
 Cross‐code messages
 Last twelve diagnosis codes posted (ICD‐9 and ICD‐10 can be displayed)
 Provider credentials Overview of Charges Window
11.5
Posting Charges
Columns for the Transaction Line on the Charges Window:
Field
Description
D
Check this box and click the Document icon on the Task Pane to provide the insurance company with additional documentation for claim processing (up to 160 characters for electronic billing). If you place a check mark in the D column and then do not add any information under the Document icon, the system automatically records the description specified with the procedure line as the documentation for electronic and paper claims.
You can set the default for each procedure using the Documentation Flag box in the Procedure Detail window. Proc
Enter the procedure code (or Explosion Code), either numerically or by description, for each service that has been rendered to the patient. If the system cannot find a match for the code or description entered, it displays a Procedure Search window that allows you to find the correct code quickly.
TIP | Remember that you can use the wildcard characters to search the list (i.e., % or _ ).
POS
This column indicates the place of service where the procedure entered. Each procedure pulls its default value from the Procedure Detail window. Staff can change this if needed.
NOTE | A warning message appears if you specify a POS of 21, 22, 23, 31, or 32 on any of the procedure lines on the Charges window and do not enter a service facility.
M1, M2, and M3
These are modifier fields that allow you to select any required modifiers required for the procedure entered. The system automatically defaults to the modifier(s) selected on the Procedure Detail window for this code, if any. You can change these as needed while posting.
Date From and Date To
These fields allow you to enter the dates services were rendered for the patient. The date fields default to your active day sheet date, but you can change the dates if needed. When you change the Date From field, that date carries through to each new transaction line until you change the date again. If the Date To field is later than the Date From field, the system automatically recalculates the Unit and Fee fields accordingly.
For example, Anthony Smith was seen at on January 3, 2009. The Date From and Date To columns for the charges on that sequence would both be 01/03/2009. If Mr. Smith was seen in the hospital from January 3, 2009, to January 5, 2009, the Date From column on his hospital charge would be 01/03/2009 and the Date To column would be 01/05/2009.
NOTE | If you attempt to post charges to a service date that exceeds the system’s current date, the program prompts you with a warning. You will also receive a warning if you attempt to post charges to a date of service of more than a year prior to the active day sheet date.
Description
11.6
This column displays the description of the procedure code as entered on the Procedure Detail window. You can change this field when posting, if needed. The field holds a maximum of 40 characters.
Overview of Charges Window
Posting Charges
Fee
The system automatically displays the amount listed in the procedure’s Standard Fee field (on the Procedure Detail window). If the plan is a Medicare plan, the system displays the amount listed in the procedure’s Medicare Fee field (on the Procedure Detail window). TIP | The system knows the plan is a Medicare plan if the plan’s Insurance Class drop‐
down list is set to the same Insurance Class indicated in the Medicare Class drop‐down on the System Preferences tab (under Setup > System Preferences).
You can change the fee when posting the charge, if necessary. You can set up the system to enter a different fee automatically based on:
 practice
 modifier
The system also updates this field based on the number in the Unit column.
Unit
Enter the number of units needed for the procedure code. The units value defaults to “1,” but you can change this when posting if needed. The system automatically changes this column when you change the date in the Date To column (if it is later than the Date From column). The system recalculates the Fee column when the Unit column changes.
TIP | If you add an asterisk before the number of units you enter in this field, the system shows the number of units posted without updating the Fee field.
Prov and BProv
You can select a rendering provider (the person providing service to the patient) while posting charges, as well as a billing provider (the person who appears on the claim), for each transaction line in a sequence. The red arrow in the column header allows you to toggle between the two lists. You identify a provider as a billing provider on the Provider Detail window and assign billing providers to a rendering provider on the Provider tab of the Practice Detail window.
When accessing this window from the Check‐In/Check‐Out Module, MicroMD PM automatically selects the provider with which the patient had their appointment. Otherwise, the system automatically defaults to the provider selected in the Default Provider drop‐down list on the Billing Preferences tab (under Setup > Practice Preferences). TIP | The system can automatically split the sequence in two based on the rendering provider. However, the billing provider still appears on the claim.
Overview of Charges Window
11.7
Posting Charges
Bill
This column determines the responsibility of the charge line and, ultimately, the sequence. The system pulls the default for each charge line from the Bill Flag drop‐
down list on the Billing Preferences tab (under Setup > Practice Preferences). If the procedure is always a patient‐responsible amount, you can check the Patient Resp checkbox on the Procedure Detail window to override the main default for this procedure. The responsibility choices are:
 Y – Ins. Billing/Pat. Resp: This flag means that both the insurance company and the patient are billed. The balance appears as patient due and when you print bills, MicroMD PM includes the entire sequence balance on the bill and indicates that the claim was filed to the insurance company as well.
 N – Pat. Billing/Pat. Resp: This flag means that only the patient is billed. The balance appears as patient due. If the patient has no insurance or a procedure is charged with a zero dollar amount when you post charges, the system automatically defaults the bill flag to N – Pat. Billing/Pat. Resp.
 X – Ins. Billing/Ins. Resp: This flag means that only the insurance carrier is billed. The balance appears as insurance due. The patient is not sent a bill, although they can receive a statement until the insurance pays, at which time the remainder of the balance becomes patient due.
If all of the charge lines in a sequence are the responsibility of the patient, the sequence is considered patient‐responsible. However, if a sequence includes one or more insurance‐responsible charge lines, the sequence is considered insurance‐
responsible.
Diag
This reference (or pointer) column allows you to associate a diagnosis code with the procedure line. The system defaults the Diag column to 1 if there is no check mark in the Diagnosis Pointer All checkbox on the Billing Preferences tab (under Setup > Practice Preferences). If there is a check mark in this box, the system defaults this column to all diagnosis codes entered and in the order entered.
You can edit this column to reflect the appropriate diagnosis and procedure association typing the diagnosis code pointers in the correct order or double‐click the field and rearrange the pointers into a different order in the Diagnosis window that opens.
11.8
Overview of Charges Window
Posting Charges
Responsibility This column indicates the party currently responsible for the amount due on each sequence. For example, if the system displays “Patient‐ABC Insurance Company” in the Responsibility column for one of Anthony Smith’s sequences, the claim is pending with the insurance company, but Mr. Smith is responsible for paying the bill.
Sequence responsibility is based on one of three different possibilities of the Bill flag on the Charges window.
 Y – Ins. Billing/Pat. Resp: This flag means that both the insurance company and the patient are billed. The balance appears as patient due and when you print bills, MicroMD PM includes the entire sequence balance on the bill and indicates that the claim was filed to the insurance company as well.
 N – Pat. Billing/Pat. Resp: This flag means that only the patient is billed. The balance appears as patient due. If the patient has no insurance or a procedure is charged with a zero dollar amount when you post charges, the system automatically defaults the bill flag to N – Pat. Billing/Pat. Resp.
 X – Ins. Billing/Ins. Resp: This flag means that only the insurance carrier is billed. The balance appears as insurance due. The patient is not sent a bill, although they can receive a statement until the insurance pays, at which time the remainder of the balance becomes patient due.
Each transaction included in the sequence is assigned one of these Bill flag values. If all of the transaction lines in a sequence are marked “N” and/or “Y,” the sequence is labeled as patient responsibility. However, if any of the transaction lines are marked “X,” the sequence is labeled insurance responsibility. OVERVIEW OF THE CLAIM TRANSACTIONS WINDOW
If one of the charge lines in the Charges window has a bill flag of either Y – Ins. Billing/Pat. Resp or X – Ins. Billing/Ins. Resp, the system knows that you want to send a claim to the patient’s insurance company for the items on that sequence. When you save the charges you enter, the system then displays the Claim Transactions window so you can enter additional information in preparation for submitting claims.
Overview of the Claim Transactions Window
11.9
Posting Charges
Figure 11‐4 Claim Transactions Window
The system pulls the default values for this window from the Cases tab on the Patient Detail window. The buttons on the bottom of the window are the actions you can take for the sequence.
 The More button provides access to the Claim Modification window used when entering information for re‐filing a claim or submitting supplemental claims.  The Extra button provides other billing options (e.g., ambulance billing and chiropractic electronic billing).  The Hold button allows you to prevent MicroMD PM from processing the claim until you are ready to release it.  For Referral, Ordering or Supervising, if there is a referring provider on the claim, it will print in box 17 with the appropriate qualifier. If there is no referring provider, but there is an ordering provider, the ordering provider will appear in box 17 with the DK qualifier. If there are no referring or ordering providers, but there is a supervising provider, the supervising provider will print in box 17 with the DQ qualifier.
 Diagnosis codes at the top of the window will display ICD‐9 and ICD‐10 codes.
11.10
Overview of the Claim Transactions Window
Posting Charges
POSTING CHARGES ON AN INDIVIDUAL BASIS
Many times, practices have people who post charges from a printed charge slip or encounter form per patient. These staff members can use the point‐and‐click method for their posting activities, but if they feel more comfortable strictly using the keyboard, the system has plenty of shortcuts for that purpose. Many practices use the Charge Slips list window to post charges. This is the best way to ensure that all patients seen on that day have charges posted to their accounts. To post charges on an individual basis:
Procedure
Details
1. Select Billing > Charges/Payments from the The Charges/Payments window opens.
main menu.
If you do not have an active day sheet, the system prompts you to select one. If this date differs from the computer’s system date, the Day Sheet Date field flashes in red on the Charges/Payments window. You can also click the Charges/Payments button on the Launch Pane, if available, or press the F6 key on the keyboard.
2. Search for the patient’s account to which Along with other criteria, you can search by patient name or account number, responsible party, and/or you want to post charges.
insured name. Once you have entered the search criteria, press Enter to see the results.
3. Double‐click the patient to display their account.
The Patient Sequences window opens. This window displays all of the patient’s outstanding sequences in MicroMD PM, with the balance due and responsibility.
4. Click the New icon on the Task Pane.
The Charges window opens so you can create a new sequence for this patient.
TIP | To generate a new sequence from an existing one, place a check mark in the P column next to the sequence and click the Copy icon on the Task Pane.
TIP | For those billers using keystroke posting, you can tell the system where you want the cursor to appear by default when you first enter the Charges window. On the Billing Preferences tab under Setup > Practice Preferences, select the field from the Default Posting Cursor drop‐down list.
Posting Charges on an Individual Basis
11.11
Posting Charges
5. Verify the Case drop‐down list displays the appropriate patient case.
Practices choose the patient’s default case on the Cases tab of their Patient Detail window. When you change the Case field on the Charges window, the Plan Set field changes appropriately. STOP | Be careful! You can change the Plan Set drop‐
down list without changing the Case list.
The green plan display bar at the top of the window displays the primary plans in the selected plan set. (Use the scrollbar to the right of that display to view other inactive primary plans.) If the patient has primary plans with different effective dates, the system compares the Date From field for the first procedure against the effective dates of the plans to select the correct primary insurance plan.
If you access this window from the Check‐In/Check‐
6. Verify the Location drop‐down list displays the appropriate practice location Out Module, the system uses the location associated with that patient’s appointment.
for the charges.
If you access this window directly, the system uses the location from the Batch Posting Options window.
Locations are practice‐specific, and although they are not required on claim forms, the system uses them to determine if the provider and/or group number should be used on the claim. Locations are also important for reporting purposes.
7. Verify the Service Facility drop‐down list displays the appropriate service facility, if applicable, for the charges.
If you access this window from the Check‐In/Check‐
Out Module, the system uses the service facility associated with the case chosen for this patient.
If you access this window directly, the system uses the service facility from the Batch Posting Options window.
11.12
Posting Charges on an Individual Basis
Posting Charges
8. Enter one or all diagnosis code(s) in the Diagnosis fields.
TIP | Since these are lookup fields, if you do not know the exact diagnosis code, type in a partial code or name, and choose from the Diagnosis Search list that pops up.
The system defaults to those diagnosis codes (if any) that a staff member entered on the patient’s Cases tab on their Patient Detail window.
The program also keeps track of the last eight diagnosis codes posted to the patient’s account. The system displays the Patient Last Diagnosis window with those diagnosis codes loaded.
If you want to use one or more of these codes, place a check mark in the box next to the code. Drag and drop the checkboxes to any of the Diagnosis fields. An information bubble appears when you have successfully grabbed the diagnosis codes with the mouse. An exclamation triangle appears when you can successfully drop the codes into the Diagnosis fields. All of the selected codes are then posted in the diagnosis field(s).
9. Click the New icon on the Task Pane.
Posting Charges on an Individual Basis
This adds a new procedure line to the bottom of area of the window. Alternatively, MicroMD PM will also create a new first line automatically after you tab out of an empty Diagnosis field. You could also simply click anywhere in the bottom area of the window to create a new first line.
11.13
Posting Charges
10. Enter a procedure code in the Proc column.
TIP | Since these are lookup fields, if you do not know the exact procedure code, type in a partial code or name, and choose from the Procedure Search list that pops up.
You can also use Explosion Codes to post charges quickly.
If you have the Charge Estimate checkbox checked on the System Preferences tab (under Setup > System Preferences), the system displays a preliminary Payment Calculation window based on the contracted and allowed amounts stored for the procedures you just posted.
11. Verify the remaining information on the transaction line.
NOTE | You can change any of the fields when posting and prior to saving the sequence. Once the sequence has been saved, you still have the option of changing some of the fields. However, certain fields require that the day sheet is still open: Location, Proc, Fee, and Unit.
12. Repeat steps 9 through 11 for any additional procedures.
The information entered for the Date From, Prov, Bill, and Diag fields remains the same on the subsequent lines. You can change this on a line‐by‐line basis, if necessary.
You can add more procedures or you can enter a personal payment made for this same date of service. Make sure the Bill column on that transaction line is set to N – Patient Payment. TIP | When you have finished entering charges, you can click the Print Receipt icon on the Task Pane to hand a line‐item printout to the patient. This saves your charges automatically and you can skip to step 14.
11.14
Posting Charges on an Individual Basis
Posting Charges
13. Click the Save icon on the Task Pane.
You could receive alert messages when you save. Read each one carefully. A couple of possibilities:
 If the practice has automated recalls established, the user will receive a recall alert if any of the procedure/diagnosis codes they posted match those on the Recall Activation Sets window.  Whenever you save charges in the system, the system verifies if the patient is deceased and if the patient’s date of death is before or after the service date posted. The system displays a warning message only if the service date on the charges you are posting is after the date listed in the patient’s Death Date field on their Patient Detail window.
Once you save your charges, the system displays the Claim Transactions window if the patient has insurance. If the patient has no insurance, the system automatically makes the balance patient‐responsible and returns to the Patient Sequences window. In that case, you are finished with posting charges.
14. Depending on the claim’s Form Type, complete the information on the Claim Transactions window as needed to send the claim correctly.
Your support team has additional documentation to help you submit claims to your carriers accordingly. 15. Click the Save button on this window.
That’s it. You’ve created a sequence for this patient and can submit a claim or bill the patient.
POSTING CHARGES FROM THE CHARGE SLIPS LIST
When you use the system to print charge slips for your patients, the system maintains a list of those patients who had charge slips printed against their accounts. Presumably, all patients with a charge slip printed need to have charges posted against their account, unless they cancelled or rescheduled. The system provides you with an interactive Charge Slips list window, listing only those patients with charge slips printed for your active day sheet date.
Your posting activity is the same as described in Posting Charges on an Individual Basis. The only difference is how you get to the Charges window to enter data. With the Charge Slips list window, you can simply double‐click the patient’s entry on the window—saving you quite a few steps and allowing you to see in a glance if you are missing a charge slip. Any remaining charge slips in the list window when you are done are the missing charge slips.
When you post through the Charge Slips List window, the system checks the most recent sequence posted to the patient’s account. If this sequence was posted on the same day sheet date as the user has active and the sequence contains only payments, MicroMD PM opens this sequence instead of creating Posting Charges from the Charge Slips List
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Posting Charges
a new one. Otherwise, the system creates a new sequence. When the biller begins to post charges to the sequence, the system automatically sets the appropriate case and plan set for the sequence, changing the sequence from patient‐responsible to insurance‐responsible.
NOTE | If the existing sequence has a case and/or plan set already specified, the system leaves that information intact and does not change it. Otherwise, the case and plan default appropriately.
You can organize your printed charge slips in the same manner that you sort your columns on the screen. Then you can easily match up your printed charge slip with the one listed in the system, use the charge slip in the system to launch the Charges window for that patient, and then post the charges. Once you save the new sequence, the system removes the charge slip from the list window, and you can set the completed charge slip aside.
NOTE | If charge slips were autoloaded from the appointment schedule, the new sequence you create defaults to the location, service facility, case, plan set, and provider specified on the appointment.
Figure 11‐5 Charge Slips List Window
On the Display Properties window (under Utility > Workstation Setup > Display Properties), check the Charge Slip List box. Now, when you access the Charges Module, the system displays a pop‐up window containing a list of charge slips printed for the day sheet you have active.
NOTE | The Charge Slips list window appears and updates based on the number of seconds chosen in the Refresh Rates field (on the General Preferences tab under Setup > Practice Preferences). You can also toggle the Charge Slips window into the search window, making it easier to view and sort the list to match up to your printed copies. Click the Toggle Display icon on the Task Pane to transfer the entries in this list to the Charges/Payments window.
A service date filter has been added to the toggled view of pending changes. This defaults to “ALL” but can be used to filter the service date range. Service Date and Location columns have also been added. Users can filter the list on both of these columns for the desired results.
11.16
Posting Charges from the Charge Slips List
Posting Charges
Note that once the adjustable service date range is set, the dates of service that fall outside of the date range will be removed when the toggle display refreshes (based on the set refresh rate or the use of the refresh icon).
Figure 11‐6 Charge Slips Window Toggle
BATCH CHARGE POSTING
The system provides two ways for you to post charges in batches. Depending on the way your practice posts charges, you can set the system to keep track while you post normally or you can post the same charges to multiple patients and only type the codes once.
Track Charges as You Post
The Batch Posting Options window is a simple tool that allows you to track payment, charge and write‐off posting activity. It also provides you with a simple way to specify the practice location, service facility and service date for the charges you are about to post. You can access this window from the Charges/ Payments window. Click the Batch Options icon on the Task Pane.
Batch Charge Posting
11.17
Posting Charges
Figure 11‐7 Batch Posting Options Window
The Batch Posting Options window is user‐specific, and aside from the Global fields, practice‐specific. It is not specific to any particular day sheet unless you use it that way. NOTE | If you click Yes to the Reset Batch Totals message you receive when you erase the day sheet, then the information on this window is cleared for the practice and reset to default values, including clearing all batch numbers.
Fields Relating to Charge Posting Activity:
Field
Description
Reset Batch
Click this button to set all fields in the Batch row to zero. This clears the total payments, charges and write‐offs this user has posted since the last time these displays were reset. Reset Day
Click this button to set all fields in the Day row to zero. This clears the total payments, charges and write‐offs this user has posted since the last time these displays were reset. This also deducts the appropriate amounts from the Global fields to reflect the global totals less the amount you have reset.
Reset All
Click this button to set all fields on this window to their default values. This clears all of the total payments, charges and write‐offs this user has posted since the last time these displays were reset, including the Global row. The Location and Service Facility drop‐downs revert to the values chosen from the Default Location and Default Service Facility drop‐downs on the Billing Preferences tab (under Setup > Practice Preferences).
Service Date
Enter a service date to use when posting charges if you need to use a date different from the current day sheet. The system uses the date specified in this field as the default service date on every charge posted after changing it. You can still change this date when posting, if necessary.
If no date is specified in this field, the system uses the current day sheet date.
11.18
Batch Charge Posting
Posting Charges
Location and Service Facility
You can use the Batch Posting Options window to specify the practice location or the outside facility for the charges you are about to post. Choosing a location or service facility on this window eliminates the need to stop and change those drop‐
downs for each patient while posting.
For example, Advanced Family Practice has four practice locations that work with five different nursing homes. They divide up the posting activity between their billers. Each one can organize their charge forms by service facility. Then they can choose the location they were assigned. They can change the facility with each new group of charge forms as they post from their stack of forms.
You can choose a specific location or facility from these drop‐downs, or you can select (Default) from the drop‐down list. Selecting (Default) sends MicroMD PM to the Billing Preferences tab (under Setup > Practice Preferences). The system then uses the choice it finds in the Default Location drop‐down or the Default Service Facility drop‐down, as appropriate. If that drop‐down has (Default) selected, then the system goes to the Patient Detail window for each patient and uses their location.
TIP | Be careful. If you select (Default) for the Location or Service Facility drop‐
down on the Batch Posting Options window, and the Default Location or the Default Service Facility on the Billing Preference tab is set to (None), staff members will be forced to select a location for each patient.
Operator
This field displays the user for whom the displayed totals apply.
Batch Pmts
This is the total dollar amount of the charges, payments and write‐offs you have posted since the last time you clicked the Reset Batch button.
Day Pmts
These totals are the total amount of charges, payments and write‐offs you have posted since the last time you clicked the Reset Day button. This allows you to track the amount you have posted for the entire day, independent of the total amount in the Batch Chgs field.
Global Pmts
These totals are only visible if the Multi‐Practice checkbox is marked (Setup > System Preferences > System Preferences tab). These are the totals posted for this user across practices. This helps you keep track of your posting activity when you work with several practices in the same database.
When you click the Reset Day button, the system subtracts the appropriate amounts from this Global field to reflect the change.
Posting Charges in a Batch
Batch Charge Posting allows you to enter charges with the same diagnosis and procedure codes for several patients quickly. For example, Advanced Family Practice spends quite a few days a week in the fall performing flu shots. They see at least a hundred patients a day when they do this. During that time, they use Batch Charge Posting to enter these particular charges quickly. They enter the diagnosis and procedures once at the top of the window, key in the list of patients, and then actually post the charges with a single click of the mouse.
Batch Charge Posting
11.19
Posting Charges
Figure 11‐8 Batch Charge Posting Window
The top portion of the window allows you to set the information for the charges you want to post. The middle section is where you enter each patient for whom you want to post those diagnosis and procedure codes from the top section. Note that this window will now display ICD‐10 codes where appropriate.The bottom of the window displays the patient’s plan information and provides access to edit the procedures as needed for each patient, just like you can when posting charges normally. The system does not actually post the charges to the patient accounts until you click the Save icon on the Task Pane. Do not confuse this icon on the Task Pane with the Save button on the window. Click the Save button on the window and assign a file name when you want to save the charges to a file so you can finish your work later. You can click the Open button to load the file and continue working. To post using Batch Charge Posting:
Procedure
Details
1. Select Billing > Batch Charge Posting from the main menu.
The Batch Charge Posting window opens.
2. Verify that you have the appropriate day sheet If you have not selected a day sheet yet and you have multiple day sheets open in the system, the date selected.
system prompts you to select the appropriate day sheet. 11.20
Batch Charge Posting
Posting Charges
3. Select all of the appropriate charge information in the top portion of the window.
4. Click the New icon on the Task Pane to enter a new patient row.
You can press the Ctrl + N key combination or simply click once in the middle portion of the window to create a new patient row.
5. Enter the patient name or ID in the ID column and press Enter.
This is a search field where you can enter partial names or ID numbers to find the patient you need.
6. Edit any fields necessary in the bottom section of the window for this patient.
You can return to this patient and edit before saving charges and posting your activity. Highlight the patient, and the bottom portion of the window displays that patient’s transactions.
7. Repeat steps 4 through 6 for each patient to whom you want to post the charges entered in the top portion of the window.
8. Click the Save icon on the Task Pane.
The system begins to post the charges for the patients you entered. If you have the Display Insurance Header box checked, the system pauses for each patient with insurance and allows you to complete the Claim Transactions window as needed for the patient’s claim. Fields on the Batch Charge Posting Window:
Field
Description
Default Diag
Select which diagnosis codes the system should use for the patients you enter in the middle section of the window.
 (Default): This choice uses the diagnosis codes you enter in the Diag1, Diag2, Diag3 and Diag4 fields of this window.
 Chronic: When you select Chronic from this drop‐down, the system knows to use the diagnosis codes entered on each patient’s Cases tab for the case marked as the default.  Last: Choosing Last from this drop‐down uses the last eight diagnosis codes posted to each patient’s account.
Entering a diagnosis in any of the Diag fields on this window overrides the choice you make from the drop‐down list.
Display Insurance Check this box to display the Claim Transactions window for each patient once you Header
save the charges. This allows you to make any changes necessary for submitting claims, such as adding an authorization number.
Service Date(s)
Batch Charge Posting
Enter the date range for the services rendered. The system uses this date range for each patient you enter.
11.21
Posting Charges
Location
By default, this drop‐down displays the selection made on the Batch Posting Options window. You can change this if needed. Choose a specific location or select (Default) from the list, which automatically selects the location listed on the Patient Detail window for each patient.
Facility
By default, this drop‐down displays the selection made on the Batch Posting Options window. You can change this if needed. Choose a specific facility or select (Default) from the list, which automatically selects the facility listed on each patient’s Cases tab (on the Patient Detail window) for their default case.
Provider
By default, this drop‐down displays the selection made in the Default Provider drop‐down on the Billing Preferences tab (under Setup > Practice Preferences). You can change this if needed. Choose a specific provider or select (Default) from the list, which automatically selects the provider listed on the Patient Detail window for each patient.
Bill Flag
This drop‐down determines the responsibility of each charge line posted in the batch and, ultimately, each sequence. The system pulls the default for this drop‐
down from the Bill Flag drop‐down list on the Billing Preferences tab (under Setup > Practice Preferences). NOTE | The choice in the Bill Flag drop‐down on the Batch Charge Posting window overrides the Patient Resp checkbox on any procedure. However, you can change the responsibility of each line item in the bottom portion of the window for each patient if necessary.
Procedure, POS, and Mod
Enter the procedure code(s), place of service and modifiers you want to post to each of the patients you enter in this window. You can enter as many procedures as you want, just click the New icon on the Task Pane or press the Ctrl + N key combination. Either action adds another row of procedure fields for you to enter more codes. (Use the scrollbar arrows to the right of the row to view all the procedure rows you have entered.)
AUTOCHARGE POSTING
For those practices that need to import a charge file from another facility, like a hospital, AutoCharge Posting allows you to post charges from an *.mcd file. You can simply load the file into the window, choose some options and post the charges. The system also provides a report of the transactions posted 11.22
AutoCharge Posting
Posting Charges
for your records. You can generate this report at any time before you post the charges. Click the AutoCharge Posting Report icon on the Task Pane and then click the Print icon. Figure 11‐9 AutoCharge Posting Window
STOP | The data within the *.mcd file must adhere to a specific format. Your support personnel have a detailed document explaining this format.
NOTE | Note that ICD‐10 codes will now display on the Auto Charge Posting window.
To post using AutoCharge Posting:
Procedure
Details
1. Select Billing > AutoCharge Posting from the main menu.
The AutoCharge Posting window opens.
2. Click the browse icon next to the path field and select the location of the file to import.
AutoCharge Posting
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3. Select the file from the Transaction Files drop‐ The information in the file displays on the down list and click the Load File icon on the Task Processed Data tab.
Pane.
4. Make any changes necessary to the transaction Highlight the appropriate row to make changes to that sequence. lines at the bottom of the window.
The system highlights in yellow any sequences with errors. Click in any of the fields to correct information as needed. When you post, MicroMD PM skips any sequences with uncorrected errors.
5. Click the Save icon to post the charges.
The sequences that have been posted are highlighted in teal. After processing the imported file, the program renames the file using this format: arc[date][time].bak, where [date] and [time] are the computer’s current system date and time.
Fields and Tabs on the AutoCharge Posting Window:
Field
Description
Batch Count
Displays the total number of sequences contained in this file. This field is for informational purposes only.
Invalid Seqs
Displays the number of sequences within the file that contain errors. This field is for informational purposes only.
Batch Charges
Displays the total amount of the charges within the file. This field is for informational purposes only.
Charge Count
Displays the total number of charge lines within the file. This field is for informational purposes only.
Invalid Chrgs
Displays the total number of individual line items in the file that contain errors. This field is for informational purposes only.
Processed Data tab
This tab displays all the information that the system is about to post. The upper portion of the tab lists the patient ID and name, as well as the location, service facility, etc. The lower portion lists the procedure information for the patient highlighted on the top of this tab.
Raw Data tab
This tab displays the exact data in the file. This tab is for informational purposes only and cannot be modified.
Insurance tab
This tab is not currently in use.
11.24
AutoCharge Posting
Posting Charges
POSTING PENDING CHARGES
The system has a holding area for pending transactions that come from MicroMD EMR encounters and/
or third‐party interfaces and from any of the additional system solutions. This holding area allows billing staff to review the charges before committing them to the database. Staff can process charges individually or in a batch using AutoCharge posting.
NOTE | This feature is only applicable to third‐party interfacing or the MicroMD family of solutions. Please contact your local authorized reseller for more information about any of these products.
ICD Code Matching of Imported Charges
When charges are imported into the PM pending charges from a third‐party, if an ICD code is included and not currently matched to the practice diagnosis list, a match is attempted from using <ALL> ICD diagnoses. When matched, the ICD code is added to the practice diagnosis list and the ICD is imported as it would have had it originally matched in the practice diagnosis list.
When using the “Send to Billing” functionality in the MicroMD EMR (connected to the MicroMD PM), the PM will attempt to map codes coming from the EMR without an existing match to an ICD‐10 code if a one‐to‐one match exists.
Pending Charges List
When you open the Charges Module, one of the windows that MicroMD PM can display is the Pending Charges list window. If you do not see this window, verify there is a check mark in the Pending Charges List checkbox on the Display Properties window (under Utility > Workstation Setup > Display Properties) and double‐check the amount of time indicated in the Refresh Rates section on the General Preferences tab (under Setup > Practice Preferences).
STOP | Only one user per office should have the Pending Charges window open at one time. If multiple users have this window open, there is a danger of duplicating charges in the system before the window refreshes to reflect another user’s activity.
Figure 11‐10 Pending Charges List Window
The easiest way to work with the entries on this window is to transfer those entries to the main window. To do this, click the Toggle Display icon on the Task Pane until those entries appear in the window. Since Posting Pending Charges
11.25
Posting Charges
this icon also toggles the Charge Slips window, it may take two clicks to toggle the Pending Charges window.
The list is also sortable by column heading. Just click on a column heading to sort the list in ascending or descending order based on that column.
TIP | You can post a charge directly from the Pending Charges list window (simply double‐click the entry); however, you lose the flexibility of reordering the sequence before adding it to the database.
Fields on the Pending Charges Window:
Field
Description
ID
This column displays the patient’s ID number. If the ID number in this column is red, that patient is a temporary patient and you’ll need to create a new account for them before you post their charges.
Name
This column displays the patient’s name associated with the number in the ID column.
Created by
This column displays the date and time that the pending charge entry was created, which application created it, and which user of that application created it.
Detail Rows
This displays the number of transactions that appear in the pending sequence.
note triangle When you hover the mouse over this red triangle, a pop‐up displays any notes entered by the user who created the entry. The system stores this note in the Sequence Notes by default. You also have the option to store the notes for each pending charge line in the line‐level adjustment window instead. To make this happen, you must place a check mark in the Pend Chgs Ln Notes checkbox. You can find this checkbox on the Billing Preferences tab (under Setup > Practice Preferences from the main menu). If there is no check mark in this box, the system continues to store the notes both in sequence and in the line level adjustment window. Review and Modify Pending Charges
Once you have the list transferred to the main window, you can review the items in the sequence to make sure that they are in the correct order before you post them. Click the folder image on the entry 11.26
Posting Pending Charges
Posting Charges
line to review the details of that sequence. You can drag and drop items to reorder the sequence before you post it. The mouse cursor turns into an arrow to let you see where the drop will occur.
Figure 11‐11 Pending Charges in Main Window
You can also combine those multiple pending charge entries that are for the same patient. Just drag and drop one sequence onto the other. The mouse cursor changes to the information bubble when you have successfully grabbed a sequence. When the mouse cursor is above the patient’s other entry, the mouse cursor changes to an exclamation point, letting you know that you can drop the sequence. Also note that ICD‐9 and ICD‐10 codes will now display in the Pending charges list. Notice also that there is now hover text for each code listed in Pending charges. Hovering over the code will display both ICD codes as well as the description.
Posting Pending Charges
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Posting Charges
NOTE | If the diagnosis codes and/or referring physician are different for each sequence, the system uses the codes and physician on the sequence you didn’t move.
NOTE | Display only the providers whose list you want to work with by clicking Provider Order in the Task Pane. This displays the Select Provider Order window. Drag and drop providers into the appropriate pane and click Accept. Posting From the List
Once you have reviewed all of the pending charges you want to review, you can post the charges either selectively or all at once. To post a single entry, simply double‐click the entry to launch the Charges window with the transactions already entered. Make any necessary changes and save. To post multiple entries at once:
Procedure
Details
1. Place a check mark in the checkbox next to the Use the Select All and Deselect All icons on the Task Pane to help select or deselect multiple pending charge(s) you want to post.
entries.
2. Click the Save icon on the Task Pane.
This launches the AutoCharge Posting window with the selected patients listed in the window.
3. Make any edits necessary and click the Save icon on the Task Pane of this window.
The system posts the charges it can and skips the ones it cannot post. Those that it posts are highlighted in teal. Those that it had to skip are highlighted in yellow. Placing a Pending Charge on Hold
Users can put charges on hold until they are ready to submit those charges for payment. (You could have a patient in the hospital for an extended period of time, and you do not want to submit the claim right away.) Staff members can place entries on hold by a Right‐click entry and selecting Place into Holding from the context menu.Those entries on hold appear in the Pending Charges list window highlighted in yellow. When staff members need to release the held item, they can right‐click the entry and select Release from Holding. Pending Charges Log
The system places all incoming charges in the Pending Charges List. Staff members can then review the charges in the list and then post those charges. While reviewing those incoming charges, the biller might make changes as needed to those charges and then post them.
When the system populates the Pending Charges List with the incoming charges, it also records those incoming charges in the Pending Charges Log. This log allows you to return and review the initial charges before changes were made. On the Task Pane for the Charges/ Payments window (under Billing > Charges/
11.28
Posting Pending Charges
Posting Charges
Payments from the main menu or press the F6 key), click the Pending Charges Log task. This displays the log in a web browser window.
Figure 11‐12 Pending Charges Log
On the left there is a date range. This date range reflects the date the pending charge was sent to MicroMD PM from MicroMD EMR encounters and/or third party interfaces and defaults to a seven‐day range. The bottom portion of the pane is broken up by date and then by the user who sent the charges. Click each tier to access precisely the information you need. The right side of the window displays all of the charges created by the user selected on the left.
POSTING PATIENT CO-PAYS
You can post personal payments, like co‐pay amounts, at the same time you post the patient’s charges. Many practices collect the co‐pay amount, note this on the patient’s charge slip, and then post that personal payment when charges are actually posted to the patient’s account.
It is recommended that the practice create a special code for posting co‐pay amounts. When you do this, the system provides the total amount of co‐pays posted in the system on the day sheet, and it also one of the criteria that allows you to track co‐pay balances. How the System Knows the Patient Has a Co-Pay
If there is an amount listed in the patient’s Co Pay field on their Plan Sets tab and there is a check mark in the EM Flag box on the Procedure Detail window for a posted charge, the text “Co Pay Applies” flashes in red on the Charges window. This helps alert staff members that a co‐pay is needed. The green plan bar at the top of the Charges window lists the amount of the patient’s co‐pay.
Posting Patient Co‐Pays
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Posting Charges
Figure 11‐13 Co‐Pay Applies Flashing Alert
Tracking Co-Pays
The system allows you to track the patient’s total current co‐pay balance from all of their posted sequences. Make sure you have the following set up in your system:
 Place a check mark in the Track Co‐Pay checkbox on the Billing Preferences tab (under Setup > Practice Preferences). This turns on the feature.
 Create a special procedure code for posting co‐pays. You must check the Co‐Pay checkbox on the new payment code’s Procedure Detail window.
When this features is in use, MicroMD PM displays a blue bar to the right of the P column for the sequence. When you hover over the bar with the mouse, a pop‐up display shows the sequence number and the outstanding co‐pay balance for the sequence. The system displays the total balance due from the patient at the bottom of the Patient Sequences window.
Figure 11‐14 Co‐Pay Tracking: Blue Bar
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Posting Patient Co‐Pays
Posting Charges
Figure 11‐15 Tracking Co‐Pay Balance
Instead of the flashing “Co‐Pay Applies” alert, MicroMD PM displays an editable Co Pay amount text field. This field contains the co‐pay balance for the sequence. The system adjusts this amount accordingly when you add or remove procedures with the EM Flag box checked on their Procedure Detail window (and if the patient has a co‐pay amount specified for the plan). You can also edit this field if different than the amount entered on the patient’s Plan Sets tab.
Figure 11‐16 Editable Co‐Pay Field
NOTE | When you post the patient’s co‐payment, you must use a payment code that has the Co‐Pay box checked. This is the only way the system knows that you have posted a co‐payment, and it can adjust the co‐pay balance accordingly.
Posting Patient Co‐Pays
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Posting Charges
When you print a receipt for the sequence that has a co‐pay balance, the amount appears above the aging box and left of the ending balance amount. The system can also print this balance on the patient’s monthly bill if you want to include it. Reset Co-pay
Sometimes it will be necessary to reset a patient’s co‐pay balance. For example, when Track Co‐Pay is turned on, and the patient makes a payment in the office with a credit card, the system may look at that as a co‐pay depending on the payment code that was used. If the payment wasn’t for a co‐pay, you can go into the sequence and change the payment code to a non‐co‐pay payment code. Even after this step, the patient may have a co‐pay credit balance.
To remove the credit balance, click the Reset Co‐Pay link in the main menu.
Figure 11‐17 Reset Co‐Pay
POSTING EXPLOSION CODES
The purpose of an Explosion Code is to make posting charges easier by automatically posting multiple charges using few simple keystrokes. Practices can group a number of procedures under an Explosion Code. To post an Explosion Code, type the @ symbol in the Proc column and then the first couple of characters in the name of the Explosion Code. Press Enter. The system automatically adds the procedures under that Explosion Code to the window. You can edit any lines, add other procedures, or remove procedures as needed.
For example, Advanced Family Practice performs the same set of procedures every time they have a patient visiting for a physical. They created an Explosion Code called PHYSICAL with each of the charge codes they would otherwise need to enter individually.
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Posting Explosion Codes
Posting Charges
TIP | If you are unsure of what Explosion Code to use, just type the @ symbol in the Proc field and press Enter to bring up a list of all Explosion Codes created in the system.
POSTING TAXABLE ITEMS
When you create procedure codes in the system for items that require you to also charge a sales tax, you can quickly tell the system which codes it should apply a sales tax (e.g., eyeglass frames, medical supplies). When a staff member posts a taxable procedure code to an account, the system calculates and displays the sales tax at the bottom of the Charges window. If you need to edit that amount, click in the Sales Tax field and enter the correct amount.
Figure 11‐18 Sales Tax Field on Charges Window
When you save your posting activity, MicroMD PM automatically creates the sales tax transaction and adds it to the sequence. Although the system adds the sales tax to the sequence balance, the tax does not print on the claim form. This is because you typically place a check mark in the Patient Resp. checkbox when creating the sales tax code, causing the code to post with a Bill flag of N – Pat. Billing/Pat. Resp. (If you want to include the sales tax on the claim form, simply leave the Patient Resp. checkbox on the Procedure Detail window for the sales tax code UNCHECKED. It will then post with a Bill flag of X – Ins. Billing/Ins. Resp. and be included on the claim.) TIP | The system also helps you keep track of your inventory. EDITING CHARGES
Once a charge has been entered into the system and saved, you can still modify the charge if the day sheet on which the sequence was posted is still open and the claim has not been printed. You can also add charges to a sequence if needed before submitting claims. Editing Charges on an Existing Sequence
You can only edit certain fields on an existing sequence when the practice has closed/erased the day sheet on which the sequence was posted. Access the sequence and make any edits needed to the charges entered. Posting Taxable Items
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Posting Charges
To edit a charge:
Procedure
Details
1. Select Billing > Charges/Payments from the main You can also click the Charges/Payments button on the Launch Pane or press the F6 key.
menu.
2. Search for and select the patient whose sequence you need to edit.
3. On the Patient Sequences window, double‐click the sequence you want to edit.
4. Make the changes and click the Save icon on the Task Pane.
Adding Charges to an Existing Sequence:
Procedure
Details
1. Select Billing > Charges/Payments from the main menu.
You can also click the Charges/Payments button on the Launch Pane or press the F6 key.
2. Search for the patient.
3. In the Patient Sequences window, double‐
click the sequence to which you want to add charges.
You can only add charges to those sequences with a status of Print.
4. Enter the new charges.
5. Click the Save icon to save your changes.
If you need to add more diagnosis codes,
simply click in the next open Diagnosis field.
Entering Sequence Notes
There are two kinds of notes on the Patient Sequences window: general notes and sequence notes. To access notes for the patient’s account as a whole, highlight the sequence and click the Patient Note General icon on the Task Pane. While general notes pertain to the patient’s account as a whole, sequence notes can be entered on each patient sequence to provide further information about a sequence. Sequence notes are both system‐ and user‐generated. To access the sequence notes, place a check mark in the P column next to the sequence and click the Patient Note Sequence icon on the Task Pane.
NOTE | A red bar ( ) appears next to sequences containing user‐generated notes.
Staff members can access and enter this information easily from the Patient Sequences window and the Billing Inquiry window for the patient. As a security precaution, whenever a staff member creates a note, only the user who creates the note and the supervisor have permission to delete or edit the note, unless there is a category assigned that allows others to alter the contents. 11.34
Editing Charges
Posting Charges
Figure 11‐19 Sequence Notes Window
The system automatically creates the first note. (Staff members with User security rights cannot edit this note.) Then the system adds lines to this sequence note to keep track of when a claim was filed, when a claim is deleted, when the responsibility of a sequence changes, etc. The system also indicates the user who performed the action.
User‐generated sequence notes are useful for recording information about phone calls staff members made or received regarding the claim, letters received, etc. This helps billing staff communicate with each other and maintain a history for each sequence.
For example, when Jennifer processed claims recently for Advanced Family Practice, MicroMD PM added a note line to the sequence‐generated note entry for every sequence filed. This note indicated that Jennifer filed the claim, to which insurance carrier it was filed, and the date it was filed. Kim posts payments for Advanced Family Practice and recently had a conversation with someone at ABC Insurance Company regarding Mr. Smith’s recently rejected claim. She created a new sequence note and recorded the conversation so that any staff member working with that sequence can find the information.
Add a New Note to a Patient’s Account:
Procedure
Details
1. Click the New button at the top of the window.
The system creates a new entry underneath the last note created.
2. Change the Date field only if necessary.
The system defaults to the current system date.
3. Type the note in the large text area.
This is an open text field and staff members can enter an unlimited amount of text.
4. Select a Note Category from the Categry drop‐down list, if other than the default.
You can set the default notes category for the practice on the General Preferences tab under Setup > Practice Preferences.
5. If you want to add this note to your task list NOTE | You must add a note to the task list when for any reason, you must place a check mark you first create the note. Once you save the note, the To‐Do List checkbox disappears.
in the To‐Do List box at this time.
6. Click Accept to save the new note.
If you chose to add a task list item, MicroMD PM launches the Task Management Module and allows you to set reminder options, etc. The system adds a red bar next to the sequence as an indicator that there are user‐generated notes attached to the sequence.
Editing Charges
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Posting Charges
Printing Notes
There may be instances where you need to print notes from a patient’s sequence. The Print checkbox on each note allows staff members to print any or all notes for this patient. Click the Print button to print all notes with a check mark in the Print box.
Figure 11‐20 Print Checkbox
CORRECTING CHARGE POSTING MISTAKES
When someone makes a mistake while posting charges, staff members can delete the line item before they save their posting activity for that patient. However, once they save the sequence, they have a couple of options available to correct this mistake. Depending on the policies of the practice, staff members can void the charge; void an entire sequence of only charges; adjust the charge and delete both entries; or adjust the charges and leave both entries.
STOP | There may be times when payments have already been applied to the incorrect charge line. You must be careful when making your adjustments as they could result in unapplied payment amounts in the system. When you void charges, MicroMD PM automatically posts the correct adjusting entry, using the built‐in system adjustment code (i.e., 41 ADJ –REDUCE CHARGE), and removes the appropriate entries from the sequence. When you void a sequence, the system does the same thing, but it also removes the sequence. Remember, you can only void charges in MicroMD PM. You cannot void payments, write‐offs, refunds, etc.
When you post adjustment codes to correct mistakes, you can use one of the built‐in system adjustment codes or the appropriate code(s) as defined by the practice. You can adjust charges, payments, write‐offs, refunds and balance forwards. The simplest way to correct a posting mistake after you have saved the sequence is to adjust off the entire amount and post the correct amount. Then you can delete the incorrect charge line and the adjustment line, preventing the mistake from appearing on the patient’s statements/bills.
NOTE | Staff members could also make mistakes when posting payments. Voiding Charges and Sequences
Voiding charges removes individual charge entries without voiding the entire sequence. You can only void charges. You cannot void payments, write‐offs, refunds, and balance forwards. You do have the ability to void an entire sequence if it only contains charges. Once the sequence contains payments, etc., the system forces you to make changes per line item instead—helping maintain your audit trail.
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Correcting Charge Posting Mistakes
Posting Charges
STOP | You can void individual charges if there are payments applied to them; however, voiding a charge line with a payment applied to it leaves the payment amount unapplied. You must then reapply the payment to the remaining charges on the sequence. Any voided charges appear in the patient’s log on the Deleted Transactions window. The Bill flag for the adjusting entry depends on the billing status of the charge line you voided. Users must also have Delete access rights before they can use the Void function.
Voiding a Charge Line
To void a charge, highlight the charge line and click the Void icon on the Task Pane. (You can also right‐click the charge line and select Void from the pop‐up menu.) The system automatically posts the correct adjusting entry (i.e., 41 ADJ – REDUCE CHARGE) and removes the two items from the sequence—all with just a few simple clicks of the mouse.
Voiding a Sequence
To void a sequence that contains only charges, place a check in the P box next to that sequence and click the Void icon that appears on the Task Pane. The system automatically voids all the charges on the sequence, deletes the sequence, and removes any claims associated with it.
Posting Charge Adjustments Automatically
When you need to make an adjustment to a sequence and your practice uses the built‐in system adjustment codes, MicroMD PM can take most of the guesswork out of posting adjustments. A right‐
click menu option in the Charges/Payments Module allows you to post the correct adjustment codes and amounts without having to go through the struggle of deciding on the proper code to use. All you have to do is drag and drop and save.
The system uses the built‐in adjustment code for reducing a charge (i.e., 41 ADJ – REDUCE CHARGE). This automatically offsets the charge line with a credit line of equal value—reducing the patient’s balance. Once you save this adjustment, you can then post the correct charge. To adjust a charge entry on a sequence with the right‐click option:
Procedure
Details
1. Right‐click anywhere on the charge line you need to adjust.
Correcting Charge Posting Mistakes
11.37
Posting Charges
2. Select the Adjust option from the pop‐up menu. The Payments window for the sequence appears, along with the blue Payment Calculation window. This window has already been completed for you with the appropriate dollar amount matched with the appropriate charge line and the correct adjustment code chosen so all you have to do is drag and drop.
When you make adjustments with this right‐click menu option, you cannot change the adjustment code or dollar amount.
3. Drag and drop the green dollar icon to the payments area.
4. Click the Save icon to save your changes.
5. If you want to delete the two entries, you can now double‐click the sequence and delete both entries. Remember to save your changes.
6. Return to the Charges window for the patient and post the correct charge if appropriate.
If you entered a charge in the wrong patient’s account, remember to open the Patient Sequences window for the correct patient and re‐enter the charge on their account.
Posting Adjustments Manually
You have two options when you post system adjustment codes to correct a charge mistake: Use the blue Payment Calculation window or do not use the blue Payment Calculation window. The recommended option is to use the blue Payment Calculation window to enter the adjustment. This prevents any unapplied payments and helps you avoid extra steps to reapply the payments. It also makes your financial reporting that much more accurate when you generate reports that pull information only from transactions posted using the green and blue Payment Calculation windows.
NOTE | When you correct an incorrect charge, the simplest way to do this is to adjust off the entire charge line and repost the correct charge line. This allows other staff members in the future to clearly understand what occurred.
To correct a charge posting mistake using the blue Payment Calculation – Patient and Non‐Primary Insurance window:
Procedure
Details
1. Select Billing > Charges/Payments from the main You can also click the Charges/Payments button on the Launch Pane or press the F6 key.
menu.
2. Search for and select the patient whose sequence you need to edit.
The Patient Sequences window opens.
3. Highlight the sequence you want to adjust.
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Correcting Charge Posting Mistakes
Posting Charges
4. Click the Payments/Adjustments icon on the Task Pane.
The payment windows typically open along with the green Payment Calculation window at this point. If you have the blue Payment Calculation window on the screen, you can skip step 6.
At this point, if you choose not to use the Payment Calculation window (not recommended), you can click in the Payments window and post the appropriate adjustment code and amount. Save your changes.
5. On the green Payment Calculation window, click the Toggle button to switch to the blue Payment Calculation window.
6. In the first Amount column for the charge line you want to adjust, enter the amount of the adjustment.
Remember that the simplest way to adjust an entry is to remove the whole amount.
7. Click in the field under the Amount column and Remember that you can type in a partial enter the correct adjustment code (e.g., 41 ADJ description in this field. The system will display a search window so you can choose the correct – REDUCE CHARGE).
code.
TIP | You can adjust off up to two charge lines at one time. Double‐click the header of the second Amount column to make it the active column. Repeat steps 6 and 7 for the second adjustment.
8. Drag and drop the dollar icon to the bottom of the Payments window.
The adjustments post to the sequence.
9. Click the Save icon on the Task Pane.
10. If you want to delete the two entries, you can now double‐click the sequence and delete both entries. Remember to save your changes.
11. Return to the Charges window for the patient and post the correct charge if appropriate.
If you entered a charge in the wrong patient’s account, remember to open the Patient Sequences window for the correct patient and re‐enter the charge on their account.
Erasing Charge and Adjustment Entries
Erasing charges and their corresponding adjustment entries prevents them from appearing on the patient’s account. Some users may not have security rights to erase entries. The system tracks this information in the Patient Log where you can see the transactions that were deleted. Correcting Charge Posting Mistakes
11.39
Posting Charges
To remove the incorrect charge line and its adjustment entry:
Procedure
Details
1. Double‐click the patient’s sequence that contains the entries you want to remove.
The Charges window opens.
2. Highlight the incorrect charge line and click the TIP | You can also use the Ctrl + D key combination.
Delete icon on the Task Pane.
3. Highlight the adjustment entry and click the Delete icon.
4. Repeat this for any other charge/adjustment entry combination you want to remove.
5. Save your changes.
The total amount of the deleted entries must be zero or the system prevents you from saving your changes.
MODIFYING THE PLAN FOR THE CLAIM
When you first create a sequence and post charges, you choose the case for the claim and that identifies the plan MicroMD PM associates with the claim. If you realize (after you save the sequence) that you forgot to choose the correct case or discover the plan on the claim is incorrect for some reason, you have the ability to edit this information before submitting the claims. NOTE | You can also edit the plan on the claim in the Claims Processing Module if that’s when you discover the error. To modify the plan or case on the sequence:
Procedure
Details
1. In the Patient Sequences window, place a check This enables various icons on the Task Pane.
mark in the P column next to the sequence you need to edit.
2. Click the Edit Claim icon on the Task Pane.
The Modify Plan window opens.
3. Select the correct group of plans from the Plan The plans within that Plan Set display in the bottom portion of this window.
Set drop‐down list.
4. Highlight the plan you want associated with this claim.
5. Click Accept.
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The Claim Transactions window opens.
Modifying the Plan for the Claim
Posting Charges
6. Make any necessary modifications for submitting the claim to the insurance carrier.
7. Click Save.
The Responsibility column for that sequence should now display the new plan.
CHANGING RESPONSIBILITY OF A SEQUENCE
Each sequence has a responsibility and an aging date associated with it. It could also have a plan and a claim associated with it. The Responsibility column on the Patient Sequences window displays the makeup of each sequence—who is currently responsible for the balance on the sequence (the patient or an insurance carrier) and whether there is a claim pending with an insurance carrier (and the name of that carrier).
Figure 11‐21 Responsibility of a Sequence
The system changes this column for each sequence automatically as the sequence progresses through the billing process in the system. If all transaction lines in a sequence are marked as patient‐responsible (i.e., N – Pat. Billing/Pat. Resp or Y – Ins. Billing/Pat. Resp), MicroMD PM labels the sequence as the responsibility of the patient to pay. However, if any of the transactions within the sequence are marked as insurance‐responsible (i.e., X – Ins. Billing/Ins. Resp), the system labels the sequence as the responsibility of the indicated insurance carrier to pay.
The system displays the following combinations in the Responsibility column.
 Insurance – Plan Name
This is typically the first responsibility of a sequence. This means that there is an insurance claim pending with the listed carrier (indicated by the “– Plan Name” portion of the displayed text) and that the insurance carrier is expected to send payment to the office (indicated by the Insurance portion of the displayed text).
 Patient
Changing Responsibility of a Sequence
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Posting Charges
Once all of the insurance carriers have paid on the claims submitted or if the patient has no insurance, MicroMD PM displays Patient to indicate that the patient is solely responsible for making payment to the office for the balance on the sequence.
 Patient – Plan Name
When the system displays this in the responsibility column, it means that there is a claim pending with the listed carrier (indicated by the “– Plan Name” portion of the displayed text) and that the patient is expected to send payment to the office (indicated by the Patient portion of the displayed text). Usually, that is because the carrier sends payment to the patient and not the office.
 Insurance – N/A
When MicroMD PM displays this in the responsibility column, it means that there is no claim associated with the sequence (indicated by the “– N/A” portion of the displayed text) and that an insurance carrier is expected to send payment to the office (indicated by the Insurance portion of the displayed text). Typically, someone has removed the claim or plan from the sequence.
To change the responsibility of a sequence, and then in turn remove a claim or plan from the sequence, you place a check mark in the P column for the sequence and then use the Change Responsibility icon on the Task Pane. This icon works differently depending on the responsibility of the sequence you want to change. Change Responsibility from Insurance to Patient
If the sequence you want to change is an insurance‐responsible sequence with a claim attached (i.e., Insurance – Plan Name in the Responsibility column), when you use this icon, the system prompts you for a new aging date and then changes the responsibility to patient, leaving the claim and plan attached (i.e., Patient – Plan Name in the Responsibility column).
Procedure
Details
1. Place a check mark in the P column of the sequence you want to change responsibility.
2. Click the Change Responsibility icon on the Task Pane.
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The system prompts you to change the aging date on the sequence.
Changing Responsibility of a Sequence
Posting Charges
3. Click OK to accept the new aging date.
You can re‐enter the old aging date to retain it.
TIP | You can also drag and drop the Prior Aging Date field into the New Aging Date field to retain the old aging date.
Notice that the Responsibility column now displays Patient – Plan Name. This means the claim on the sequence is still pending with the insurance company, but the patient is the one responsible for paying the practice.
If this had been a sequence with Insurance – N/A in the Responsibility column, the system would now display simply Patient in the Responsibility column since Insurance – N/A means there is no claim or plan attached to the sequence.
Removing the Plan
If the sequence is a patient‐responsible sequence with a claim and plan attached (i.e., Patient – Plan Name in the Responsibility column), this means the claim is still pending with the insurance company, but the patient is responsible for paying the practice for the sequence. When you use the Change Responsibility icon, the system prompts you for a new aging date and then prompts you to remove the claim and/or remove the plan.
Figure 11‐22 Removing a Claim or Plan
Simply click the Rem Plan button. The system changes the responsibility to patient and removes the plan from the sequence (i.e., Patient in the Responsibility column).
Removing the Claim
If the sequence is a patient‐responsible sequence with a claim and plan attached (i.e., Patient – Plan Name in the Responsibility column), this means the claim is still pending with the insurance company, but the patient is responsible for paying the practice for the sequence. If you need to remove the claim from the sequence because you do not want the patient to receive a bill, you use the Change Responsibility icon to do so.
When you use the Change Responsibility icon, the system prompts you for a new aging date and then prompts you to remove the claim and/or remove the plan.
Simply click the Rem Claim button. The system changes the responsibility to insurance and removes the claim from the sequence (i.e., Insurance – N/A in the Responsibility column).
Changing Responsibility of a Sequence
11.43
Posting Charges
Change Responsibility from Patient to Insurance
You can use the Change Responsibility icon to change responsibility on a sequence from patient to insurance; however, since you would generally also want to pick a plan and create a claim, you should use the Edit Claim icon instead. This allows you to first pick the plan for the sequence and then add details as necessary for submitting a clam. If you do want to simply change the responsibility on the sequence, resulting in Insurance – N/A in the Responsibility column, perform the same steps as when changing from Insurance to Patient.
MERGING SEQUENCES
There could be times when you need to merge several patient‐responsible sequences or two insurance‐
responsible sequences. You might have a payment on one sequence and charges on the other sequence that you really need to file together. You may have split a sequence for filing purposes and now need to merge them together to send on to the secondary. The system allows you to do this.
STOP | This procedure cannot be undone.
To merge sequences:
Procedure
Details
1. Select Billing > Charges/Payments from the main You can also click the Charges/Payments button on the Launch Pane or press the F6 key.
menu.
2. Search for and select the patient whose sequences you need to edit.
The Patient Sequences window opens.
3. Place a check mark in the P box next to each sequence you want to merge.
This enables various icons on the Task Pane.
4. Click the Merge Sequences icon.
NOTE | You can only merge two insurance‐
responsible sequences; however, you can merge several patient‐responsible sequences.
The Merge Sequences window opens.
This window lists the sequences you checked.
5. Highlight the sequence into which you want to merge the other sequence(s) and click OK.
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Merging Sequences
Posting Charges
6. Confirm that you do want to merge the sequence(s).
If merging patient‐responsible sequences, you are finished. Note that the balance on the sequence now reflects the items from the other sequence(s). The system also transfers sequence notes to the main sequence.
If merging two insurance‐responsible sequences, continue with step 7.
7. Select the appropriate plan set and plan for the The Claim Transactions window opens.
new merged sequence and click Accept.
8. Edit this window as needed for the new claim.
9. Click the Save button on the window.
Note that the balance on the sequence now reflects the items from the other sequence(s). The system also transfers sequence notes to the main sequence. NOTE | If one or both of the sequences were involved in a split, the system does not recombine the payments, write‐offs, etc.
SPLITTING SEQUENCES
Practices have the ability to break a sequence in two, allowing them to re‐file unpaid items to the primary insurance carrier while sending the paid items on to the supplemental insurance or billing the patient.
For example, Advanced Family Practice submitted Anthony Smith’s claim to XYZ Insurance Company; however, when Kim received the EOB with information about Mr. Smith’s claim, the insurance company, for some reason, did not pay procedures 93000 and 80100. She wants to resubmit those procedures to the insurance company for payment, but she wants to go ahead and send Mr. Smith a bill for the remaining balance on the other items. The practice uses the Split Sequences feature to accomplish this.
NOTE | Use of this feature depends on the correct and consistent use of the green and blue Payment Calculation windows when posting payments.
STOP | This procedure cannot be undone.
Splitting Sequences
11.45
Posting Charges
Figure 11‐23 Split Sequence Window
When you split a sequence, the system recalculates and attaches any payments, write‐offs or adjustments associated with the items you remove from the sequence. Those amounts on the original sequence then relate only to the items on that sequence, and the amounts on the new sequence relate only to the items on the new sequence. NOTE | While the system adjusts the totals on the original sequence accordingly, it does not adjust note lines such as co‐
insurance. Be sure to address note lines as appropriate.
NOTE | You can modify the location of the original sequence after it is split if it on an open daysheet. However, you cannot edit the location of the new sequence created from a split even if it is on an open day sheet.
All sequence notes or activity history of the original sequence (before it was split) stay with the original sequence once the user splits it in two. Once the user splits the sequence, the system adds a new note to each sequence indicating who split the sequence and the old/new sequence number. The system then treats the new sequence as a brand‐new sequence with notes/history of its own. You do have the ability to copy notes from the original sequence to the new sequence as explained a little later.
11.46
Splitting Sequences
Posting Charges
Choices Available on the Split Sequence Window:
Field
Description
Modify Original Sequence
If you only want to change the plan, responsibility, etc. on the existing sequence, you can check this box, make changes to the left side only and then save your changes. If you do want to split the sequence in two and you check the Create New Sequence box, the system automatically checks Modify Original Sequence for you.
Create New Sequence
When you want to split a patient’s sequence in two, check this box. The system then displays the Line Items section at the bottom of the window. That area allows you to transfer the appropriate line items to the new sequence.
Copy Sequence Notes
Check this box to duplicate the notes from the original sequence to the new sequence. Once you save the sequences, they each then maintain their own set of notes.
Responsibility
Select the appropriate party currently responsible for the payment of the original sequence and then choose the party currently responsible for the payment of the new sequence you want to create.
Create Claim and Remove Claim
If the original sequence has a claim associated with it, the system provides the option to delete the claim from the system (Remove Claim checkbox). The system displays the text “Open Claim Exists” next to the checkbox when there is a claim. If there is no claim associated with the original sequence or you are creating a new sequence, the system provides the option to create one (Create Claim checkbox).
Claim Status
You can either change the status of the existing claim or specify the status for the new claim created.
Plan Set
You can also choose which plan set to use for the sequences and which plan to use in that plan set. If you select (None) from the Plan Set list, the system removes the plan from sequence and deletes the open claim.
Aging Date
Enter the date at which aging should begin for each sequence. The system defaults to the current aging date of the original sequence. Line Items section
Drag and drop the line items you want to remove from the original sequence to the new sequence. You should drag‐and‐drop these items in the same order you posted them originally. The system numbers these line items with new numbers in the new sequence.
TIP | You can reorder line items in any sequence. Just right‐click the sequence and select Reorder Sequence. How to Split a Sequence
You can split sequences for a variety of reasons and in different configurations. To help you understand the flexibility of the tool, we will use a specific situation for illustration.
For example, Advanced Family Practice submitted Anthony Smith’s claim to XYZ Insurance Company; however, when Kim received the EOB with information about Mr. Smith’s claim, the insurance company, Splitting Sequences
11.47
Posting Charges
for some reason, did not pay procedures 93000 and 80100. She wants to resubmit those procedures to the insurance company for payment, but she wants to go ahead and send Mr. Smith a bill for the remaining balance on the other items. The practice uses the Split Sequences feature to accomplish this.
To split a sequence:
Procedure
Details
1. Place a check mark in the P column next to the sequence you want to edit.
This enables various icons on the Task Pane.
2. Click the Split Sequence icon on the Task Pane.
You can also right‐click the sequence and select Split Sequence from the pop‐up menu. The Split Sequence window opens.
3. Place a check mark in the Create New Sequence This displays the transaction lines in the current sequence at the bottom left of the window.
checkbox.
4. Make all necessary choices for the existing sequence (left side) and the new sequence (right side).
5. Click Accept.
The system modifies the original sequence and creates the new sequence (if applicable) at the end of the list. For example, when splitting sequence 12 out of 15, the new sequence number is 16.
Other Uses of Split Sequences
While the split sequence feature provides the user the flexibility to re‐file unpaid items while continuing the billing process for the paid items, it also allows the user to modify an existing claim in the following ways without splitting the claim in two. Simply check the Modify Original Sequence checkbox, edit any of the following on the left side of the window only, and click Accept.
 Change the responsibility
 Change the plan set to change the plan
 Change the status of the claim to print, hold, or processed
 Delete an open claim from the sequence (check the Remove Claim box)
 Remove a plan from the sequence (select (None) from the Plan Set drop‐down)
REORDER ITEMS IN A SEQUENCE
You have the ability to reorder the line items within the sequence. If you need to resubmit a claim because the primary procedure was incorrect, you can reorder the line items and resubmit the claim. The right‐click menu items in the Patient Sequences window provide this ability.
11.48
Reorder Items in a Sequence
Posting Charges
To reorder a sequence:
Procedure
Details
1. Right‐click the sequence that contains the line items you want to reorder.
2. Select Reorder Sequence from the right‐
click menu.
The Reorder Sequence window opens.
3. Drag and drop the line items into the appropriate order.
The cursor changes to an arrow and a line appears between the line items as you move the mouse.
4. Click Accept to save your changes.
Click Cancel to exit the window without saving any changes made to the order of the items.
EXTRA BILLING OPTIONS
The system provides additional billing options to help you submit claims and get paid for the services your practice renders. You can access these items from the Claim Transactions window. When you save the charges you post, the system displays a button labeled Extra on the Claim Transactions window.
Figure 11‐24 Extra Information Choices
Ambulance Billing
This allows practices that need to bill ambulance services to send the claims electronically or on paper without physically writing the information on the CMS 1500 form. When you choose Ambulance, the Ambulance Addtl Info window opens.
Extra Billing Options
11.49
Posting Charges
Figure 11‐25 Additional Information for Ambulance Billing
NOTE | For electronic billing (ANSI claim files only), the Transport Code, Transport Reason Code, Miles, Weight, and Round Trip Description/Block 32 on CMS1500 fields are required.
Fields Available on the Ambulance Addtl Info Window:
Field
Description
Transport Code
Select the code describing the type of trip made for the patient. This field is required when submitting ANSI claim files.
If the claim must contain the Round Trip Description, set the code to "X" for round trip. The system will add the text from the Round Trip Description/
Block 32 on CMS1500 field (80 characters maximum) to the ANSI claim file for electronic billing. If the code is not set to X, the system will not add this description to the file.
Transport Reason Code
Select the code describing the reason for the patient’s trip in the transport vehicle. This field is required when submitting ANSI claim files.
Miles
Enter the total length of the transport trip in miles. This field is required when submitting ANSI claim files.
Weight (lbs)
Enter the weight of the patient in pounds. This field is required when submitting ANSI claim files.
11.50
Extra Billing Options
Posting Charges
Round Trip Description/ Block 32 on CMS1500
If the Transport Code is set to X ‐ Round Trip, MicroMD PM adds the description entered in this box to the ANSI claim file (80 characters maximum). Otherwise, the system ignores this field. For printing paper CMS 1500 claims, you have five (5) lines of space available. The first line can contain up to 40 characters, and the remaining lines can contain 30 characters each. To indicate a line break, press the Ctrl + Enter key combination. To create a blank line, you must press Ctrl + Enter at the end of the line of text, press the spacebar twice for the blank line, and press Ctrl + Enter again to begin typing next line of text.
Stretcher Description
Enter the information (if needed in the claim file) regarding the stretcher used for the patient during transport. This is a free‐form text field.
Condition Codes Apply
Check this box to tell MicroMD PM to include the choices made in the Condition Code drop‐downs in the electronic claim file (ANSI only). The condition codes indicate the condition of the patient at the time of the ambulance service. ANSI Guidelines explicitly state that at least one code must appear in the claim file, even if the condition code does not apply to the ambulance service. If these codes and the checkbox are left blank, the system automatically enters the default of 01 ‐ Patient was admitted to a hospital into the claim file.
Service Facility and Address
Enter the service facility and address as the point of pick up, if needed. This information is then submitted in the ANSI file in the 2310D loop of the file.
Chiropractic Billing
If you have a chiropractic practice and you want to submit electronic claims, you have the ability to enter additional information as required in your electronic file.
Figure 11‐26 Chiropractic Additional Information Window
NOTE | You only have access to this window when you are submitting electronic claims. You must have the Claim Indicator drop‐down on the Electronic Billing Setup window set to C – Chiropractic to enable access to these options.
Extra Billing Options
11.51
Posting Charges
Fields on the Chiropractic Additional Information Window:
Field
Description
Treatment Date
Enter the date the patient initially sought treatment for this condition.
X‐Ray Date
Enter the date of the patient’s last x‐ray for this condition.
Manifestation Date
Enter the date of acute manifestation of a chronic condition.
Nature of Condition
Select the type of condition the patient has.
Complication Indicator
Select the code that indicates the complexity of the patient’s condition.
X‐Ray Availability
Check this box to indicates the maintenance and availability of X‐Rays for carrier review.
Number in Series
Enter the rank of this treatment in the total number of treatments in the series. For example, if there are 12 treatments in the series and the treatment on the claim is the fourth treatment, enter 4 in this field.
Total in Series
Enter the number of treatments in the entire series.
Begin Level of Subluxation
Select the code that identifies the beginning of the partial dislocation.
End Level of Subluxation
Select the code that identifies the ending of the partial dislocation.
Treatment Period
Enter the number of days, weeks, months, or years that the patient’s treatments occur. Select the unit of time measurement from the drop‐down list.
Number of Treatment
Enter the number of treatments rendered to the patient during the current month.
Symptoms Description
Enter a description of the patient’s symptoms for the condition being submitted.
Claim Attachment Information
This allows you the ability to send additional attachment details with an electronic claim. For example, if an insurance plan requires PWK segments in an ANSI file, your practice can provide that attachment information when creating the claim.
Default attachment information for a patient can be set on the Cases tab of the Patient Detail window by clicking the Extra button. The system automatically populates the saved fields when you add attachment details to the patient’s claim.
11.52
Extra Billing Options
Posting Charges
Figure 11‐27 Claim Attachment Information Window
Fields on the Claim Attachment Information Window:
Field
Description
Report Type Code In this drop‐down, select a valid code for sending the claim information to the insurance carrier. Transaction categories are located in parentheses at the end of each entry:  Prof: Professional claims
 Inst: Institutional claims
 Dent: Dental claims
Report Trans Code
In this drop‐down, select how the claim attachment will be sent to the carrier. Attach Control Enter the attachment control number in this field. No
File Path
This field is not currently in use.
New Click this button to add a new attachment line to the claim.
NOTE | You can send up to 10 attachment rows per claim. Any additional segments are ignored when the claim is sent.
Finish Click this button to save and close the window. Delete Click this button to remove the selected line from the window. Cancel Click this button to close the window and remove any changes.
Additional Forms
For the remaining forms under the Extra button, your support team has the most recent documentation for submitting the correct information on the claim.
Extra Billing Options
11.53
Posting Charges
KEYSTROKE POSTING
If you prefer, you can use shortcut keys on the keyboard to post charges, rather than using the mouse and clicking through the fields. Although your personal posting methods depend solely on the policies of your practice, this is a set of brief instructions for posting charges using the keyboard. Posting Charges with Keyboard Shortcuts:
Procedure
Details
1. Press F6 to open the Posting Module.
Ctrl + F6 opens the Posting Module for the last patient viewed.
2. Type the name or number of the patient and You can use the Tab key to move the cursor to another search field.
press Enter.
3. Press the Tab key to transfer the cursor. Tab once to transfer the cursor to search area. Tab again to transfer to Based On field
Tab three times to transfer to the Patient list
4. Use the arrow keys to highlight the appropriate patient.
5. Press Enter to select the patient.
The Patient Sequences window opens.
6. Press Ctrl + N to create a new sequence.
The Charges window opens.
7. Use the Enter or Tab key to move through the TIP | Remember that you can indicate where you want the cursor to first appear when this window top portion of the window.
opens.
8. Press Ctrl + N whenever you want to create a When you exit a Diagnosis field without entering any information, MicroMD PM transfers you to new transaction line.
the transaction area of the window automatically.
9. Use the Enter or Tab key to move through the columns and edit as needed.
10. When finished, press Ctrl + S or Ctrl + X.
11. If prompted to save changes, press Alt + Y (for The Claim Transactions window opens.
Yes), Alt + N (for No), or Alt + C (for Cancel).
12. Use the Enter or Tab key to move through the fields and edit as needed.
13. When finished, press Alt + O (for OK).
This saves your changes and takes you back to the Patient Sequences window for that patient.
14. Continue posting for the same patient or press Esc to exit the Patient Sequences window.
15. Repeat steps 2 through 14 as needed.
11.54
Keystroke Posting
PROCESSING CLAIMS
You learned in earlier chapters how to create Form Types and associate those Form Types with the plans in your system. You also learned how to associate those plans with your patients. Earlier, you learned how to post charges to patient accounts. Now it’s time to submit claims to insurance carriers. Practices can submit claims electronically or on paper.
STOP | Your system must be set up for claims processing prior to your first submission, whether electronically or on paper. Since the information is specific to your practice and the carriers to whom you submit claims, your support team does this for you or guides you along the way.
IN THIS CHAPTER
In this chapter, we cover how to:
 Create a claim
 Process electronic claims
 Process paper claims, print labels and the claims report
 Edit claims
 Enter claim adjustment codes and other information if needed
 Refile claims
 Track filing information
HOW THE SYSTEM CREATES CLAIMS
When you post charges against a patient account, MicroMD PM automatically determines the Bill flag for each transaction based on a number of criteria. The system automatically generates a claim for the items on the sequence that have a Bill flag of Y – Ins. Billing/Pat. Resp or X – Ins. Billing/Ins. Resp. If there are items on the sequence with a Bill flag of N – Pat. Billing/Pat. Resp, the system does not include those on claims.
The system keeps the claim in the system under the primary plan with a status of Print until the practice processes claims. Once a claim is processed, its status changes to Processed. A processed claim remains in the system as an open claim until staff members post the payments made by the primary plan.
If a patient has a secondary insurance carrier, the system can transfer the claim to the secondary for payment after staff members post the primary payments. The system then keeps that secondary claim in the system under the secondary carrier with a status of Print. Once a claim is processed, its status changes to Processed, and it remains in the system as an open claim until staff members post payments made by the secondary carrier.
The same is true for a tertiary insurance carrier if one exists. When the system runs out of insurance carriers or the practice decides not to submit a supplemental claim, the system then transfers the remaining amount due to the patient. In This Chapter 12.1
Processing Claims
CLAIM FORMS AND ICD-10
The ANSI 5010 831I and the ANSI 5010 837P and 837D claim forms have been modified to use ICD‐10 codes.
PROCESSING ELECTRONIC CLAIMS
There is no differentiation on a claim in the system as to whether the user will transmit it electronically or print it on paper—only whether a plan uses a Form Type with an EB Type associated with it. Prior to your first electronic submission to a carrier, your support team must set up your system to fulfill the carrier’s transmission requirements and provide additional submission instructions unique to the insurance carrier. Please contact your local authorized reseller for more information.
STOP | Always process your electronic claims first (primary, secondary, and tertiary), then process your paper claims (primary, secondary, and tertiary). When you process all of your electronic claims first, the only claims left in the system are your paper claims.
Figure 12‐1 Claims Processing – Electronic Billing Window
12.2
Claim Forms and ICD‐10
Processing Claims
To process electronic claims:
Procedure
Details
1. Select Claims > Claims Processing – EB from the The Claims Processing – Electronic Billing window opens.
main menu.
2. Select the appropriate form type from the Form Type drop‐down list.
Only Form Types with an EB Type appear in this list.
3. Make the appropriate selections from the Date Type, Posting Date (or Date of Service or Filed Date), Claim Type and Claim Status sections of this window.
The default Claim Type is Primary. If you want to also process electronic secondary claims, place a check mark in the Secondary checkbox.
TIP | You can have the system check the Secondary box by default when processing electronic claims. Click the EB Setup icon on the Task Pane and check the Process Secondary box.
The Bill Prv drop‐down displays all of the billing 4. Select the appropriate billing provider from providers associated with the practice.
the Bill Prv drop‐down list to pull claims for a certain provider or for multiple providers.
5. Make the appropriate selection from the Plan The drop‐down displays only those plans or or Ins Class section of the window and select insurance classes associated with the Form Type the appropriate plan or insurance class from selected.
the drop‐down list.
6. Click the Search icon or the Search button at the bottom of the screen to display the claims available to print.
OR
To select claims for specific patients, click the Select Patients icon or the Select Patients button to choose patients by name, account number, chart number, or social security number.
7. Click the Report icon on the Task Pane to generate a Summary Report for the selected claims.
Processing Electronic Claims
All of the open claims matching the selected search criteria appear on the screen. Please note that all the claims have a check mark in the P checkbox. If you do not need to send a claim at this time, uncheck this box.
The system also skips a claim when processing if the Status column displays Hold or Processed for that claim. Claims with a Hold status are kept in the system as unprocessed until the status changes. This report runs a preliminary validation check through all the claims in the window. You can view the report on the screen, but we recommend printing the report to make it easier to correct any errors with the claims. (If there are no errors, keep the printout for your records.)
12.3
Processing Claims
8. Review the Summary Report carefully.
The system marks in red any errors it finds on the report. A WARNING message indicates a possible rejection by the insurance company and lists what the user should correct. It is up to the user whether to correct the error. The system will still send the claim.
The system will not send any claims marked with an INVALID message. This indicates that the insurance company will reject the claim for the reason listed in the message.
TIP | The Show Only Warning/Invalid icon on the Task Pane of the Summary Report allows you to toggle the Summary Report to show only those entries that contain warning or invalid messages.
9. Correct any errors found.
10. Regenerate the Summary Report if you corrected any errors.
Continue this correction process until no WARNING or INVALID messages appear in the report. 11. Print the final, error‐free Summary Report for Keep the printout for your records in case you your records using the Print icon on the Task need to refer back to this batch of claims for any reason.
Pane.
STOP | You cannot batch these claims until you print this report.
12. Click the Batch icon on the Task Pane to batch Notice that the Status of each marked claim the claims and prepare the electronic file for changed from Print to Processed. A batch has now been created and is ready to be transmitted sending.
electronically.
Once you click the Batch icon, MicroMD PM validates the file even further. If the system finds an error while performing the post‐batch validation, it provides a post‐batch report (different from the Summary Report) and deletes the batch file.
12.4
Processing Electronic Claims
Processing Claims
13. If you receive this report, you must:
This helps you prevent delays in payments caused when the insurance company rejects your file.
a. Change the Status of the claim(s) back If you do not receive this post‐batch report, you to Print. (Click the Claim Status Reset can proceed to step 14.
icon on the Task Pane.)
b. Go back and correct the issues causing the system to reject the claim file.
c. Repeat steps 1 through 12.
14. Click the Send icon on the Task Pane to connect automatically to the insurance carrier’s system.
15. Follow the instructions provided by your support team for your insurance carrier(s).
16. Once you submit your claims and complete the transmission, the 997 Report and any other reports available from insurance carrier(s) print automatically.
If you have other claims to transmit electronically, repeat this procedure as needed until all electronic claims have been transmitted.
NOTE | The system creates a log in the patient file once the system creates a claim for that patient. This note is attached to each sequence. Functional Acknowledgement (997) Reports
Due to the HIPAA changeover from NSF to ANSI, practices must download and review a Functional Acknowledgement Report (or 997 Report). It contains acceptance/rejection information regarding the structure of the ANSI claim file that you sent to the carrier.
The system stores each claim file that you send so that when you retrieve the 997, the system can compare it to the stored claim file to help you pinpoint the cause of any errors. To assist you in interpreting these errors, MicroMD PM automatically displays the 997 Report window after you download the report.
STOP | We recommend that you print this report as soon as you receive it. The system does not store this report after you close it.
In the example of a 997 Report:
 The line DTP error on line 46 (for patient 1-21.0-4) refers to line 46 of the original claim file.
 DTP*435*D8~ is the original segment taken right from line 46 of the claim file.
 The next few statements tell you that the admission date is missing.
Processing Electronic Claims
12.5
Processing Claims
Figure 12‐2 Example of Functional Acknowledgement Report (997)
From the figure above, you can determine that the claim for patient account 1‐21.0, sequence 4 was rejected because the admission date is missing.
Processing Secondary Electronic Claims
You process secondary claims electronically along with the primary claims. Just be sure to place a check mark next to Secondary on the Claims Processing – Electronic Billing window. STOP | Secondary claims sent electronically need a payer ID from the primary plan, even if the primary claim was sent on paper. If the primary plan has no payer ID, then you can type the generic ID of ALPHA in the Payer ID field for the primary plan (on the IDs tab of the Plan Detail window).
PROCESSING PAPER CLAIMS
Be sure that you process all claims marked for electronic billing FIRST (including any secondary claims that can be submitted electronically). All of the remaining claims in your system will then be paper claims. Remember, you can print all payer types (i.e., primary, secondary, and tertiary) at the same time.
TIP | Before you print your paper claims for the first time, perform a print test to ensure that the information prints properly on the claim form. 12.6
Processing Paper Claims
Processing Claims
NOTE | The following paper claim forms have been modified to use ICD‐10 codes: The Alabama 340 Medicare XOVER, Illinois DPA 2360, Illinois DPA 3797 Medicare Rev, Illinois DPA 3797 Medicare XOVER, Nevada FH40 XOVER, New York eMedNY, New York Medicaid Form, New York MV (NF‐3) Rev (1/2004), New York WCB (C‐4.2), New York WCB (OT/PT‐4), Oregon Medicare XOVER, Virginia DMAS (30‐R Title XVIII), BCBSM ‐ CF 1362 Status Claim Review Form, Ohio BWC C‐84 (NO DIAGNOSIS), Ohio BWC C‐9 Family Planning 2017 Claim Form and TX DWC Form‐73 (Uses ICD‐9 on Page 5 of 5, extra screen)
Procedure
Details
1. Select Claims > Claims Processing – Paper from the main menu.
The Claims Processing – Paper window opens.
2. Check the Form Type or Form radio button to access the drop‐down list.
Form Type is the way the form is completed. Form is the specific paper form name (e.g., CMS 1500, Ohio Medicaid 6780, UB‐92 CMS 1450).
If you select Form, the system displays all the form types that use that form—all at one time for easier processing.
3. Select the appropriate form type or claim form from the Form Type or Form drop‐down list.
4. Make the appropriate selections from the Date Type, Posting Date (or Date of Service or Filed Date), Claim Type and Claim Status sections of this window.
The default claim type of Primary, Secondary and Tertiary are already marked. In the Claim Status section, the defaults are Print and Hold. If you want to choose different options, you may do so.
5. Select the appropriate billing provider from the Bill Prv drop‐down list to pull claims for a certain provider or for multiple providers.
The Bill Prv drop‐down displays all of the billing providers associated with the practice.
6. Make the appropriate selection from the Plan The drop‐down displays only those plans or or Ins Class section of the window and select insurance classes associated with the Form Type selected.
the appropriate plan or insurance class from the drop‐down list.
Processing Paper Claims
12.7
Processing Claims
7. Click the Search icon or the Search button at All of the open claims matching the selected the bottom of the screen to display the claims search criteria appear on the screen. available to print.
Please note that all the claims have a check mark in the P checkbox. If you do not need to print a OR
claim at this time, uncheck this box. To display claims for specific patients, click the The system also skips a claim when processing if Select Patients icon or the Select Patients the Status column displays Hold or Processed for button to choose patients by name, account that claim. Claims with a Hold status are kept in number, chart number, or social security the system as unprocessed until the status number.
changes.
TIP | If you only want to process certain claims in the list, you can uncheck all the claims by clicking the Deselect All icon on the Task Pane and then marking only the ones you want to process.
8. Load the appropriate forms in the printer.
9. Click the Print icon.
This sends the claims to the printer. Notice that the Status of each marked claim changes from Print to Processed as the claims print.
10. Repeat steps 3 through 9 for each Form or Form Type until you have printed all paper claims.
NOTE | The system creates a log in the patient file once the system creates a claim for that patient. This note is attached to each sequence. 11. Click the Exit icon when you have printed all paper claims.
The Claims window opens to allow you to print a Claims Processing Report and/or address labels for the claims just processed.
Print Mailing Labels
1. Load labels into the printer.
2. Click the Labels option.
3. Click the Print button.
The Label Info dialog appears.
4. Select the appropriate Label Type from the drop‐down.
You can also tell the system where to start printing on the sheet of labels by specifying how many rows down on the sheet to start (Sheet Start Row) and how many columns over (Sheet Start Column).
5. Click the Label print button.
One label prints for each plan address for which you just printed claims.
The system takes you back to the Claims dialog box to allow you to also print a Claims Processing Report or to exit (click Cancel to exit).
Print the Claims Processing Report
1. Load plain paper into the printer.
12.8
Remember to remove your claim forms!
Processing Paper Claims
Processing Claims
2. Click the Report option.
3. Click the Print button.
A report prints listing all the claims printed during this session along with line totals. The system groups this report by Form Type.
4. Click Cancel when finished.
NOTE | If you will need or want to review or reprint the report later, you must click Yes when prompted to save the report for later viewing. You can then access this report under Utility > Review Most Recent > Claims Report. Adjusting the Printer Margins
If the information on your claim forms does not line up properly, you can adjust the margins until the information is properly aligned. Use the following procedure to adjust the printer margins:
Procedure
Details
1. Select Claims > Claims Processing – Paper from the main menu.
2. Select the appropriate Form Type from the drop‐down.
3. Click the Test print button on the bottom of the The Form Alignment window opens.
window.
4. If this is the first time printing a test, click the Test print button on the Form Alignment window without making any changes.
Skip to step 6 to make adjustments.
5. Retrieve your test print from the printer. If the form printed correctly, you are finished.
If you need to make some adjustments, proceed to the next step.
6. Increase/decrease the Top Margin and Left For the CMS 1500 claim form, the Top Margin should be about 260 – 320, and the Left Margin Margin fields in increments of at least 20 when should be about 300.
adjusting margins.
This margin, however, changes for other forms and different printer specifications and should be adjusted accordingly.
Processing Paper Claims
12.9
Processing Claims
7. Click the Test print button to verify the alignment of the form.
STOP | The only forms that are printable with the Test button are: CMS 1500 0805; Ohio Welfare 6780; ADA Universal Form 2002; Virginia DMAS (30‐R); All other forms will receive the message “Unable to Print Test Claim”, but the Margin settings will be retained and used.
8. Repeat steps 6 and 7 until you are satisfied with the alignment.
9. Once you are satisfied with the alignment, click These settings are automatically saved for future claims processing for this form type.
the Close button.
These settings are workstation/printer‐specific.
EDITING CLAIMS
There are times when you need to correct information before submitting a claim, either electronically or on paper. The following sections explain the various ways to edit claims so that you can correct any errors that appear on the electronic billing Summary Report or for any other reasons. You can also edit claims from the Charges Module. Editing from the EB Summary Report
When you see invalid or warning messages in italics on an EB Summary Report, you can drill‐down to the appropriate window to make the necessary corrections. Double‐click on the red error message to fix the issue.
Figure 12‐3 Drill‐Down on EB Summary Report
NOTE | When you drill down and correct the information contained in the invalid or warning message, you’ll need to regenerate the report to remove the error message.
12.10
Editing Claims
Processing Claims
You have to ability to drill down to the Claim Transactions window, the Patient Detail window, the Plan Details window, the Practice Detail window, the Provider Detail window, the Referring Doctor Detail window and the Service Facility Detail window.
Editing Plan Only
The need to change a plan may occur if the claim was originally created for the wrong plan or the plan was changed in the Patient Detail but not updated on the claim.
NOTE | Once the plan has been changed, the claim disappears from the Claims Processing window if it uses a different form type.
Procedure
Details
1. On the Claims Processing – Electronic Billing or Claims Processing – Paper window, highlight the claim for which you want to change the plan.
2. Click the Modify Plan icon on the Task Pane or the Plan button at the bottom of the window.
The Modify Plan window appears.
3. If you need to change plan sets to find the correct plan, select the appropriate plan set from the Plan Set drop‐down list 4. Highlight the correct plan.
5. Click the Accept button.
Click Cancel if you want to exit without saving changes.
Editing Claims
You can edit claims from either the Claims Processing window or the Patient Sequences window. You can also enter additional information for submitting claims.
Procedure
Details
1. On the Claims Processing – Electronic Billing or Claims Processing – Paper window, place a check mark in the P column for the claim you want to edit.
This enables various icons on the Task Pane.
Editing Claims
The Additional Info icon appears only when your practice is marked as C ‐ Chiropractic in the Claim Indicator field in the Electronic Billing Setup window. Clicking this icon brings up an information window where you can record necessary claim information (e.g., X‐ray date, treatment date, nature of the condition).
12.11
Processing Claims
2. Click the Modify Claim icon on the Task Pane.
The Claim Transactions window opens.
3. Modify the appropriate fields.
You can edit any of the fields except the Code field and the Fee field. You must perform an adjustment in the Payment Module to modify these fields. When you click the More button at the bottom of the window, you can access the Claim Modification window that allows you to enter a wealth of information needed in the secondary claim file or for resubmitting a claim. 4. Click the Save button to save your changes and exit the window.
Click the Cancel button to exit the window without saving changes.
Adding Non-Charge Line Information
In MicroMD PM, practices can add notes to those items on a patient’s sequence that are not charges, including payments, adjustments, and note codes. This window is similar to the charge adjustments windows but simply provides note fields. From within the patient’s sequence (double‐click the sequence to open it), highlight a non‐charge line item and click the Line Adj. Notes icon on the Task Pane. The Payment Line Notes window opens. Click Insert to add a new note to the line item and Accept to save your changes.
Figure 12‐4 Payment Line Notes
To copy one or more notes to all other non‐charge lines in the sequence, place a check mark in the box next to the note and click the Copy icon. Confirm your action, and the system applies the same note to all non‐charge lines in the sequence.
Claim Adjustment Information
The system has the ability to send secondary claims electronically to certain major carriers that accept them. (Contact your local authorized reseller for more information.) You actually process the claims the same way. Claim adjustment codes come from the primary EOB and are required in the claim file for the secondary carrier.
The system provides the ability for you to enter both line‐level and claim‐level adjustment codes. You can access these windows when posting with the green Payment Calculation – Primary Insurance Plan window, when processing the secondary claim after posting payments, or when editing a claim. Getting there is different, but what you do when you get there is the same. 12.12
Editing Claims
Processing Claims
TIP | You can also access these windows to view the information captured by the system from the remittance files.
Those claim adjustment codes make it into the secondary claim file through one of the following avenues:
 The system captures these claim adjustment codes automatically from the primary electronic remittance file (*.835) when you use AutoPayment Posting. (Please refer to that module’s documentation for more information about using AutoPayment Posting.)
 If you post payments manually and do not enter any claim adjustment codes yourself, MicroMD PM automatically enters basic codes based on the amounts you post to the columns on the green Payment Calculation – Primary Insurance Plan window. The information is entered when you save your posting activity. The system uses the following line‐level claim adjustment codes:
For the write‐off on each line item (Writeoff column): • Group Code: CO – Claim Adjustment Group Code
• Reason Code: 42 – Charges exceed our fee schedule or maximum allowable amount.
For the deductible on each line item (Deduc column):
• Group Code: PR – Patient Responsibility
• Reason Code: 1 – Deductible Amount
For the coinsurance on each line item (Coins column):
• Group Code: PR – Patient Responsibility
• Reason Code: 2 – Coinsurance Amount
 If you do not use AutoPayment Posting or post payments manually with the green Payment Calculation window, you must manually enter the codes for each claim and transaction yourself to send the secondary claim electronically.
Finding the Adjustment Windows
When you post primary payments using the green Payment Calculation – Primary Insurance Plan window, you can click the icon in the A column for the line‐level adjustment codes window or click the Adj. Codes button (at the bottom of the window) for the claim‐level adjustment codes window.
Another opportunity to add adjustment codes is when you post primary payments and save (and the patient has a supplemental insurance). The system displays the Process Secondary Claim window. This window gives you the option to delete, crossover or process the supplemental claim. When you click Process, the system displays the Claim Modification window so you can enter additional information as needed by the secondary carrier. This is where you can click the icon in the A column or the Adj. Codes button to enter or view codes.
NOTE | Both situations are also true when using the blue Payment Calculation – Patient and Non‐Primary Insurance window.
Editing Claims
12.13
Processing Claims
TIP | You can use the Ctrl + L key combination to access the line‐
level adjustment window and the Alt + A key combination to access the claim‐level adjustment window.
The final way you can access the claim adjustment windows is editing a claim after you have posted payments and before you process the claim. You can do this from the Claims Processing – Electronic Billing or Claims Processing – Paper windows. Place a check mark in the P column of the claim you need to modify and click the Modify Claim icon on the Task Pane. The Claim Transactions window opens. Click the More button, and the system displays the Claim Modification window where you can click the icon in the A column or click the Adj. Codes button.
Now that you know how to get to these windows, you can learn how to enter information from the EOB if you need to do it manually.
Entering Line-Level Adjustment Codes
When you want to enter line‐level adjustment codes, you click the icon in the A column as described earlier. This displays the line‐level Claim Adjustment Information window. Click each section’s header to activate it (the header text turns a darker color).
Figure 12‐5 Line‐Level Claim Adjustment Window
The top section of the window is the main area where you enter line‐level adjudication information. The horizontal scrollbar allows you to access all the fields in this section. The system populates this information automatically when you process an electronic remittance file from the primary. This helps you prepare to send the claim on to the secondary insurance. The system also grabs information from the secondary claims in the remittance file in preparation for sending the claims to a tertiary insurance carrier.
The second section of the window allows staff members to enter information required in the claim file for drug transactions and contract information. The bottom section of the window allows staff members to enter transaction‐specific notes. These notes are for the practice’s use only and do not appear in the claim file. Practice’s can also create up 12.14
Editing Claims
Processing Claims
to 10 additional information fields to include with each note and can copy a note to all transactions on the claim.
To insert a new item in each section, click the Insert button at the top of the window and complete the fields in that section. Click Accept to save your changes. You can remove an item from any of the sections. Just highlight the item and click the Delete button.
TIP | Remember: When you use AutoPayment Posting, the system captures this information for you automatically.
Fields on the Line‐Level Claim Adjustment Information Window:
Field
Description
Adjudication
Payer Type
This column displays if this adjudication information relates to a payment from the patient’s primary, secondary or tertiary payer. Only those plans listed for the patient on their Plan Sets tab appear in this list (based on effective date for the plan and service date for the claim). Payer No.
This field displays the plan ID for the payer selected from the Payer Type drop‐
down. You cannot edit this field.
Name
This field displays the plan description for the payer selected from the Payer Type drop‐down. You cannot edit this field.
Group Code
This column displays the general category for this payment adjustment.
Reason Code
This column displays the detailed reason the adjustment was made.
Amount
This column displays the amount of the adjustment.
Quantity
This column displays the units of service involved in the adjustment.
Payment Date
This column displays the date the insurance carrier made payment on this line item.
Send
This box indicates that the line item will be included in the secondary claim file.
Payment Method
This column displays the way the carrier made payment on this line item.
Check No
This column displays the check number of the payment included in the file.
Payer ICN
This column displays the control number listed in the remittance file.
Record Type
This column displays the type of information included in the row.
Group No
This column displays the group number that appears in the remittance file.
Routing Number
This column displays the routing number that appears in the remittance file.
MOA
This column displays the remark codes included in the remittance file.
EOB Message
This column displays any message in the file from the carrier regarding this line‐
item adjustment.
Line‐Level Information
Editing Claims
12.15
Processing Claims
NDC and Contract Information
This section of the window allows staff members to enter information required in the claim file for drug transactions (NDC fields) and any information needed for the CN1 segment of the electronic claim file (Contract Information fields).
Each of these fields is a simple text‐entry field. In the NDC fields section, the NDC Code drop‐down list is editable. As is the Code drop‐down in the Contract Information section. To edit the items available in either of these drop‐downs, use the Master Table Setup (under Setup > Master Table Setup). Edit the NDC Code and Contract Type Code respectively. Charge‐Line Notes
No.
This is a system‐assigned identifier number for the user‐generated line‐item note. You cannot edit this number.
Category
Select the Note Category you want to assign to this note. Each practice can set the default for all Note Category drop‐downs on the General Preferences tab in the Setup Module (under Setup > Practice Preferences).
Note Text
Enter any line‐item notes necessary for this line item. This information is for the practice’s information only and is not included in any claim files. By default, MicroMD PM includes the date the note was created and the user who created the note.
Fields 1–10
The system provides 10 additional fields that the practice can use to standardize information entered for the line item. The setup button at the top of the window allows the practice to label the fields as needed. If there is no label created, the system does not display the field(s).
Click the setup button to display the Transaction User Note Fields window. Enter the label for the additional fields you want to display. Click Accept to save your changes.
Copy an Adjustment Line/Note to All Lines in a Claim
To copy an adjustment entry or a charge line note to all other line items on a claim, place a check mark in the box next to the item(s) you want to copy and click the Copy button at the top of the window. The system asks you to confirm this action and then applies the change when you save your claim edits.
12.16
Editing Claims
Processing Claims
Entering Claim-Level Adjustment Codes
When you want to enter claim‐level adjustment codes, you click the Adj. Codes button as described earlier. This displays the claim‐level Claim Adjustment Information window. Click each section’s header to activate it (the header text turns a darker color).
Figure 12‐6 Claim‐Level Claim Adjustment Window
The top section of the window is the main area where you enter claim adjustment codes. The horizontal scrollbar allows you to access all the fields in this section. The columns in this section of the window relate to the same type of information as at the line level. To insert a new item, click the Insert button at the top of the window and complete the fields needed. Click Accept to save your changes. You can remove an item from this section. Just highlight the item and click the Delete button.
The bottom section of this window is where you can enter information about the type of claim submitted. Complete the following fields if required:
 Claim Frequency Type Code: This drop‐down allows you to indicate the type of claim this is for the patient (e.g., a replacement, a voided claim).
 Service Authorization Exception Code: If required by the carrier, select the reason no service authorization was requested prior to submitting the claim.
 Override ICN: This overrides the Original‐Ref No/CRN field on the Claim Modification window with up to 30 characters and is included in the electronic claim file.
 Contract Info: If required, enter this information to be included in the CN1 segment of the electronic claim file.
Entering Other Claim Information
There are times when you need to include additional information in the claim file for the carrier, whether primary or secondary. The system captures most of the adjustment information needed from the remittance file. However, if you need to enter this information manually, the Claim Modification window provides a central area to enter this information as needed by your insurance carrier.
The system displays this window when you have a supplemental carrier to the one for which you entered payment, if posting payments manually. You can also access this window when initially posting charges or when editing a claim. Click the More button on the Claim Transactions window.
Editing Claims
12.17
Processing Claims
Figure 12‐7 Claim Modification Window
Fields Available on the Claim Modification Window:
Field
Description
Code, Fee, Allowed, Misc, Ded, Coins, and Paid
These fields list the information entered on the green Payment Calculation – Primary Insurance Plan window, reflecting payment made by the patient’s primary carrier.
Ins Paid
This field displays the total amount paid by any insurance other than primary.
Vist1 and Vist2
These fields display codes identifying the reason for the patient’s visit.
A
Totals
These are the total amounts of the Fee, Allowed, Misc, Ded, Coin, Paid, and Ins Paid columns.
Due
This field lists the amount due from the carrier about to receive the claim. The system subtracts the amount in the Paid column from the amount in the Allowed column.
Date Ins Paid
This field lists the date that the previous insurance paid on the claim.
Patient Amount Paid
This field lists the amount that the patient paid towards this claim before it was filed. The system automatically completes this field once any staff member posts a patient payment.
Ins Type
This field identifies the type of secondary insurance the patient has with the carrier. To choose a default MSP (Medicare Secondary Payor) type to automatically populate in this field for Medicare secondary claims, select the Medicare as Secondary Payer Applies field on the Plan Sets tab of the Patient Detail window. Medicaid Resub code/ This field lists the two‐digit number of the weekly remittance advice cycle on RA
which the rejected claim appeared.
12.18
Editing Claims
Processing Claims
Original‐Ref No/CRN
This field lists the unique 10‐digit number assigned by the Department of Public Welfare (DPW) to the rejected claim. This field can hold up to 20 characters; however, what prints on the claim form is limited per carrier’s requirements. An ANSI claim file will contain up to 20 characters.
# of Attachs, Attach1, These fields are for certain insurance plans that require the number of Attach2, Attach3, and attachments submitted with the claim. The Attach1, Attach2, Attach3 and Attach4
Attach4 fields are used for certain insurance plans that require attachments.
Delay Reason
This field tells the insurance carrier why the claim was not filed at an earlier date. Typically, the carrier rejected the claim due to untimely filing, and you need to resubmit the claim because of it.
Disallowed Cost Contain
This field lists the amount disallowed by the primary payor due to the failure of either the provider or insured to meet the cost containment provisions of the insurance contract, managed care contract, or PPO contract under which payment has been requested for this claim.
Disallowed Other
This field lists the amount disallowed by the primary payor for reasons OTHER than the failure of the provider or insured to meet the cost containment provisions of the insurance contract, managed care contract, or PPO contract under which payment has been requested for this claim.
Adjudication Indicator
This field lists the reason why the payor denied or reduced benefits on this claim.
Remarks
This field allows you to enter any notes pertaining to this claim.
Adj. Codes button
PLACING A CLAIM ON HOLD
You can place a claim on hold until you are ready to submit it. Once you get to the Claim Transactions window, you can simply click the Hold button instead of the OK button. This saves your changes and changes the status of the claim to Hold instead of Print.
REFILE CLAIMS
At times, you may need to refile claims. There are two ways to accomplish this in MicroMD PM: re‐file a batch (or batches) of claims or refile an individual claim. The following sections detail the steps you should take to accomplish this.
Placing a Claim on Hold
12.19
Processing Claims
Refiling a Batch (or Batches):
Procedure
Details
1. Select Claims > Claims Processing – EB from the main menu.
OR
Select Claims > Claims Processing – Paper from the main menu.
2. Select the appropriate Form Type from the drop‐down.
3. Click the Filed option button and select the appropriate Filed Date range for the claims you want to re‐file.
4. In the Claim Status section, remove the check marks next to Print and Hold.
5. Place a check mark next to Processed.
6. Click the Search icon or the Search button.
The system displays a list of all claims for that Form Type that were filed during the date range you specified. These claims are marked as Processed.
TIP | To submit only a few claims, click the Deselect All icon to remove the check mark from the P box of each claim and then check only the claims you want to send. To submit all but a few claims, leave all of the claims checked and just uncheck the few you do not want to send.
7. Reset the Status field of each claim to Print.
To change the Status of a single claim, select Print from the Status drop‐down.
OR
To change the Status of all the claims selected:
a. Click the Claim Status Reset icon on the Task Pane.
The Claim Status Reset window opens.
b. Select the Print option and click the Reset button.
c. Click Yes or No to confirm that you want (or do not want) to reset the status of the selected claims.
12.20
Refile Claims
Processing Claims
8. To submit the claims, follow the instructions for electronic claims or paper claims.
Refiling an Individual Claim:
Procedure
Details
1. Select Claims > Claims Processing – EB from the main menu.
OR
Select Claims > Claims Processing – Paper from the main menu.
2. Select the appropriate Form Type from the drop‐down.
3. Click the Filed option button and select the appropriate Filed Date range for the claims you want to re‐file.
4. In the Claim Status section, remove the check marks next to Print and Hold.
5. Place a check mark next to Processed.
6. Click the Select Patients icon on the Task Pane.
7. Search for the appropriate patient.
8. Click the Search icon on the Task Pane or the Search button on the window.
The system displays a list of all claims for that Form Type that were filed during the date range you specified. These claims are marked as Processed.
TIP | To submit only a few claims, click the Deselect All icon to remove the check mark from the P box of each claim and then check only the claims you want to send. To submit all but a few claims, leave all of the claims checked and just uncheck the few you do not want to send.
Refile Claims
12.21
Processing Claims
9. Reset the Status field of each claim to Print.
To change the Status of a single claim, select Print from the Status drop‐down.
OR
To change the Status of all the claims selected:
a. Click the Claim Status Reset icon on the Task Pane.
The Claim Status Reset window opens.
b. Select the Print option and click the Reset button.
c. Click Yes or No to confirm that you want (or do not want) to reset the status of the selected claims.
10. To submit the claims, follow the instructions for electronic claims or paper claims.
FILING NOTES
For tracking purposes and user convenience, MicroMD PM automatically logs information relating to claim filing (both electronic and paper claims). Each time a claim is filed, the system logs the date, type of claim, how the claim was processed (paper or electronic), and the plan name. The system also automatically records if a claim is manually deleted or responsibility is changed.
12.22
Filing Notes
POSTING PAYMENTS
Now that you’ve posted charges and submitted claims, you wait for payment. Once you receive those funds, MicroMD PM makes it easy for you to post payments, write‐offs and adjustments to a patient’s account and to retrieve that information in the future with in‐depth financial reports. The system also tightly integrates the claims process with posting payments, allowing your practice to streamline your work flow and maximize the time your staff members spend at their duties. IN THIS CHAPTER
In this chapter, we cover how to:
 Use the green Payment Calculation – Primary Insurance Plan window and the blue Payment Calculation – Patient and Non‐Primary Insurance window
 View the distribution of each payment after the fact
 Post payments, adjustments, write‐offs, and refunds using line‐item posting
 Post partial payments and re‐file unpaid items
 Post payments in batches
 Adjust entries
 Post batch payments
 Post a single patient payment to a family account or across a multiple sequences for an individual patient
 Transfer patient payments
 Credit card payments
 Printing receipts
 Correct posting mistakes
 Associate unapplied payment/write‐off amounts to the items on a sequence
 Post financial transactions without the Payment Calculation windows (not recommended)
OVERVIEW OF THE PAYMENT CALCULATION WINDOWS
Using the Payment Calculation windows is the most recommended way to post payments, write‐offs, adjustments, and refunds—allowing for the most accurate financial tracking per line item in the system. You can use the Payment Calculation windows to post both patient‐ and insurance‐responsible sequences, as well as make any posting corrections.
Once you enter the information in the Payment Calculation window, whether green primary window or the blue patient/supplemental window, you just drag and drop (or press Ctrl + A key combination) to apply the information to the sequence. The system posts all the codes and amounts you entered in the box to the sequence. Then you can save the information.
In This Chapter 13.1
Posting Payments
Figure 13‐1 Posting from the Payment Calculation Window
Green Primary Payment Calculation Window
The greatest thing about the green Payment Calculation window is that you can have the system remember the amounts (for each procedure, provider and plan) allowed by the insurance carriers. When you go to post payments from the patient’s primary carrier, the system automatically populates the green box with appropriate allowed amount for that procedure, for that plan, for that provider. Figure 13‐2 Green Payment Calculation – Primary Insurance Plan window
In most cases, you need to supply only the Allowed amount for each procedure line. If the insurance company only provides one of the values (i.e., allowed or write‐off) on the EOB or summary notice, you do have the option to have the values computed in the green Payment Calculation window based on the Writeoff amounts instead of the Allowed. Double‐click the Allowed or Writeoff column to select that column. The header of the selected column appears in yellow. As you post values to the selected column, the system automatically computes and populates the other values on the Payment Calculation window. 13.2
Overview of the Payment Calculation Windows
Posting Payments
Fields on the Payment Calculation – Primary Insurance Plan Window:
Field
Description
check mark
The first column is the transaction update column. Removing the check mark from this column disables these line items from being updated. For example if the claim has five line items posted to it and the primary insurance only pays on three line items, the user can disable the other two lines from being updated and these lines are not included in any payment or write‐off amounts or any other payment totals.
Proc
The Proc column lists the procedure code for the transaction.
Service Dt
The Service Dt field pulls the service date from the charges for which the user is posting payments.
Contract
The Contract field lists the contracted amount for this procedure with this insurance plan. This field lists the amount contained on either the Plan Allowed tab of the Procedure Detail or the Procs Allowed tab of the Plan Detail. This amount, if not assigned already, is set automatically the first time a payment is posted using this procedure and this code. This field does not update after the first instance. This field is for informational purposes only and cannot be changed on this screen. Charges
The Charges field lists the charges for the procedure and cannot be edited.
Allowed
The Allowed field displays the amount allowed by the insurance plan. The system automatically places an amount in this field if either the Plan Allowed tab of the Procedure Detail or the Procs Allowed tab of the Plan Detail lists an amount for this procedure and plan. If the Update box is checked, both the Plan Allowed tab of the Procedure Detail and the Procs Allowed tab of the Plan Detail are updated with the amount listed here after posting this procedure and plan combination. If the allowed amount differs for a given procedure, it is recommended to change it and check the Update field if this new allowed amount needs to be used for future calculations. If an amount received is not the usual amount received (applied to deductible, payment on the EOB was miscalculated by insurance carrier, etc), deselect the Update flag.
Misc
Enter any miscellaneous deduction amounts in this column. This allows for proper calculation of any other insurance carrier deduction when computing the payment values. Entering an amount in this field recalculates the Co‐Ins and Paid amounts to allow for the reduction in payment.
Deduc
Enter the amount applied to the patient’s deductible. The system recalculates the Co‐Ins and Paid amounts to allow for the reduction in payment.
Overview of the Payment Calculation Windows
13.3
Posting Payments
Co‐Ins and Paid
The system computes these fields automatically for you based on the amount you enter in the Allowed column (or the Write‐off column if you activate and use that column instead). Each procedure has a Coverage Class associated with it. Each plan has a list of payment rates entered on its Plan Sched. tab based on these Coverage Classes. The system calculates the Co‐Ins and Paid columns using the Coverage Class of the procedure and the percentage that this plan pays for those kinds of procedures.
 Co‐Ins: Lists the portion of the amount in the Allowed column for each procedure that is the responsibility of either the patient’s supplemental insurance carrier or the patient (if they have no supplemental insurance).
 Paid: Lists the portion of the amount in the Allowed column for each procedure that was paid by the insurance carrier.
Write‐off
Generally, MicroMD PM subtracts the amount allowed by the insurance carrier for the charged item from the amount you charged/submitted for the procedure. In the system, the following factors can affect whether or not the write‐off is automatically calculated for you:
 If the Compute Writeoff field in the Plan Detail is not checked, the system does not compute the write‐off automatically for you.
 If the plan is Medicare and the Assignment field in the Claim Transaction window is not checked when posting charges and preparing the claim, the system does not compute the write‐off automatically for you.
If either of the above factors applies to the current posting, the write‐off amount for each of the charge lines is not automatically computed in the Payment Calculation – Primary Insurance Plan window. You can, however, manually change the write‐off amount in each charge line if needed.
Update
This checkbox controls whether the system updates the payment profile for this procedure, for this plan, for this provider. When there is a check mark in this box, MicroMD PM updates the Allowed column both on the Plan Allowed tab (on the Procedure Detail window) and on the Procs Allowed tab (on the Plan Detail window) with the amount entered in the Allowed column on the green Payment Calculation window. There is a check mark in this box by default for those procedures with the Update Flag box checked on their Procedure Detail window.
NOTE | If a staff member posts an amount less than the allowed amount stored for the charge line, the system highlights the Allowed column in red and removes the check mark from this column. You can then print an Allowed Exceptions section on the day sheet. 13.4
Overview of the Payment Calculation Windows
Posting Payments
Codes
For the Misc, Deduc, and Co‐Ins columns, the system automatically enters the codes chosen as the defaults on the System Preferences tab (under Setup > System Preferences). The system uses the codes selected in the Misc Deduction, Deductible Code and Co‐Insurance Code drop‐downs in the Billing/Claims section.
For the Paid and Write‐off columns, the system automatically enters the codes chosen as the default for the plan for whom you are posting payments. The system pulls the codes selected in the Payment Code and Write‐off Code drop‐downs on the Plan Detail window for this plan.
Blue Supplemental and Patient Payment Calculation Window
When you post patient payments, supplemental insurance payments and write‐offs, MicroMD PM adjustment codes and any other financial transactions in the system (besides the primary insurance payments, etc.), you should always use this blue Payment Calculation – Patient and Non‐Primary Insurance window. Just like the green Payment Calculation – Primary Insurance Plan window, the blue Payment Calculation window provides accurate financial reporting and helps your practice maintain an accurate audit log regarding virtually every transaction.
Figure 13‐3 Blue Payment Calculation – Patient and Non‐Primary Insurance Window
Columns on the Blue Payment Calculation Window:
Field
Description
Proc
This field displays the procedure code for the service provided and billed to the insurance company.
Charges
This field displays the fee amount posted for the line item.
Recd
This field displays the total payment amounts already received for the line item.
Balance
This field displays the remaining balance due amount for each line item.
Amount
Enter the amount for any type of financial procedure in the first Amount column (payment, write‐off, adjustment).
(first column)
Amount
Only use this Amount column when you want to post two financial procedures (for example, a payment and a write‐off) for the same line item.
Overview of the Payment Calculation Windows
13.5
Posting Payments
Disbursement Type
Select the method the system should use to disburse the amount entered in the Disburse field.
 FIFO (First In, First Out) disburses the payment from the oldest charge entered to the newest until the total payment is disbursed.  Prorate disburses the payment proportionately to all of the charges in the sequence.
You set the default for this field using the Disbursement Method options in the Billing/Claims section of the System Preferences tab (under Setup > System Preferences). Disburse
Enter a patient or supplemental payment amount in the Disburse field and click the Disburse button to allocate that payment amount using the method chosen in the Disbursement Type option.
Codes
Enter the appropriate payment, write‐off, or adjustment codes that correspond to the Amount column(s) to allow for proper identification of line‐item posting for supplemental claims.
VIEWING PAYMENT DETAILS
One of the benefits of posting with the green and blue Payment Calculation windows is that you can view exactly what portion of any payment, write‐off, adjustment or refund relates to each individual charge line. Simply double‐click a payment line to open the Payment Details window and view how that payment was disbursed across the charge lines on the sequence.
Figure 13‐4 Payment Details Window
You can change the disbursement of the amounts, if needed; however, the total amount has to remain the same. For example, in the screen shot above, you can change the Amount columns for each line item as long as the total still equals a payment of $146.43.
NOTE | When editing the Amount column, you must precede payment values with a minus sign (‐) to indicate that it is a credit value. For example, you would enter -11 as the value for a payment of $11.00.
13.6
Viewing Payment Details
Posting Payments
LINE-ITEM POSTING
Now that you understand the fields and columns on the Payment Calculation windows. We can put them to some use. Remember you post primary insurance payments using the green Payment Calculation – Primary Insurance Plan window. You post supplemental insurance payments, patient payments, and the system adjustment codes using the blue Payment Calculation – Patient and Non‐Primary Insurance window. In order for your financial reports to be accurate, you must use the Payment Calculation windows to post your payments, write‐offs, adjustments, etc. When using line‐item posting, you apply the payments received and the corresponding write‐off amounts to the individual charges submitted to the insurance carrier.
Posting Primary Insurance Payments
The green Payment Calculation – Primary Insurance Plan window automatically appears when posting primary insurance payments if there is a check mark in the Payment Calculation checkbox on the System Preferences tab (under Setup > System Preferences).
To post primary insurance payments:
Procedure
Details
1. Click the Charges/Payments icon on the tool bar.
You can also select Billing > Charges/Payments from the main menu or press the F6 function key.
The Charges / Payments window opens.
STOP | Always verify that you are about to post to the correct day sheet.
2. Search for the patient.
You can enter the patient’s name, account number, responsible party, insured name, chart number, policy, or date of birth.
Many EOBs or summary notices contain the account number, such as 1‐1001.0‐2. This should be interpreted where 1 is the practice number, 1001.0 is the patient’s ID number in the system, and the 2 is the sequence to which you want to apply the payment.
TIP | To post directly to a specific sequence, enter the patient’s account number, along with the sequence number. For example, type 1001.0-2 to post charges for sequence 2 for patient 1001.0.
3. Double‐click the patient’s entry.
The Patient Sequences window opens.
4. Highlight the sequence to which you want to apply the payment.
Line‐Item Posting
13.7
Posting Payments
5. Click the Payments / Adjustments icon on the Task Pane.
The Payments window appears along with other windows, including the useful Payment Calculation – Primary Insurance Plan window.
Click the Toggle button to switch from the Payment Calculation – Primary Insurance Plan window to the Payment Calculation – Patient and Non‐Primary Insurance window in case you need to post a transaction other than the primary insurance payment first.
Click the Payment Calculation icon on the Task Pane to return to the Payment Calculation – Primary Insurance Plan window without posting.
6. Populate the fields within the Payment Calculation – Primary Insurance Plan window based on the EOB or summary notice supplied by the plan.
7. Drag and drop the dollar icon to the payment area on the Payments window.
This action automatically posts the entries from the Payment Calculation window, along with the appropriate financial procedure codes.
If you want to post only the payment or write‐off amount, along with the associated code, simply drag and drop the appropriate total from the Payment Calculation window. The miscellaneous deductions, deductible, and co‐insurance notes are also created if they are non‐zero amounts.
You can edit the Description fields if needed. For example, you may want to insert the check number for each payment description.
8. Verify that the Bill Flag is correct.
Your choices are:
N – Patient Payment: any patient payment
Y – Insurance Payment: an insurance payment
where the patient has a remaining balance
pending with an insurance carrier
X – Transfer Responsibility to Patient:
an insurance payment where the remaining
balance is now the patient’s responsibility
TIP | You can choose to have responsibility transferred automatically to the patient by removing the check mark from the Responsibility – Sec box on the Plan Detail window of the secondary insurance. 13.8
Line‐Item Posting
Posting Payments
9. Click the Save icon on the Task Pane.
If the system displays a Process Secondary Claim window, please refer to information on processing secondary claims.
Partial Claim Payment and Refiling
You can select which procedure lines in the Payment Calculation – Primary Insurance Plan window are not included in the payment and for which you want to refile a claim. Removing the check mark from the first column for those items not paid by the insurance carrier allows you to post payments for only those procedures on which the carrier has paid.
Figure 13‐5 Partial Claim Payment
When you apply your posting activity, the system recognizes that you have not posted all line items, and it prompts you to refile the unchecked line items to the insurance company. If you click Yes, the system sets the claim Status of only those line items to Print. If you do not want to refile the unpaid items to the primary and want to pass the unpaid items to either the patient’s secondary insurance or to the patient, click No when prompted to refile the unpaid items to the primary insurance.
When the Claim Modification window opens, it does not include information on the refiled line items, allowing you to enter information regarding the items on which the insurance carrier did pay—in preparation for submitting to the secondary carrier. The primary insurance company remains responsible for the entire sequence. The next time the practice processes claims, the two line items you wanted to refile are the only items that appear on the claim. When you later open the payment window to post the payments received for those remaining line items, only those lines are active in the Payment Calculation – Primary Insurance Plan window.
Once you post those payments, the system prompts you to delete, crossover or process the secondary claim and you can continue as normal.
Posting Patient and Supplemental Insurance Payments
The Payment Calculation – Patient and Non‐Primary Insurance window automatically appears if the Post Line Items box is checked on the System Preferences tab (under Setup > System Preferences). We highly recommend that you train yourself to use this efficient tool to post secondary insurance payments and patient payments, as well as write‐offs, adjustments, and refunds. Line‐Item Posting
13.9
Posting Payments
TIP | If you want to post a patient payment, but the system displays the green Payment Calculation – Primary Insurance Plan window, you can click the Toggle button on the window to switch to the blue Payment Calculation window and post the patient’s payment.
To post supplemental insurance payments and/or personal payments:
Procedure
Details
1. Click the Charges/Payments icon on the top tool bar.
You can also select Billing > Charges/Payments from the main menu or press the F6 function key. The Charges/Payments window opens.
STOP | Always verify that you are about to post payments to the correct day sheet date.
2. Search for the patient.
You can enter the patient’s name, account number, responsible party, insured name, chart number, policy, or date of birth.
Many EOBs or summary notices contain the account number, such as 1‐1001.0‐2. This should be interpreted where 1 is the practice number, 1001.0 is the patient’s ID number in the system, and the 2 is the sequence to which you want to apply the payment.
TIP | To go directly to the patient’s list of sequences, enter the patient’s entire account number. For example, type 1001.0 to display the Patient Sequences window for Mr. Smith.
3. Double‐click the patient’s entry in the list.
The Patient Sequences window opens.
4. Highlight the sequence to which you want to apply the payment.
5. Click the Payments / Adjustments icon on the Task Pane. 13.10
The Payments window appears along with other windows, including the Payment Calculation – Patient and Non‐Primary Insurance window.
Line‐Item Posting
Posting Payments
6. Enter the payment, write offs or adjustments in the Amount column(s), based on the EOB or summary notice supplied by the plan for the appropriate line items.
You can post any type of procedure in the first Amount column (payment, write‐off, adjustment). Only use the second column when you want to post two financial procedures at the same time (for example, a payment and a write‐off).
To post two procedures, double‐click the first Amount column header to enter the first set of values (for You can enter the payment amount in example, payments). Then double‐click the second the Disburse field and click the Disburse Amount column header to enter the second set of values (for example, write offs).
button.
OR
You set the default for the disbursement method (FIFO or Prorate) under Setup > System Preferences > System Preferences tab > Default Disbursement options. However, you can change the method at the time of posting.
7. Verify that the correct payment, write‐
off, or adjustment codes appear in the Codes fields.
The Codes fields should correspond to the appropriate payment, write‐off, or adjustment codes to allow for proper identification of line‐item posting for secondary claims.
Clicking in the payment or write‐off code field displays the code’s description. The default payment and write‐
off codes can be changed, if necessary.
8. Drag and drop the dollar icon to the payment area on the Payments window.
This action automatically posts the entries from the Payment Calculation window, along with the appropriate financial procedure codes.
9. Click the Save icon on the Task Pane.
BATCH PAYMENT POSTING
The system provides two ways for you to post payments in batches. Depending on the way your practice posts payments, you can set the system to keep track while you post normally or you can post a single insurance check to multiple patient accounts accessed from one window, instead of searching patient by patient.
Track Payments as You Post
If you have a bunch of separate payments to post, you can use the system to set your location and service facility automatically. You can also set the system to track the payments you post, so you can easily balance the checks that you have in front of you with the totals in MicroMD PM to help double‐check your work. You can access this window from the Charges/ Payments window. Click the Batch Options icon on the Task Pane.
Batch Payment Posting
13.11
Posting Payments
Figure 13‐6 Batch Posting Options Window
The system allows you to keep a running total of payments as you post a check to ensure that it balances. For example, if you reset the batch options before posting a $500 check, as you post the check, the system adds each posting so you can be sure that you are posting payments correctly. The batch options can be reset for every check to aid you as you post.
The Batch Posting Options window is a simple tool that allows you to track payment, charge and write‐off posting activity. It also provides you with a simple way to specify a batch number for the payments you are about to post. To access the Batch Posting Options window, click the Batch Options icon on the Task Pane when you are in the Charges/Payments window. For a detailed explanation of the fields on this window related to posting payments, please refer to the table below.
The Batch Posting Options window is user‐specific and, aside from the Global fields, practice‐specific. It is not specific to any particular day sheet unless you use it that way.
NOTE | If you click Yes to the Reset Batch Totals message you receive when you erase the day sheet, then the information on this window is cleared for the practice and reset to default values, including clearing all batch numbers.
Fields Relating to Payment Posting Activity:
Field
Description
Reset Batch
Reset Day
Reset All
Batch No
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If you have a batch number for the payments you are about to post, you can enter that batch number here. The system attaches that batch number to the payments you post until you click the Reset Batch or Reset All button. Batch Payment Posting
Posting Payments
Check Number
Enter the check number of the insurance check you are about to post. The system automatically uses the check number from this field in the Description field when you apply your posting activity from the green or blue Payment Calculation windows.
NOTE | Be careful. The system continues to use this check number until you change it.
Operator
This field displays the system user for whom the displayed totals apply.
Batch Pmts and Wrtoff
This is the total dollar amount of the charges you have posted since the last time you clicked the Reset Batch button. This allows you to track batches of payments and write‐offs throughout the day, independent of the total amount in the Day Pmts and Wrtoff fields.
TIP | The system displays the total from the Batch Pmts field (and the Global Pmts field if this feature is being used) in the upper right‐hand corner of the Charges/
Payments window.
Day Pmts and Wrtoff
These totals are the total amount of payments and write‐offs you have posted since the last time you clicked the Reset Day button. This allows you to track the amount you have posted for the entire day, independent of the total amount in the Batch Pmts and Wrtoff fields.
Global Pmts and Wrtoff
These totals are only visible if the Multi‐Practice checkbox is marked on the System Preferences tab (under Setup > System Preferences). These are the total payments and write‐offs posted by this user across the practices to which they have access. This helps you keep track of your posting activity when you work with several practices in the same database.
When you click the Reset Batch or Reset Day button, the system subtracts the appropriate amounts from this Global field to reflect the change.
Batch Payment Posting
If you have an insurance check that you want to post for the claims you filed to that insurance company on a specific day or within a range of days, you can use the Batch Payment Posting feature. You can search for all open claims pending with a selected plan or group of plans and then apply payments to the appropriate sequences in the display, as opposed to selecting each patient individually. Batch Payment Posting is useful for those carriers that send bulk payment and do not support automatic payment posting.
NOTE | For those plans you want available in this module, you must place a check mark in the Batch checkbox on their Plan Detail window.
Batch Payment Posting
13.13
Posting Payments
Figure 13‐7 Batch Payment Posting Window
If you have a large check and you need to exit before you have posted the full amount, MicroMD PM allows you to save this information and then come back later to finish. The system keeps the information in the window until that user opens it again.
To use Batch Payment Posting:
Procedure
Details
1. Select Billing > Batch Payment Posting from the The Batch Payment Posting window opens.
main menu.
STOP | Always be sure you are about to post to the correct day sheet date. 2. Choose either Plan or Class to determine the type of choice you have in the drop‐
down list.
Only those plans with a check mark in the Batch checkbox on their Plan Detail window appear in this list. If you pick an Insurance Class where one of the plans does not have this box checked, the system does not include claims submitted to that carrier.
3. Select the plan(s) or class(es) for which you want to search for open claims.
4. Change the Filed Date if necessary to find the appropriate claims.
The ending date for this field defaults to 10 days prior to the system’s current date.
5. n the Date Paid field, enter the appropriate payment date for the check you are about to post. The system enters the date from the Date Paid field in the Date Insurance Paid field on the Claim Modification window for processing the supplemental claim. 6. Enter the number of the insurance check in the Check No field.
The system appends each payment code with this check number as you post.
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Batch Payment Posting
Posting Payments
7. Enter the amount of the check in the Check Amt field.
As you post, the system subtracts the payments from this amount so you can see when you have posted the entire check.
8. If you have multiple checks to post and want to assign a batch number, you can enter that number in the Batch No field.
9. Click the Search icon on the Task Pane.
Open claims that meet the criteria you selected appear in the bottom of the window. The system lists these claims in alphabetical order.
At this point, you click the Print icon on the Task Pane to print the rows displayed on the window.
10. Highlight the sequence to which you want to post part of the insurance check.
11. Click the Post Payments icon on the Task Pane and post payments as you would normally.
12. Save your posting activity.
The system highlights in yellow those sequences to which you have posted payments.
13. Repeat steps 10 through 12 for each payment you want to post.
POSTING PATIENT PAYMENTS FOR ENTIRE ACCOUNT
In MicroMD PM, you can post a single patient payment across multiple patient‐responsible sequences for the same patient or across the entire account when you have family sub‐accounts. This is called Uniposting. By entering the payment as one entry, the system automatically distributes that payment among the outstanding balances due by the patient.
For example, if Anthony Smith has a remaining balance from the last three visits, you can post one payment using Uniposting, and the system properly distributes that payment to the individual sequence for each visit. NOTE | You can only use the Uniposting feature for those sequences that are patient‐responsible.
Posting Patient Payments for Entire Account
13.15
Posting Payments
Figure 13‐8 Uniposting Window
To use the Uniposting feature:
Procedure
Details
1. Select Billing > Charges / Payments from the main menu.
You can also click the Charges/Payments button on the Launch Pane or press the F6 function key.
The Charges/Payments window opens.
2. To post to across a family account, search for the family’s account and highlight the main account.
You can enter the last name of the family or enter the main account number.
OR
To post to multiple sequences in an individual patient’s account, search for the patient’s individual account and double‐click the patient’s entry, opening the Patient Sequences window for that patient.
3. Click the Uniposting icon on the Task Pane.
The Family Posting window opens and displays all patient‐responsible sequences outstanding.
4. In the Code field, enter the payment code that you want to use for this payment.
This field defaults to the choice made in the Default Payment Code drop‐down list on the System Preferences tab (under Setup > System Preferences).
This is a search field, and you can enter partial descriptions to launch the search window.
5. Enter the amount of the payment in the Amount field.
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Posting Patient Payments for Entire Account
Posting Payments
6. Click the Print icon on the Task Pane.
You can also press the Ctrl + P key combination.
The system automatically distributes the payment to the items in each sequence based on the choice made in the Detail Disburse section—
first in, first out or prorated—prints a receipt for the patient, and saves the posting activity.
The Detail Disburse field defaults from the choice made in the Default Disbursement field on the System Preferences tab (under Setup > System Preferences).
If you do not need a receipt, you can simply click the Save icon on the Task Pane. The system posts the payments without printing a receipt.
7. Close the Family Posting window.
TRANSFER PATIENT PAYMENTS
The system allows you to transfer patient payments from one patient account to another if the payments are on the current day sheet or within the same account from one sequence to another, provided you have not posted any adjustments to these payments. The system records transferred entries in the Patient Log.
NOTE | You cannot transfer patient payments between different patient accounts if the day sheet on which the payment was originally posted has been closed.
Figure 13‐9 Posting Transfer Window
Transfer Patient Payments
13.17
Posting Payments
To transfer a patient payment:
Procedure
Details
1. Right‐click the patient payment line item that you want to transfer.
STOP | You must make sure that no adjustments were made to the entry you want to transfer or you end up with unapplied payments in the system. 2. Select Transfer from the pop‐up menu.
The Posting Transfer window opens. You can double‐click any sequence in this window to view the details of that sequence.
3. Choose the sequence to which you want to transfer the patient payment line item.
Enter the patient account number in the Name/
DOB field if transferring to a different patient account.
NOTE | Remember that you cannot transfer items between different patient accounts once the day sheet on which the payment was originally posted has been closed.
4. Click the Transfer button.
The Payments window for the sequence appears, along with the blue Payment Calculation window. This window has already been completed for you with the appropriate dollar amount disbursed based on your default (FIFO or Prorate). You can change the amounts, but their total must still equal the amount you transferred.
5. Drag and drop the green dollar icon to the payments area.
You can also press the Ctrl + A key combination to apply the amount. The system moves the payment items to the sequence indicated, removes it from the original sequence, and logs this in the patient log. If you move between patient accounts, the system creates a log entry in both patient logs.
6. Click the Save icon on the Task Pane to apply your changes.
If the payment you transfer is the only line item in the original sequence, the system automatically deletes the sequence after the transfer.
13.18
Transfer Patient Payments
Posting Payments
CREDIT CARD PAYMENTS
If your practice has installed a credit card swiper to process credit card payments through Moneris, follow the instructions below to process credit card payments. Please keep in mind that this is only for Patient Payments.
Processing Credit Card Payments:
Procedure
Details
1. Click the Charges/Payments icon on the top tool bar.
You can also select Billing > Charges/Payments from the main menu or press the F6 function key. The Charges/Payments window opens.
STOP | Always verify that you are about to post payments to the correct day sheet date.
2. Search for the patient.
You can enter the patient’s name, account number, responsible party, insured name, chart number, policy, or date of birth.
TIP | To go directly to the patient’s list of sequences, enter the patient’s entire account number. For example, type 1001.0 to display the Patient Sequences window for Mr. Smith.
3. Double‐click the patient’s entry in the list.
The Patient Sequences window opens.
4. Highlight the sequence to which you want to apply the payment.
5. Click the Payments / Adjustments icon on the Task Pane. Credit Card Payments
The Payments window appears along with other windows, including the Payment Calculation – Patient and Non‐Primary Insurance window.
13.19
Posting Payments
6. Click Credit Card Pay from the menu.
7. Select Charge from the Transaction Type If this is a co‐pay payment, and the amount of the co‐pay is in the patient’s plan set, the amount will automatically drop‐down menu. be entered.
8. Enter the payment amount in the Amount field.
13.20
Hit the Tab or Enter key. The box prompting you to swipe the patient card will open for each type of transaction.
Credit Card Payments
Posting Payments
9. Swipe the credit card.
The Card Number and Credit Card Verification information will populate in the Credit Card Processing window.
10. Click the Submit button, then Click the Save icon on the Task Pane.
Processing credit card payments for chip‐enabled cards, EMV and NFC:
Procedure
Details
1. Click the Charges/Payments icon on the top tool bar.
You can also select Billing > Charges/Payments from the main menu or press the F6 function key. The Charges/Payments window opens.
STOP | Always verify that you are about to post payments to the correct day sheet date.
2. Search for the patient.
You can enter the patient’s name, account number, responsible party, insured name, chart number, policy, or date of birth.
TIP | To go directly to the patient’s list of sequences, enter the patient’s entire account number. For example, type 1001.0 to display the Patient Sequences window for Mr. Smith.
3. Double‐click the patient’s entry in the list.
Credit Card Payments
The Patient Sequences window opens.
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Posting Payments
4. Highlight the sequence to which you want to apply the payment.
5. Click the Payments / Adjustments icon on the Task Pane. The Payments window appears along with other windows, including the Payment Calculation – Patient and Non‐Primary Insurance window.
6. Click Credit Card Pay from the menu.
7. When the MicroMD Credit Card Form appears, and the status message reads “Terminal Ready”, enter the amount of the transaction in the Amount text box.
13.22
Credit Card Payments
Posting Payments
8. Click the Charge button.
“Select Tender, Debit, Credit” will appear on the card swiper. Select Credit or Debit.
9. Swipe the credit card.
The transaction information will populate the MicroMD Credit Card Form window as shown in an expanded view in the example below.
10. Click the OK button. A Credit Card Transaction Details window opens.
Credit Card Payments
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Posting Payments
Reimbursements with the standard swiper
If a payment is made by mistake, it must be removed with a Reimbursement. However, if you’ve not left the processing screen, you can remove the payment by clicking the Void button.
If you have already left the credit card processing window, you can highlight the sequence and open the Payment window, select ‘Reimbursement” as the transaction type, and enter the amount.
Figure 13‐10 Reimbursement transaction for standard card swiper
Figure 13‐11 Receipt for the Reimbursement
13.24
Credit Card Payments
Posting Payments
Reimbursements with the chip-enabled swiper
For Reimbursements, run the transaction in the same manner as you would for a charge, only use the Reimbursement button instead of the charge button.
Figure 13‐12 Reimbursements with the chip‐enabled swiper
Figure 13‐13 Receipt for the reimbursement
Credit Card Payments
13.25
Posting Payments
Security code for refunds and voids
Many practices will require a security code for refunds and voids. Using a security code adds an extra level of safety and protection from loss or theft.
If your practice uses a security code, it will have been set‐up during the set‐up of the credit card swiper. Details of the set‐up procedure can be found in the MicroMD PM Configuration Manual.
Payments made before the charge is entered
If a patient would like to make a payment before the actual charge is entered, follow the directions below.
Procedure
Details
1. In the Charges and Payments window, search for and select the patient making the payment.
2. Double‐click the sequence that the patient is paying on.
3. Click New on the task bar.
4. Click the Credit Card Pay icon on the task bar.
5. Follow the directions for making a credit card payment as you normally would.
13.26
Credit Card Payments
Posting Payments
Force posting
If the transaction is denied and the client calls the credit card company, you can Force Post. The credit card company must give you an authorization number to proceed.
Figure 13‐14 Force Posting
Figure 13‐15 ForcePosting with the chip‐enabled swiper
Credit Card Payments
13.27
Posting Payments
Credit card payments over the phone
Sometimes a client may want to make a payment over the phone. Follow the steps below to complete this transaction. Procedure
Details
1. Make sure the Transaction Type is “Charge.’. If you are using a chip‐enabled swiper, use the Charge ‐ Card NOT Present button (after entering the amount of the charge in Step 2).
2. Enter the amount of the charge in the Amount text box.
You will be prompted to swipe or hand‐key card number.
3. Enter the credit card number on the swiper’s keypad and click Enter.
4. Enter the expiration date of the card and click Enter.
5. Close the swipe window and click Submit. You will be presented with the approval (shown below).
Printing a receipt
When outside the payment module, you can still print a receipt for a payment.
Procedure
Details
1. Highlight the patient’s sequence where the payment was made.
2. Click the Print Receipt icon in the task pane.
13.28
You will be presented with a receipt for the payment containing additional transaction details.
Credit Card Payments
Posting Payments
Transaction detail
To view the details of a credit card transaction, click the Transaction Details icon on the task bar.
Figure 13‐16 Credit Card Transaction Details window
Day sheet
When you process credit card transactions, they will be reflected on the day sheet.
Credit Card Payments
13.29
Posting Payments
Figure 13‐17 Day Sheet with Credit Card Transactions
PRINTING PATIENT RECEIPTS
When you want to print a receipt for a patient, you have a few options in the Charges/Payments Module.
 Once you have posted charges and/or payments from the Charges window, simply click the Print Receipt icon on the Task Pane. This saves your posting activity and prints a receipt at the same time.
 You can print one receipt for multiple sequences by placing a check mark in the P column on the Patient Sequences window for the sequences you want to include on the receipt. Click the Print Receipt icon.  You can also print a receipt for certain line items by placing a check mark in the P column on the Billing Inquiry window for the line items you want to include on the receipt. CORRECTING POSTING MISTAKES MADE IN PAYMENT MODULE
When someone makes a mistake while posting payments, staff members can correct the amount in the green or blue Payment Calculation window before they save their posting activity for that patient. However, once they save the payments, they have a couple of options available to correct the mistake. Depending on the policies of the practice, staff members can post the adjustment to the payment or write‐off and either delete the entries or leave them on the patient’s account.
13.30
Printing Patient Receipts
Posting Payments
NOTE | If you leave both entries, they print on patient statements/bills. If there is no need for the patient to view these corrections, it is best to erase the adjustment entries.
If you need to adjust a patient payment (i.e., a code that have been assigned a TOS other than “II – Insurance”), you can edit the payment, rather than reposting, provided that the day sheet has not been erased. To edit the code, simply double‐click the sequence on the Patient Sequences window. Change the patient‐payment code (e.g., change payment code 1 – PATIENT PAYMENT CASH to 2 – PATIENT PAYMENT CHECK).
Posting Adjustments Automatically
When you need to make an adjustment to a sequence and your practice uses the built‐in system adjustment codes, MicroMD PM can take most of the guesswork out of posting adjustments. A right‐
click menu option in the Charges/Payments Module allows you to post the correct adjustment codes and amounts without having to go through the struggle of deciding on the proper code to use. All you have to do is drag and drop and save.
Keep in mind that when you need to correct a payment posting mistake, you most likely need to correct the write‐off amount as well. You may need to correct any coinsurance or deductible amounts also. You can post the system adjustment codes to correct the payment and write‐off amounts and then delete the coinsurance and deductible lines.
TIP | Most of the time, it is just easier and safer to post your payments for the sequence from scratch. Take the sequence back to its original state before you posted payments to the sequence and begin again.
The system uses the built‐in adjustment code for reducing a payment (i.e., 101 ADJ – REDUCE PAYMENT). This automatically offsets the payment line with a debit line of equal value—increasing the amount the patient owes. When adjusting a write‐off, the system uses the built‐in write‐off adjustment code (i.e., 104 – ADJUSTMENT TO WRITE‐OFF). Once you save these adjustments, realign the responsibility on the sequence and set the status of the claim back to Processed, you can then post the correct payment. The following steps provide more detail.
To adjust a payment/write‐off entry on a sequence with the right‐click option:
Procedure
Details
1. Double‐click into the sequence that contains the payment and write‐off lines you need to correct.
2. Right‐click anywhere on the payment (or write‐off) line you need to adjust.
Correcting Posting Mistakes Made in Payment Module
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Posting Payments
3. Select the Adjust option from the pop‐
up menu.
The Payments window for the sequence appears, along with the blue Payment Calculation window. This window has already been completed for you with the appropriate dollar amount matched with the appropriate line items and the correct adjustment code chosen so all you have to do is drag and drop.
When you make adjustments with this right‐click menu option, you cannot change the adjustment code or dollar amount.
4. Drag and drop the green dollar icon to the payments area.
You can also press the Ctrl + A key combination to apply the amount.
5. Since this is an adjustment to an insurance If this is an adjustment to an insurance write‐off, payment, change the Bill Flag column to Y – the Bill Flag choice is Y – Ins. Write‐off/Adj.
Ins. Payment/Adj.
When you change the Bill Flag column to an insurance choice, the Plan Select window opens to allow you to choose to which plan the payment or write‐off adjustment applies.
6. Double‐click the plan for whom the adjustment applies.
7. Click the Save icon on the Task Pane to save your changes.
8. Repeat steps 1 through 7 for the write‐off adjustment.
9. Double‐click the sequence to open it up again.
10. Depending on the policies of your practice, delete the adjusted payment and write‐off lines, along with the lines containing the adjustment codes and amounts.
Click the Delete icon on the Task Pane, or press the Ctrl + D key combination. When you delete these lines, their total must equal zero.
11. Delete any coinsurance or deductible line items if needed.
Deleting these line items now makes re‐posting the payments easier.
12. Save your changes.
Now you have to change the status of the claim back to Processed. When you posted your payments the first time, the system performed several actions automatically in preparation for submitting claims to the secondary or transferring responsibility to the patient.
13. Place a check mark in the P column next to the sequence you are correcting.
The enables various icons on the Task Pane.
14. Click the Edit Claim icon on the Task Pane.
The Modify Plan window opens.
13.32
Correcting Posting Mistakes Made in Payment Module
Posting Payments
15. Make sure the primary plan is highlighted and click Accept.
The Claim Transactions window opens.
16. Change the Status drop‐down for each line item to Processed.
When you change the first line item, the system prompts you to change them all to Processed to make it easier.
17. Click the Save button.
Now you can post the payments correctly.
Posting Payment Adjustments Manually
If your practice uses its own system adjustment codes, you have two options when you need to correct a payment mistake: Use the blue Payment Calculation window or do not use the blue Payment Calculation window. The recommended option is to use the blue Payment Calculation window to enter the adjustment. This prevents any unapplied payment/write‐off amounts and helps you avoid extra steps to reapply those amounts. It also makes your financial reporting that much more accurate when you generate reports that pull information only from transactions posted using the green and blue Payment Calculation windows.
Once you save your adjustments, you’ll need to realign the responsibility on the sequence and set the status of the claim back to Processed. You can then post the correct payment. The following steps provide more detail.
To correct a payment/write‐off posting mistake using the blue Payment Calculation – Patient and Non‐
Primary Insurance window:
Procedure
Details
1. Select Billing > Charges/Payments from the main You can also click the Charges/Payments button on the Launch Pane or press the F6 key.
menu.
2. Search for and open the patient’s account that contains the sequence you need to edit.
The Patient Sequences window opens.
3. Highlight the sequence you want to adjust.
4. Click the Payments/Adjustments icon on the Task Pane.
The payment windows typically open along with one of the Payment Calculation windows (green or blue). If you have the blue Payment Calculation window on the screen, you can skip to step 6.
At this point, if you choose not to use the Payment Calculation window, you can click in the Payments window and post the appropriate adjustment code and amount. Save your changes.
5. On the green Payment Calculation window, click the Toggle button to switch to the blue Payment Calculation window.
Correcting Posting Mistakes Made in Payment Module
13.33
Posting Payments
6. In the first Amount column for the line item you Remember that the simplest way to adjust an want to adjust, enter the entire amount as the entry is to remove the whole amount and then re‐post the correct amount, rather than trying to adjustment amount.
calculate it.
7. Click in the field under the Amount column and Remember that you can type in a partial description in this field. The system will display a enter the correct adjustment code search window so you can choose the correct (e.g., 101 ADJ –REDUCE PAYMENT).
code.
TIP | You can enter two adjustment codes at one time. Double‐click the header of the second Amount column to make it the active column. Repeat steps 6 and 7 for the second adjustment.
8. Drag and drop the dollar icon to the bottom of the Payments window.
The adjustments post to the sequence.
If this is an adjustment to an insurance write‐off, 9. Since this is an adjustment to an insurance payment, change the Bill Flag column to Y – Ins. the Bill Flag choice is Y – Ins. Write‐off/Adj.
Payment/Adj.
When you change the Bill Flag column to an insurance choice, the Plan Select window opens to allow you to choose to which plan the payment or write‐off adjustment applies.
10. Double‐click the plan for whom the adjustment applies.
11. Click the Save icon on the Task Pane.
12. If you want to delete the two entries, you can now double‐click the sequence and delete both entries. Remember to save your changes.
13. Return to the Charges window for the patient and post the correct charge if appropriate.
If you entered a charge in the wrong patient’s account, remember to open the Patient Sequences window for the correct patient and re‐enter the charge on their account.
Erasing Payments/Write-offs and Their Adjustments
Erasing payments, write‐offs and their corresponding adjustment entries prevents them from appearing on the patient’s statements/bills. The system tracks this information in the Patient Log where you can see the transactions that were deleted. NOTE | Some users may not have security rights to erase entries.
13.34
Correcting Posting Mistakes Made in Payment Module
Posting Payments
To remove the incorrect payment/write‐off lines and their adjustment entries:
Procedure
Details
1. Double‐click the patient’s sequence that contains the entries you want to remove.
The Payments window opens.
2. Highlight the incorrect payment or write‐off line and click the Delete icon on the Task Pane.
You can also press the Ctrl + D key combination.
3. Highlight the adjustment entry and click the Delete icon.
4. Repeat this for any other adjustment entry combination you want to remove.
5. Save your changes.
The total amount of the deleted entries must be zero, or the system prevents you from saving your changes.
UNAPPLIED PAYMENTS
If the system is set up to use line‐item posting, and a staff member posts a transaction without using the green or blue Payment Calculation windows or performs some other action that results in an amount becoming disassociated from a line item, the system considers this amount an “unapplied” amount. When you see a green bar next to a sequence, this means the sequence has a payment amount posted, but it was not associated with the line items.
You can apply an unapplied amount using the blue Payment Calculation window, the Payment Details window, or the Unapplied Payments utility.
Using the Payment Calculation Window
All unapplied payment amounts on a sequence appear in the blue Payment Calculation – Patient and Non‐Primary Insurance window in the Unapplied Amt(s) drop‐down, along with a Save button.
Figure 13‐18 Unapplied Amount on Blue Payment Calculation Window
Unapplied Payments
13.35
Posting Payments
To apply that amount to the line items on the sequence:
Procedure
Details
1. Highlight the sequence with the green bar next to it.
2. Click the Payments/Adjustments icon on the Task Pane.
If the green Payment Calculation – Primary Insurance Plan window opens, click the Toggle button to access the blue Payment Calculation – Patient and Non‐Primary Insurance window.
The Recd column on the blue Payment Calculation window contains zeroes since no one associated a payment with the line items.
3. From the Unapplied Amt(s) drop‐down list, select the unapplied transaction.
Once you select the transaction you want to apply, the system automatically populates the highlighted Amount column based on the disbursement method chosen. You can also manually disburse the amount, if needed.
TIP | Remember: You can enter two transactions at the same time if needed. Just double click the second Amount column to highlight it and enter (or select) the other transaction.
4. Verify that your procedure codes (payment, write‐off, etc.) appear correctly under the Amount columns.
5. Click the Save button.
Using the Payment Details Window
You can also apply an unapplied payment amount without using the blue Payment Calculation window. You must know how much to apply to each line item when you use this option. 13.36
Unapplied Payments
Posting Payments
Figure 13‐19 Payment Details Window
Procedure
Details
1. Double‐click the sequence that contains the unapplied payment/write‐off amount.
The Charges window opens.
2. Double‐click the transaction line for the unapplied payment.
The Payment Details window opens.
3. In the Amount column of the Charge Details section, enter the appropriate payment amount for each charge line.
The total of the amounts you enter must equal unapplied payment amount shown in the top portion of the window. The system displays that total at the bottom of the window for your reference.
4. Click the Close button and click Yes when prompted to save your changes.
Unapplied Payments Utility
This utility generates a report detailing all of the unapplied amounts in the system that it can automatically apply. To use the utility:
NOTE | This utility will not work with multiple charge lines, multiple payment lines, or multiple adjustment lines in a sequence.
Unapplied Payments
13.37
Posting Payments
Procedure
Details
1. Select Utility > Billing and Claim Utilities > Unapplied Payments from the main menu.
The Unapplied Payments Report Options window opens.
2. Choose the appropriate criteria on the options window to display the sequences containing the unapplied payment/write‐off amounts you want to apply.
3. Click the Print icon to print this report to keep as backup in case someone makes a major mistake.
4. Place a check mark in the box next to each of Remember to use the Select All icon or the Deselect the sequences for which you want to apply All icon on the Task Pane to make selecting sequences easier.
the payments.
5. Click the Update icon on the Task Pane.
The system confirms that you want to perform this action and then associates the unapplied payment/
write‐off amounts using the method chosen in the Default Disbursement drop‐down list on the System Preferences tab (under Setup > System Preferences).
Report Options Available for the Unapplied Payments Report:
Field
Description
Payment Posting Date (or To find sequences where the unapplied payment (or write‐off) was posted Write‐off Posting Date)
on or within a certain date range, enter that date or date range in these fields.
Sequence Posting Date
To find sequences with an unapplied payment or write‐off amount where the sequence was posted on or within a certain date range, enter that date or date range in these fields.
Service Date From
To find those sequences with an unapplied payment (or write‐off) amount that has a specific date (or within a date range) in the Date From column on the transaction, enter that date or date range in these fields.
Payment (or Write‐off or Refund)
To find the sequence(s) with a specific payment (or write‐off or refund) code posted as an unapplied amount, select the code(s) from this list.
Provider
To find the sequence(s) posted for a specific provider and that has an unapplied payment (or write‐off) amount, select the provider(s) from this list.
13.38
Unapplied Payments
Posting Payments
Report Type
The options in this section allow you to choose the kind of report to generate.
 Summary: Select Summary to display a list of those unapplied transactions and the unapplied amount, including dates, patient and sequence number.
 Detail: Select Detail to displays the same information as a summary report. The Detail option also displays the total amount of the payment for which there is an unapplied amount.
Procedure Type
You can choose whether to search for unapplied payments, unapplied write‐off amounts, or unapplied refund amounts. The choice in this section changes the labels on the first Posting Date field, the code drop‐
down, and the Group By option.
Group By
You can organize the information in the report by Payment or Write‐off (depending on the choice you make in the Procedure Type section) and/or by Patient.
POSTING WITHOUT PAYMENT CALCULATION WINDOWS
Some offices may choose not to use the Payment Calculation windows for posting and post everything as a lump sum. This is a very basic method of posting and results in unapplied amounts in your system, impacting your ability to generate accurate financial reports.
STOP | You are strongly discouraged from using this manner to post financial transactions. Many of the automated processes and your financial reports rely on your use of these windows.
Figure 13‐20 Payments Window
Posting Without Payment Calculation Windows
13.39
Posting Payments
To post payments, write‐offs, refunds, or adjustments without associating the amounts to specific transaction line items:
Procedure
Details
1. Select Billing > Charges/Payments from the main You can also click the Charges/Payments button on the Launch Pane or press the F6 key.
menu.
The Charges / Payments window opens.
STOP | Always verify that you are about to post to the correct day sheet.
2. Search for the patient.
You can enter the patient’s name, account number, responsible party, insured name, chart number, policy, or date of birth.
Many EOBs or summary notices contain the account number, such as 1‐1001.0‐2. This should be interpreted where 1 is the practice number, 1001.0 is the patient’s ID number in MicroMD PM, and the 2 is the sequence to which you want to apply the payment.
TIP | To post directly to a specific sequence, enter the patient’s account number, along with the sequence number. For example, type 1001.0-2 to post charges for sequence 2 for patient 1001.0.
3. Double‐click the patient’s entry.
The Patient Sequences window opens.
4. Highlight the sequence to which you want to apply the payment.
5. Click the Payments / Adjustments icon on the Task Pane.
The Payments window opens.
6. Enter the appropriate financial code in the Code column in the lower portion of the Payments window.
7. Add a check number to the end of the Description field if necessary.
8. In the Amount column, enter the amount of the payment, write‐off, adjustment, or other financial transaction.
9. Verify that the Bill Flag column reflects the appropriate type of payment.
10. Click the Save icon on the Task Pane.
13.40
Posting Without Payment Calculation Windows
Posting Payments
KEYSTROKE POSTING
If you prefer, you can use shortcut keys on the keyboard to post payments, rather than using the mouse and clicking through the fields. Although your personal posting methods depend solely on the policies of your practice, this is a set of brief instructions for posting payments using the keyboard. Procedure
Details
1. Press F6 to open the Posting Module.
Ctrl + F6 opens the Posting Module for the last patient viewed.
2. Type the name or number of the patient and You can use the Tab key to move the cursor to another search field.
press Enter.
3. Press the Tab key to transfer the cursor to the list area of the window.
4. Use the arrow keys to highlight the appropriate patient.
5. Press Enter to select the patient.
The Patient Sequences window opens.
6. Use the arrow keys to highlight the appropriate sequence.
7. Press Ctrl + R to post new payments to the sequence.
8. Use the Enter or Tab key to move through the Payment Calculation window and edit as needed.
9. When finished, press Ctrl + A to apply the payments.
10. Press Ctrl + S or Ctrl + X to save changes and exit the window.
11. If prompted to save changes, press Alt + Y (for Yes), Alt + N (for No), or Alt + C (for Cancel).
12. If prompted to bill secondary insurance, press Alt + P (for Process), Alt + X (for Crossover), or Alt + D (for Delete).
Make sure you have the correct insurance highlighted. You can use standard shortcuts when processing the secondary insurance.
13. Continue posting for the same patient or press Esc to exit the Patient Sequences window.
14. Repeat steps 2 through 13 as needed.
Keystroke Posting
13.41
STATEMENTS AND BILLS
During the billing process, you can send a patient a statement to keep them informed of the activity on their account. Or you can simply send them a bill after all insurance money has been received for the services rendered. MicroMD PM allows each practice in the database to send patient statements or bills, depending on the needs of each practice and each patient. So, what’s the difference between the two?
A bill lists only those sequences for which the patient is completely responsible for the remaining balance. If a patient has no patient‐responsible sequences, the system does not generate a bill. If the patient has a transaction within an insurance‐responsible sequence that is their responsibility, the system does not print a bill until you post payments from all of the patient’s insurance carriers. (This is not true if you use the Track Co‐pay feature. A statement lists all sequences, whether they are patient‐responsible or still pending with the insurance carriers. The system clearly marks each sequence with the appropriate responsibility, and then lists only the total amount due from the patient at the bottom of the page. Practices typically generate statements when they want to send the patient documentation of all activity on their account, regardless of who is currently responsible for payment.
IN THIS CHAPTER
In this chapter, we cover how to:
 Set up the Statements/Bills Module
 Charge Finance Charges
 Set up cycle billing
 Generate statements/bills
 Warn patients of overdue amounts
 Generate itemized statements
OVERVIEW OF GENERATING STATEMENTS/BILLS
Practices can print all statements, all bills or a combination of both, depending on the needs of the practice and the patients you see. The system generates a statement/bill for each patient account, unless the practice uses the sub‐account feature. (When you use the sub‐account feature, MicroMD PM prints a single statement/bill containing transaction information for the entire family.) Statements/bills list all transactions within the specified time period that meet all of the criteria you set on the Billing Options window.
You should decide first whether you want to send mostly statements or mostly bills to your patients. This lets you decide the default value for new patients created in the system. Each patient has an option on their Patient Detail window that indicates the type of document they should receive, and you can set the default for that field for new patients with the Bill/Statement field on the Billing Preferences tab (under Setup > Practice Preferences). You can override this option when printing if needed, but this lets you have a consistent billing process in general. (We will go into how to choose which one to print a little later.)
In This Chapter 14.1
Statements and Bills
SETTING UP STATEMENTS/BILLS MODULE
When you first generate statements/bills for your patients, you can establish how the system determines which patients receive a statement or bill, what information prints on each kind of document and whether to apply finance charges. Once you establish these settings, you should only have to change them for special cases when you need to print statements/bills at times other than your normal billing schedule or when you need to adjust the official settings.
Once you establish the settings you want for your statements/bills and then print a full cycle (a statement/bill for every patient in the system due to receive one), the system saves the settings you entered (if you have the Save Settings box checked). This lets you alter the options to print a specific set of statements/bills for a selected set of patients, then keep the options for the official printing date for statements/bills.
NOTE | You should remove security settings from any user that does not need to alter the official settings To access the Billing Options window, select Billing > Statements/Bills from the main menu. Figure 14‐1 Billing Options Window 14.2
Setting Up Statements/Bills Module
Statements and Bills
Choices Available on the Billing Options Window:
Field
Description
Posting Dates
These fields default to a one‐year date range backward from today’s date. The system includes all transaction details on the statements/bills for sequences posted within that date range that meet the other criteria set on this window.
Statement Options
Show amount due
Check this box to print the patient’s portion of the total account balance on the statement. This information prints in the Please Pay box at the top of the statement and in the area near the bottom of the statement.
NOTE | When you activate the budget feature and have data entered in a patient’s Next Payment and Due fields on their Patient Detail window, MicroMD PM prints the amount listed in the Due field instead of the full amount due from the patient, regardless whether this box is checked. Min Balance
Enter the minimum total account balance a patient must have in order to have a statement print for them. This field takes those balances that are greater than or equal to the amount entered. For example, if $5.00 is chosen as the minimum balance, the system does not include a patient account with a balance of $4.99, but it does if the balance is $5.00.
Min Amt Due
Enter the minimum amount due a patient must have in order to have a statement print for them. This amount represents only the portion of the account that is patient due if it is greater than or equal to the amount entered in this field. For example, if $5.00 is chosen as the minimum amount due, the system does not include a sequence with a patient balance of $4.99, but it does if the amount the patient owes is $5.00.
Show Paid Sequences
In general, if there is a sequence that has no amount due from the insurance carrier or from the patient, the system does not print them on the patient’s statement. Check this box to include those sequences on the patient’s statement.
Bill Options
NOTE | Remember: Bills only display those sequences that are solely the patient’s responsibility.
Show balance amount
Check this box to print the patient’s total account balance at the bottom of the bill. This amount shows the total of all patient‐responsible sequences that meet the other criteria on this window. It does not reflect any insurance‐
responsible sequence amounts.
Inc Co Pay
Check this box to print the patient’s outstanding co‐pay balance on their bill. The system lists the co‐pay balance as a separate entry next to the patient’s balance. To activate this checkbox, you must have the Track Co‐pay checkbox marked on the System Preferences tab (under Setup > System Preferences). Setting Up Statements/Bills Module
14.3
Statements and Bills
Min Balance
Enter the minimum total account balance a patient must have in order to have a bill print for them. This field takes those balances that are greater than or equal to the amount entered. For example, if $5.00 is chosen as the minimum balance, the system does not include a patient account with a balance of $4.99, but it does if the balance is $5.00.
Min Amt Due
Enter the minimum amount due a patient must have in order to have a bill print for them. This amount represents only the portion of the account that is patient due if it is greater than or equal to the amount entered in this field. For example, if $5.00 is chosen as the minimum amount due, the system does not include a patient‐responsible sequence with a balance of $4.99, but it does if the amount the patient owes is $5.00.
Show Paid Sequences
In general, fully paid sequences do not print on the patient’s bill when they receive one. Check this box to include those sequences.
Finance Charge
STOP | The Finance Charge feature is an involved feature that affects your accounts receivable. Print Options
What to Print
From the drop‐down list, choose the type of document you want to print:
 Default: The system either prints a bill or statement depending on the choice that appears on the Patient Detail window for each patient.
 Bill: The system prints a bill for each patient, overriding any selection on the Patient Detail window.
 Statement: The system prints a statement for each patient, overriding any selection on the Patient Detail window.
For example, if all the patients in the system are marked to receive a bill, you can choose the Statement option from the What to Print drop‐down list, and all the patients receive statements rather than bills.
14.4
Setting Up Statements/Bills Module
Statements and Bills
Sort Order
From the drop‐down list, choose the order in which you want MicroMD PM to print your statements/bills:
 Account: Statements/bills print in account order. When you select this option, the system displays the Account Range pop‐up window to allow you to specify a range of patient accounts for whom to generate statements/bills.
 Name: Statements/bills print in alphabetical order by patient’s last name. When you select this option, MicroMD displays the Name Range pop‐up window to allow you to specify a range of patient names for whom to generate statements/bills.
 Selected: Statements/bills print for selected patients only. Use the Select Patients icon or the Autoload feature to select patients.
 ZIP Code: Statements/bills print in ZIP code order according to patient’s address. When you select this option, MicroMD PM displays the ZIP Code Range pop‐up window to allow you to specify a range of ZIP codes for which to generate statements/bills.
Statement Type
From the drop‐down list, choose the type of statement/bill to process:
 Double‐Window: Choose this option if you use the double‐window envelopes to send your statements/bills. This format prints the return address in the upper left‐hand corner of the document and the patient’s address on the right side of the document to show through the windows in the envelope.
 Consolidated: Choose this option to print only the month, total charge and total payments on the statements/bills. No transaction details print.
 eStatement V1: Choose this option to write the statement/bill data to an electronic file. This format allows you to upload the data to a billing vendor.
 eStatement V2: Choose this option to write the statement/bill data, including line item details and provider‐specific Pay‐To information, to an electronic file.
 eStatement V3: Choose this option to write the statement/bill data, including diagnosis per line item and per sequence, to an electronic file.
 Window 10: Choose this option if you use the standard envelopes with a window for the mailing address to show through. This format prints the patient’s address in the lower left‐side of the statement/bill.
Setting Up Statements/Bills Module
14.5
Statements and Bills
Entries Per Statement/Bill
Enter the number of line items you want to print per statement/bill. The default entry is 20, which prints only the last 20 entries (posted within the dates selected) on the statement/bill and fits them on one sheet of paper. You can increase this number if needed. If there are more lines than the specified number, the balance of those previous items appears as the very first entry on the statement (i.e., the Balance Forward amount).
When there are multiple sequences, if a sequence is split due to the Entries Per Statement number, the Balance Forward and Patient Balance may be incorrect. To correct this, the Entries Per Statement is automatically decreased until one full sequence exists. All balances will then be correct.
With only one sequence, the balances may be incorrect if the sequence has been split.
TIP | To print all of the outstanding sequences on the statements/bills, set this field to 999. You must be careful, however, since this can result in multiple pages per individual statement/bill. You should also verify that you have the Show Paid Sequences box unchecked.
Show transactions
Check this box to print the line items posted for each sequence on the statements/ bills. With this unchecked, the system leaves the transaction area blank.
Show due date
Check this box to print the due date on the statement/bill as calculated using the number of days indicated in the Due in Days field and today’s date.
Show personal message
Check this box to print the text entered on each patient’s Patient Detail window. This text prints at the bottom of their statement/bill. Due In Days
Enter the number of days that MicroMD PM should use when calculating the due date to print on the statements/bills. The system counts forward this number of days from the date you print your statements/bills. Keep in mind that the patient does not receive that statement/bill right away. This date then prints on the statements/bills when you have the Show due date box checked.
Include Pre Collection
When a patient has received the last patient dunning message and is set to receive pre‐collection letters, they automatically do not continue to receive statements/bills. Check this box to print statements/bills for those patients that are going through the pre‐collection process.
Exclude Deceased
Check this box to avoid printing a statement/bill for patients that have passed away. The system knows the patient is deceased when there is a date entered in the Death Date field on the Patient Detail window for that patient.
TIP | You can use the Responsible Party feature when you need to send statements/bills regarding deceased patients. (Leave the Exclude Deceased box unchecked in this case.) Credit card entry lines
If the practice accepts credit card payments, place a check mark in this box to print a grid at the top of the statement/bill that allows patients to enter their credit card information.
Aging
14.6
Setting Up Statements/Bills Module
Statements and Bills
Show Patient
Check this box to print the aging grid with the patient amounts displayed in the appropriate aging bucket(s).
Show Insurance
Check this box to print the aging grid with the insurance amounts displayed in the appropriate aging bucket(s).
Cycle Billing
STOP | Cycle billing is an involved feature that you must use a specific way. Use Cycle Billing
Check this box to activate the cycle billing option. This enables other options for this feature.
Days Since Last Stmt
Enter the number of days that should elapse since MicroMD PM last printed a statement/bill for the patient. The system prints statements/bills for any patient who has not received a statement/bill within this number of days. The system records the last statement/bill print date on the Patient Detail window in the Last Stmt/Bill field.
Use Force Stmt Flag
Check this box to print a statement/bill for patients with the Force Stmt box checked, regardless of whether or not the patient is due to receive one. The Force Stmt checkbox appears on the Patient Detail, Patient Sequences and Billing Inquiry windows. TIP | To print only statements for patients with the Force Stmt box checked (and they have sequences that meet the criteria set), select Account from the Sort Order drop‐down. Enter a range of 99999999 to 99999999 in the Account Range pop‐up and then print statements/bills.
Patient Messages Posting Date and Calendar Date STOP | The system marks the Posting Date field by default. We suggest you do not change this default.
If you select Calendar Date, the system checks the calendar date the payment was posted rather than the last patient payment date (the date of the day sheet the payment was posted on). If the patient made a payment that was posted on a previous day sheet after his or her last statement was printed, the system resets the patient messages on the next bill or statement.
NOTE | Be aware that if you use the Calendar Date option, the system still displays the last payment date based on the day sheet date rather than the calendar date it was posted. This may cause confusion with staff expecting the bill or statement to progress to the next collection message when printed.
Other Options
General Message
If you want to add an additional message to the bottom of the statement/bill (e.g., “Have a safe and happy Fourth of July holiday!”), you can type the message in the General Message field. This field allows a limited number of characters, including spaces, and prints on every patient’s statement or bill. TIP | If you type Insurance in this field, the patient’s insurance companies listed in their default plan set print on the statement/bill.
Setting Up Statements/Bills Module
14.7
Statements and Bills
Patient Category
If you want to print statements/bills for only those patients in a specific category that meet the criteria on this window, choose the category(ies) from this drop‐down list. The system defaults to (All). The system matches the choice you make here to the selection made in the Category drop‐down on each Patient Detail window.
Patient Location
If you want to print statements/bills for only those patients that meet the criteria on this window and are at a specific practice location, choose the location(s) from this drop‐down list. The system defaults to (All). The system matches the choice you make here to the selection made in the Location drop‐
down on each Patient Detail window.
Stmts per print job
Set the number of statements/bills you want MicroMD PM to include in each print job sent to the printer. This allows you to better control how your printer behaves for this large group of documents. With this field set to 10 statements per print job, the system creates 300 print files instead of 3000. In most cases, you can leave this field set to the default value.
Save Settings
Check this field to save all choices made on this window for future statement print cycles. The system only saves these selections after you print a complete cycle. A complete cycle is when you print a statement/bill for every patient in the database who is due to receive one, rather than picking and choosing patients.
Additional Setup Options
The system provides additional practice‐specific options for the appearance of your statements/bills. You can access these options on the Billing Preferences tab (under Setup > Practice Preferences).
 Show Prov on Stmt: Check this box to print the name of the rendering provider on the patient statements/bills following each transaction description and truncates the description to allow enough room.
 Pat Full Name on Stmt: Check this box to print each patient’s first and last name on their statements/bills next to each transaction. This is particularly useful for pediatric practices using sub‐accounts where the patients have different last names.
FINANCE CHARGES
The system allows practices to charge finance charges for outstanding patient balances. MicroMD PM creates a new sequence for this finance charge to allow for easier reporting capabilities and account receivables management. To turn the feature on or off, you check the Apply Finance Charge checkbox on the Billing Options window for statements/bills. However, this does not work by itself. You need to tell the system to which patients you want to apply the finance charge and which code you want the system to post when it does apply the charge.
Create a Finance Charge Adjustment Code
The practice must create an appropriate system adjustment code for finance charges. This enables you to apply and track this amount properly. When you create the code you want to use for the finance charges, 14.8
Finance Charges
Statements and Bills
you must select CI – ADJ – INCREASE CHARGE from the POS drop‐down and PP‐Patient from the TOS drop‐down.
Set up to Apply Finance Charges
Once you have created the new adjustment code, you can finish setting up to apply finance charges. Once you place a check mark in the Apply Finance Charge box on the Billing Preferences tab (under Setup > Practice Preferences), MicroMD PM displays the Finance Charge Code drop‐down list. From this drop‐
down, select the code you created for applying finance charges.
Figure 14‐2 Finance Charge Setup
The Apply Finance Charge box on the Billing Preferences tab is the default for new patients created in the system. If you decide that you do not want new patients to have their Apply Fin Chrg box checked by default on the Patient Detail window, you can remove the check mark on the Billing Preferences tab. Existing patients still have their box checked.
NOTE | Remember: You actually control the application of finance charges through the Statements/Bills Module, not the Billing Preferences tab.
You can uncheck the Apply Finance Charge box on the Billing Preferences tab, and the system still recognizes the existing patients who have the Apply Fin Chrg checkbox marked on their Patient Detail window when you choose to apply finance charges when you print statements/bills.
NOTE | Existing Emdeon clients who decide to use finance charges MUST notify Emdeon ahead of time to notify their mapping department to accommodate for the additional field.
Finance Charge Calculation
When you print statements/bills and want to apply finance charges to balances that exceed a certain amount of days without payment, check the Apply Finance Charge checkbox on the Billing Options window of the Statements/Bills Module. This displays several other options to specify the parameters you want the system to use when deciding whether to charge a patient a finance charge.
The system applies finance charges to those accounts that meet the aging criteria specified in the Minimum Aging Days field on the Billing Options window. The system calculates the finance charge by dividing the percentage entered in the Yearly Rate field by 12 to get a monthly rate (e.g., 15% divided by 12 = .0125). The system multiplies the total patient‐responsible amount in the account that goes beyond the number of days specified in the Minimum Aging Days field by this figure. This is the finance charge for the account.
Finance Charges
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Statements and Bills
NOTE | You must enter the percentage in the Yearly Rate field as its decimal equivalent (e.g., enter 15% as .15).
Figure 14‐3 Finance Charge Options
If that finance charge is less than the amount listed in the Minimum Charge field, the system ignores it. If it’s greater than or equal to that amount, the system then looks at the Last Fin Chg date field on the Patient Detail window. If that date is greater than the number of days entered in the Days Since Last Charged field, the system recalculates if there are more patient‐responsible amounts that go beyond the minimum number of aging days and creates another sequence. If that date is less than the number of days indicated, the system ignores the sequence.
The system displays the finance charges at the bottom of the statement/bill when printed. The system then updates the Last Fin Chg and Amount fields on the Patient Detail window and adds this finance charge to the patient’s account balance, creating a separate patient‐responsible sequence using the finance charge code you created and specified on the Billing Preferences tab (under Setup > Practice Preferences).
NOTE | The actual posting of the finance charge sequence occurs AFTER the practice prints the statement/bill (using the current day sheet date).
Remove Finance Charge
If a practice decides that they have made a mistake when applying finance charges and want to remove some or all of the finance charges recently applied, they can remove the last set of finance charges that were applied in the Statements/Bills Module with the Remove Finance Charge utility (under Utility > Billing and Claim Utilities > Remove Finance Charge). This utility works similar to the other utilities in that you generate a report to find the accounts you need to adjust, choose the patients, and then update them.
Procedure
Details
1. Select Utility > Billing and Claim Utilities > Remove Finance Charge from the main menu.
This displays the Remove Finance Charges Options window.
2. Select your criteria and click Accept.
This will generate a report containing patient accounts that meet the criteria you set.
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Finance Charges
Statements and Bills
3. Place a check mark next to each of the accounts from which you want to remove the last finance charge applied.
You can only remove finance charges for those posted on day sheets that are currently open in the system. If the day sheet is closed/
erased, there is no checkbox and you cannot remove those finance charges.
4. Click the Print icon on the Task Pane to print the report for you records.
You must print this report before you can remove the finance charges.
5. Click the Update icon on the Task Pane.
The system posts 41 – ADJ TO REDUCE FINANCE CHARGE to the last finance charge sequence and removes the sequence.
Options Available for the Remove Finance Charges Utility:
Field
Description
Patient ID
To view the last finance charge posted for specific patients by ID, enter the ID or range of IDs here. Leave the default value if you want to include all patients. For a single patient, enter the patient’s ID in both the From and the To field.
Patient Name
To view the last finance charge posted for specific patients by name, enter the name or name range here. For a single patient, enter the patient’s last name in both the From and the To field. For a range of patient names (e.g., patients from Abercrombie to Connor or all patients from N through T), enter the range here.
Posting Date
To view the last finance charge posted to a patient’s account based on the date it was posted, enter that date range here. If the patient had a finance charge posted during that date range, but there are later finance charges posted, the patient will not appear on the report.
Max Seq Balance
Enter the maximum finance charge amount you want to remove with this utility. Remember: The system posts a separate sequence for the finance charge. It is this sequence balance the system uses for this Max Seq Balance field.
CYCLE BILLING
For those practices that like to send statements/bills in a staggered time frame (e.g., patients A – J in the first week of the month, K – T in the second week of the month, and U – Z in the third week), Cycle Billing provides the ability to do this. The main distinguishing feature between Cycle Billing and regular statements/bills is that, with Cycle Billing, MicroMD PM generates statements/bills for patients based on the last time they received a statement or bill.
Once you establish your batches, the system no longer looks at the patient’s name. It looks at the date they last received a statement/bill and whether they have any sequences that meet the criteria set on the Billing Options window.
Example
For example, Advanced Family Practice is a large practice that prints their statements/bills in a staggered time frame (i.e., patients A – J in the first week of the month, K – T in the second week of the month, and Cycle Billing
14.11
Statements and Bills
U – Z in the third week). Tom and Kim post payments for the practice, and Jennifer generates the statements/bills throughout the month. This is the third week of the month, which means that those patients in the U – Z bracket will receive a statement or bill, if they have patient‐responsible amounts and haven’t received a statement/bill within 28 days (the number of days Advanced Family entered in their Days Since Last Stmt field when they established their cycle a few months ago).
While Tom and Kim were posting insurance payments, Mr. Smith, who normally falls within the K – T bracket and didn’t receive a statement or bill during the K – T billing cycle this month, now has a patient‐
responsible amount. Normally, he would not receive a statement or bill until his next billing cycle, which could be another four weeks away. However, since one of the criteria for Cycle Billing is the number of days since the patient received a statement or bill, Mr. Smith’s account falls into the U – Z cycle, and he will receive a timely statement.
How to Establish Cycle Billing
If you want to set up Cycle Billing, it typically takes the length of time of an entire print cycle to establish the billing cycle for your practice. We recommend setting your Days Since Last Stmt field to 28 days or less since 28 is evenly divisible by seven days to get an even four weeks in a month.
 Generate your first batch (e.g., A – J during the first week of the month) of statements/bills.
 When you come to the date you want to establish for your next batch of statements/bills (e.g., K – T for the second week), print that batch as described.
 Continue for the remaining batches in your cycle.
After you establish your complete billing cycle, generally all you need to do is print. You have already established your options and saved your settings. You do not have to enter the range of accounts again unless you need to re‐establish the cycle in the future. The system takes over and automatically prints statements/bills for those patients who have not had a statement/bill printed in the number of days indicated in the Days Since Last Stmt field and who have sequences that meet the criteria you established on the Billing Options window.
GENERATING STATEMENTS/BILLS
Now that you know about all of the options you can establish for printing statements/bills for your patients, you can set them to meet the needs of your practice and generate a cycle.
Procedure
1. Select Billing > Statements/Bills from the main menu.
Details
STOP | Always verify that you are using the correct day sheet when printing statements/bills.
The Billing Options window opens.
Either the Account Range, Name Range, or ZIP Code range pop‐up window also appears to allow you to specify a range of patients for whom to generate statements/bills in this session.
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Generating Statements/Bills
Statements and Bills
2. In the pop‐up window, you can choose a starting and ending range of patients for whom to generate statements/bills in this session.
If using Cycle Billing for the first time, you want to enter the range applicable for this billing session (e.g., enter A in the From field and Jz in the To field). If you have already established a full cycle, leave the default values. OR
If you want to generate statements/bills for all patients that are due to receive one, leave this range wide open.
3. Click Accept.
The Billing Options window is enabled, and the selected print range appears in red at the bottom of this window.
4. Change any options as needed.
Generally, you do not need to change these settings unless you are generating statements/bills for the first time or are generating a special set of statements/ bills outside the established specifications. You can preview the list of patients that will be receiving statements/bills BEFORE you click the Print icon. Click the Preview List icon on the Task Pane to populate the Patient Selection window prior to printing.
5. Click the Print icon on the Task Pane.
The Select Printer dialog opens.
If you chose an electronic statement file in the Statement Type drop‐down list, MicroMD PM automatically begins to create the batch file for you at this point and shows the file’s progress in a pop‐up window. Skip to step 7.
6. Click the appropriate printer button.
Generating Statements/Bills
Your statements/bills print for patient accounts meeting the criteria established on the Billing Options window. The system shows the current print status in a pop‐up window.
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Statements and Bills
This creates a PDF of each statement/bill print job 7. When prompted to save the statements/
bills and the summary report (if printed) to and makes each PDF available under Utility > Review Most Recent > Statements/Bills. If you choose to print view at a later time, click Yes.
the Billing Report in step 9, you can find that PDF under Utility > Review Most Recent > Statements/Bills Summary. You can choose not to save the statements/bills for later viewing, but you will not have the ability to review the same document that the patient has in front of them if they call with questions.
After you make your choice, the system finishes processing your statements/bills and closes the Billing Options window.
NOTE | You can also choose to save electronic statements for later viewing; however, please be aware that the statements/bills you view do not match exactly with the document the patient has in front of them.
8. When prompted to update the patient messages, click Yes or No.
Typically you want to click Yes, unless you are printing outside your normal printing schedule. 9. When prompted to print the summary report, click Yes or No.
This report summarizes the list of patients who received a statement/bill in this session.
Including Patients with a Newly Patient-Responsible Balance
Practices can also use the Autoload feature to print statements/bills for additional patients. This involves a table in the database that tracks those patients with a sequence paid by an insurance carrier and who now have a patient‐responsible balance. You can send a statement/bill to those patients as soon as the sequence becomes the patient’s responsibility, rather than waiting for the normal billing cycle, which could be as much as four weeks away.
STOP | For those clients performing cycle billing, we do not recommend using the Autoload feature since you would need to deactivate cycle billing, causing your established statement/
bill cycle to be off.
Click the Autoload Newly Responsible icon to load a list of those patients with a sequence paid by an insurance carrier (resulting in a patient‐responsible balance) into the Patient Selection window. When printing the statements/bills, the user should click the No button when prompted to update patient messages. If the user clicks Yes, the system could update the messages too quickly and transition the patient into pre‐collection when they really do not need to be.
NOTE | If someone prints a statement/bill for the patient(s) with a patient‐responsible balance after an insurance payment (without using autoload), the system removes that patient from the autoload list.
14.14
Generating Statements/Bills
Statements and Bills
Where Does the Patient Send Payment?
The system uses the Pay To fields on the Practice Detail window to determine what address to print in the Pay To area of the statements/bills. These fields appear in two places on this window: on the Detail tab and on the Provider tab. When you have a different billing address for the practice as a whole, enter that information in the Pay To fields on the Detail tab.
STOP | Be extremely careful. When this information differs from the information in the Practice fields, the system creates a new loop in the electronic claim file (if you are sending claims electronically).
If a provider has his or her own address where they need patients to send payment, you can enter that address per provider on the Provider tab in the Pay To fields. The system checks the Pay To fields for the practice’s default provider. If there is no Pay To information for that provider, the system prints the practice’s Pay To information. You can find the Default Provider drop‐down on the Billing Preferences tab (under Setup > Practice Preferences).
NOTE | Remember: When this is set to (Default), the system uses the provider from the Patient Detail window of each patient.
AUTOMATED DUNNING MESSAGES
Statements/bills each contain a dunning message that allows you to communicate with the patient regarding the status of their account. These messages appear at the bottom of the statement/bill and are themselves based on the aging of the account. The system automatically progresses through these messages based on the total aging of the account, the last time a statement/bill was generated, and the last time the patient made a payment. You create these messages on the Patient Message tab (under Setup > Practice Preferences). ITEMIZED STATEMENTS
Practices have the ability to print an itemized statement on demand for those patients who require a specific detailed list of the different types of information posted to their account, regardless of the patient’s current billing status or the balance due amount. This is helpful when the patient needs documentation for major medical insurance purposes. The system prints one statement per patient, regardless whether you use sub‐accounts. This is different from the monthly statements/ bills in that the monthly statements are for the entire family.
TIP | You can also use this feature to print transaction histories within the specified time period for your patients, tailoring the statements to needs of the situation.
Itemized Statement Options
The options in this section allow practices to print a customized statement for a patient on an individual basis or for a range of patients. This module is not designed for printing monthly patient statements but for printing them on demand when necessary.
Aside from the options on this window, you have one more option on the Billing Preferences tab (under Setup > Practice Preferences) that affects Itemized Statements: Show Federal ID on Receipt. Automated Dunning Messages
14.15
Statements and Bills
Figure 14‐4 Itemized Statement Options
Choices Available for Printing Itemized Statements:
Field
Description
Show these procedure types
Choose the types of procedures you want to print on the patient’s itemized statement: Charges, Payments, Note procedures (only available when you check Payments), Write‐offs, Refunds, and/or Balance Forwards. For example, Mr. Smith called Advanced Family Practice and asked for them to send an itemized statement of all his payments to them since the beginning of the year. They chose only the Payments option and then the Patient option in the Criteria section.
Service Date
Select the range of dates when the services were rendered to include in the itemized statement(s). This field defaults to last year’s date range.
When you choose Sequence in the Order By section, MicroMD PM changes this date range to Posting Date and uses the posting date of the sequence.
Patient Name and Patient ID
Choose to print for a specific range of patients according to their name or account ID. These fields relate to the account level only and automatically include any sub‐accounts.
TIP | To select a single patient, click the Select Patient icon on the Task Pane.
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Itemized Statements
Statements and Bills
Track Code
Check this box to print an itemized statement that only includes procedures from the explosion code you selected from the associated drop‐down list. The Track Code option is only available when you choose Service Date in the Order By section and Both in the Criteria section.
TIP | You can produce an immunization history for children seen by your practice to provide as records to their schools or day care facilities. Be sure you have an Explosion Code created containing all of your vaccine codes so you can select that code from this drop‐down list. Statement Type
Choose the format in which you want the itemized statement to print. These two options allow you to specify the type of envelope you want to use so the addresses print appropriately for you.
Name to Print
Select which name you want to print on the itemized statement: the patient’s name or the name of the responsible party for that patient.
Criteria
Choose whether you want to print only patient‐responsible, insurance‐
responsible, or both patient‐ and insurance‐responsible transactions on the itemized statement. The system prints the type of transaction(s) you selected in the Show procedure types section of this window.
If the user selects Sequence in the Order By section, then the system disables these Criteria options.
Order By
Choose to arrange the entries on the statement by Service Date or by Sequence. When you choose to order the statement by sequence, the Service Date range fields change to Posting Date. This also enables the Sequence Detail option in the Misc Options section.
Show Diagnosis
With the onset of HIPAA regulations, MicroMD PM provides practices the option to suppress diagnosis codes and descriptions from printing on the patient’s itemized statement. To suppress the diagnosis when printing, be sure that there is no check mark in the Show Diagnosis checkbox.
The system takes the default for this checkbox from the Show Diagnosis on Receipt box on the Billing Preferences tab (under Setup > Practice Preferences).
Transaction Detail
The system enables this option when you check Sequence in the Order By section. Check Transaction Detail to print every transaction and its details on the itemized statement. When you check this box, the system disables the choices in the Procedure Types section but allows you to prevent notes from printing—in case your practice uses them for internal office purposes only.
Printing Itemized Statements
To print itemized statements, use the following procedure:
Procedure
Details
1. Select Billing > Itemized Statements from the main menu.
The Print Itemized Statements window opens.
Itemized Statements
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Statements and Bills
2. Select the appropriate patient(s) and document options.
3. Click the Print icon on the Task Pane.
The system retrieves the information and prints the itemized statement(s) as appropriate.
THIRD-PARTY STATEMENTS
When a third party such as an employer or an attorney is involved with the patient’s case, MicroMD PM allows practices to assign that third party to the sequence involved, even if there is no insurance plan associated with the sequence. Practices can then generate itemized statements for these entities in relation to a single patient or a group of patients associated with that entity.
NOTE | Even though the system uses the Employer List to store third parties, MicroMD PM only displays Employer entries for Employer search fields throughout the system.
Entering Third Parties into the System
MicroMD PM uses the Employer List for all of your third parties that might be involved with patient cases, including attorneys. In order to do this, each of the entries in the employer table must have an identifier. MicroMD PM already has the choices of E – Employer or A – Attorney you can use to identify new entries. Simply proceed as if you were going to create a new employer and be sure to assign the correct identifier in the Record Type drop‐down list.
Figure 14‐5 Record Type Drop‐down List
NOTE | If you need other types of third parties, you can add more under Setup > Master Table. From that drop‐down, choose Third Party Type and add more indicators as needed. These indicators then appear in the Record Type drop‐down list. Assigning a Third Party to a Case
If there is a third party involved with the patient’s case, you can create a new case and assign the appropriate party at that time or you can assign that third party to the case after posting. As long as you have the third party associated with the appropriate case when you generate the itemized statement for that third party, that patient’s case will appear on the statement.
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Third‐Party Statements
Statements and Bills
If the case associated with the third party does not involve an insurance company, you can still create a case in the system. Simply do not select a plan set from the Default Plan Set drop‐down list and do not select a plan set when creating the sequence in the Posting Module. Just make sure to select the appropriate case when posting charges.
Figure 14‐6 Assign a Third Party to a Patient’s Case
On the Cases tab, if this is the patient’s default case and you have not specified a plan set for this case, the system enables the Create Claim checkbox. (If you specify the plan set for the case, the system already knows that you want to create a claim, and therefore, does not need to provide a choice.) If you place a check mark in the Create Claim checkbox, MicroMD PM creates a claim to the primary plan indicated in the patient’s default plan set when staff members post charges against this case.
Generating a Third-Party Statement
The Third‐Party Statements are almost exactly like Itemized Statements on the individual patient level. However, there is an important difference. You can print detailed statements for each patient sequence or you can just print a summary of all the patient sequences associated with that third party. To print statements for a third party, select Aux > Third‐Party Statements from the main menu. This opens the Third‐Party Itemized Statements window.
NOTE | Sequences for a case associated with a third party do not appear on patient statements/bills unless you check the Inc 3rd Party checkbox on the Billing Options window.
NOTE | When you generate a third‐party statement, the system adds a note to the patient’s account and saves the statement in the Review Most Recent utility. This statement remains in the system for 35 days. Third‐Party Statements
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Statements and Bills
Figure 14‐7 Third‐Party Statement Options
Just make your selections and click Print in the Task Pane. You generate these statements just like the patient’s itemized statements, including selecting patients, procedure types, and the amount of detail you want on the document.
 In the Third Party section, you can choose the appropriate indicator for the third party for whom you want to print statements (e.g., employer or attorney). Choose this indicator from the Type drop‐down list. This filters the Name drop‐down to include only that type of entry. For example, if you choose A – Attorney from the Type drop‐down list. MicroMD PM filters the Name drop‐down to include only the attorneys you have created in the system.
 The Posting Date field allows you to include only those sequences posted within a certain date range on the statement(s) you print.
 In the Misc Options section, you have the following choices:
• Show Diagnosis: With the onset of HIPAA regulations, MicroMD PM provides practices the option to suppress diagnosis codes and descriptions from printing on the patient’s itemized statement. To suppress the diagnosis when printing, be sure that there is no check mark in this checkbox.
MicroMD PM takes the default for this checkbox from the Show Diagnosis on Receipt box on the General Preferences tab (under Setup > Practice Preferences).
• Transaction Detail: Check this box to print every transaction and its details on the itemized statement. When you check this box, the system disables the choices in the Procedure Types section but allows you to prevent notes from printing—in case your practice uses them for internal office purposes only.
• Consolidated: When you choose Consolidated from this section, the system disables the Show Diagnosis and Sequence Detail options and enables the Consolidated Options section. A consolidated statement can provide a list of patient sequences associated with the selected third party, along with each transaction within that sequence (choose the Detailed option from the Consolidated Options section). Or it can provide a simple list of sequences associated with the selected third party (choose the Summary option from the Consolidated Options section).
• The Statement Title field allows you to change the title on the third‐party statement. 14.20
Third‐Party Statements
Statements and Bills
Third-Party Report
With this module there is an associated Patient Report. With the Third‐Party Report (under Reports > Patient > Third Party), you can generate a report that displays each patient that has a case associated with a third party and a breakdown of the sequences associated with that third party. Figure 14‐8 Third‐Party Report Options
Report Options Available for the Third‐Party Report:
Field
Description
ID
To search for specific patients with third‐party cases by their MicroMD PM account number, enter the ID or range of IDs here. Leave the default value if you want to include all patients. For a single patient, enter the patient’s ID in both the From and the To field.
Name
To view third‐party cases for specific patients by name, enter the name or name range here. For a single patient, enter the patient’s last name in both the From and the To field. For a range of patient names (e.g., patients from Abercrombie to Connor or all patients from N through T), enter the range here.
Third Party
If you want to see only those sequences for cases associated with a specific third party, select the third party from this drop‐down list. You can also choose multiple entities from this list. The sequence must also meet all other criteria on this window.
Posting Date
When you choose Comprehensive from the Report Type section, MicroMD PM enables this date range. If you want to view sequences associated with a third party that were posted during a certain date range, enter that range here.
Service Date
When you choose Comprehensive from the Report Type section, the system enables this date range. If you want to view sequences associated with a third party where the service date on the sequence falls within a certain date range, enter that range here.
Third‐Party Statements
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Statements and Bills
Report Type
The options in this section allow you to choose the kind of report to generate.
 Standard: Select Standard to display a simple list of patients that have third parties attached to a case.
 Detail: Select Detail to show the same list as the Standard Report with additional case information.
 Comprehensive: Select Comprehensive to display all information from the Detail report and including a breakdown of the patient sequences, if any exist.
Show
This section provides additional display options for the report.
 Exclude Deceased: Check this box to prevent patients from appearing on the report who have a date listed in the Death Date field on their Patient Detail window.
 Zero Seq Bal: The system enables this checkbox when you choose Comprehensive from the Report Type section. When you check this box, the system includes those sequences associated with a third‐
party case, even if the balance on the sequence is zero. Payments may have already been applied to some of the sequences.
Group By
You can organize the information in the report by Third Party and/or Patient.
Sample Report
GM hired Advanced Family Practice to provide flu vaccinations for their employees beginning November 1,2009. Kim was sure to associate the General Motors third party with each employee’s case that pertained to the flu shot. Now she wants to see a breakdown of the sequences posted for the GM flu shots to date, and today is January 30,2010. When she generated the report, she chose the following options and left all others at their default values:
 Third Party: From this drop‐down list, Kim chose the General Motors entry.
 Report Type: From this section, Kim chose Comprehensive. This choice enabled the Posting Date and Service Date range fields.
 Service Date: Kim typed 11012009 in the From field and left the To field at its default value.
Explanation of the Report
When she generated the report, the system displayed all of the sequences in the system related to the case associated with General Motors where the service date on the sequence fell between November 1, 2009 and January 30, 2010. For this example, it is only a single sequence (number 643) for Anthony Smith who came in on 12/14/2009 for his flu shot. The total charges for which Kim would bill General Motors (when she generated the statement) is $209.00. This encompasses all patients with sequences posted for cases associated with General Motors/Lordstown as the third party.
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Third‐Party Statements
Statements and Bills
Figure 14‐9 Third‐Party Report
Third‐Party Statements
14.23
BILLING AND CLAIMS TOOLS
MicroMD PM contains some useful tools to help you to maintain the billing and claims data in your system.
IN THIS CHAPTER
In this chapter, we cover how to:
 View details about transactions in the patient’s account and access their account history
 Post “courtesy” write‐offs for negligible balances left on patient sequences
 Transfer responsibility for multiple sequences from Insurance to Patient
 Delete open claims in the system
BILLING INQUIRY
Billing inquiry allows you to view a patient’s entire transaction history and access that history from several different modules throughout the system, including the Patient Module and the Charges/
Payments Module. This module also has a drill‐down feature that you can use to go deep into the transaction to find the information you need.
You can access the Billing Inquiry window for a patient from a number of other windows, including the Patient Detail and Patient Sequences windows. Simply click the Billing Inquiry icon on the Task Pane. This takes you to the Billing Inquiry Module for the selected patient.
TIP | If you are in another module and need quick access to Billing Inquiry for your current patient or the last patient account with which you worked, press the Ctrl + F7 key combination.
You can also open the Billing Inquiry Module and search for a patient’s account, just like when you search for a patient in the Patient Module or in the Charges/Payments Module. Select Billing > Billing Inquiry from the main menu and select your patient.
In This Chapter 15.1
Billing and Claims Tools
Figure 15‐1 Billing Inquiry Window
Top Portion of Window
The top portion of the window displays aging buckets for the patient’s account. The system maintains an aging date for each sequence independent of the posting date. Whenever a new charge is posted, the aging date and posting date are initially the same date. The system updates the aging date automatically as the responsibility for payment of the sequence transfers from one insurance carrier to another (primary to secondary to tertiary) or from insurance to patient. The aging columns are based on the difference between the current system date and each sequence’s aging date. As a sequence ages, the system automatically moves the balance into the next aging column. When a change in responsibility occurs and the system resets the aging date, the remaining balance transfers back into the Current column.
Middle Portion of Window
The middle portion of the window contains information about the patient’s account, such as plan information and the last time the patient received a statement or bill. This section also provides some filtering choices for the window. You also have access to the floating toolbar.
Bottom Portion of Window
The bottom portion of the window displays the patient’s sequences. The system displays each sequence in alternating white and gray to enable you to scan through the transactions quickly. In addition, each sequence has a trailer band that displays posting and aging dates, patient name, rendering provider name, diagnosis codes, claim filing status, the service facility where the services were performed, and the amount due and who is currently responsible for payment of that amount.
NOTE | Amounts listed in red and in parentheses represent credits.
15.2
Billing Inquiry
Billing and Claims Tools
Most of the columns in this section are self‐explanatory; however, two of the columns bear some further explanation. The Balance and Total columns represent running balances, which is different than other windows in the system:
 Balance: This column displays the sequence balance after each line item is added.
 Total: This column displays the total account balance after each line item is added.
To view details of any line item, simply double‐click the transaction item. A new window opens, and you can use the scrollbar in the top section of the window to scroll to the other items in the sequence without closing this window. If you want to print the information displayed in the window, click the Print button in the top section of the window.
Filtering the Billing Inquiry Window
You can filter the list of sequences in this window to help you find exactly the information you want. When you choose these options, a sequence must match all of the criteria you set. For example, if you select a posting date range of 01/01/2010 to 01/31/2010 and you select a plan set for which the patient has nothing posted during that period, the system does not display anything.
 Plan Set: Select a plan set from this list to display only those sequences posted for the plan(s) within that set for this patient.
 Posting Dates: Enter a date range to display only those sequences posted during that period and click the Search icon on the Task Pane.
 Descending: Check this box to display the sequences in order from most recent service date to the oldest.
 Account: If your practice uses sub‐accounts, or family billing, a check mark in this box includes sequences for all sub‐accounts.
 Non‐Zero: Check this box to pull only those sequences that have a balance due, hiding any sequences that are fully paid.
Forcing a Statement/Bill
If your practice uses Cycle Billing and you need this patient to receive a statement or bill the next time the practice generates them, even if the patient is not actually due to receive one, place a check mark in the Force Stmt checkbox on the Billing Inquiry window for that patient. Printing Patient Receipts
There are a few ways to print patient receipts. You can print the patient a receipt from the Charges/ Payments Module; however, if you need to print a receipt for only specific transactions throughout a patient’s entire account, you can print that receipt from the Billing Inquiry Module.
Place a check mark in the P column next to each transaction line you want to include on the receipt. Click the Print Receipt icon on the Task Pane.
Editing a Claim
When you place a check mark in the P column next to a sequence item, the system enables the Edit Claim icon on the Task Pane. Billing Inquiry
15.3
Billing and Claims Tools
Viewing Account Notes
You can view the notes on the patient’s account. Click the General Note icon to view general account notes for the patient. Click the Sequence Note icon to view the notes entered for the sequence currently highlighted. Account Details
You can access the details of specific types of transactions posted to the patient’s account. On the Task Pane in the Billing Inquiry window, click the Account History icon. This displays the Account History window where you have easy access to view or print all of the payments, charges, adjustments and write‐
offs made to the patient’s account. TIP | To include sub‐accounts in this history, check the Account box before clicking the Account History icon.
Figure 15‐2 Account History Window
You can use the drill‐down feature to double‐click on any item (e.g., Daniel’s cash payment of $85.00) in the Account History window and see how that payment was disbursed. The system displays the selected item in bold. In our example, you see that $15.00 was applied to Daniel’s sequence 4, $30.00 to Daniel’s sequence 5, $20.00 to Peter’s sequence 1, and $20.00 to Andrea’s sequence 1—totaling $85.00.)
Notice also that the Account History window now displays ICD‐9 and ICD‐10 codes where appropriate.
15.4
Billing Inquiry
Billing and Claims Tools
Figure 15‐3 ICD‐9 and ICD‐10 Codes on the Account History window
Figure 15‐4 Sequences Window in Billing Inquiry
You can use the scrollbar in the top section of the Sequences window to scroll to the other items that appear in the Account History window without the need to close out of the Sequences window. If you want to print the information displayed in the window, click the Print button in the top section of the window.
Billing Inquiry
15.5
Billing and Claims Tools
Figure 15‐5 Payment Details Window
If you want to see even more detail about the payment, charge, adjustment, or write‐off, double‐click the item in the Sequences window to open a detail window for the item (e.g., the payment amount $15.00 on Daniel’s sequence 4). This allows a practice to view how users applied payments to each charge, what adjustments were made and by whom, etc. In the screen shot above, you can see how KIM applied the $15.00 of the original $85.00.
Transaction Details
You may have the patient on the phone asking about a particular payment—curious about how that payment was disbursed to services on their account. You can open their account in the Billing Inquiry Module and then you have a few options to find that payment:
 You can enter posting date of the payment in the Posting Date fields on the Billing Inquiry window. This filters the list so you can double‐click the payment line for which you want details and see how that payment was posted to the sequence. (This is true for other types of transactions as well.)
 If your practice uses the green and blue Payment Calculation windows faithfully and accurately, you can highlight a line in that sequence and click the Transaction Detail Sequence icon on the Task Pane to view a more visually sorted detail. The system highlights all charge lines of the sequence in gray, and you can see in a glance how payments, adjustments and write‐offs were applied.
If you want to print the information displayed in the window, click the Print button in the top section of the window.
 If your practice uses the green and blue Payment Calculation windows faithfully and accurately, you can click the Transaction Detail All icon on the Task Pane to view a more visually sorted detail of all sequences displayed in the Billing Inquiry window. The system highlights all charge lines of the sequence in gray, and you can see in a glance how payments, adjustments and write‐offs were applied.
If you want to print the information displayed in the window, click the Print button in the top section of the window.
BALANCE WRITE-OFF
Some practices exercise a “Courtesy Write‐off” for patient balances below a certain minimal dollar amount. Some practices also prefer to write off a nominal insurance amount left on a patient’s account. However, even though the practice wants to write off small dollar amounts left on patient sequences, if 15.6
Balance Write‐off
Billing and Claims Tools
the same patient has multiple sequences with a small amount due, that amount could add up. In that case, the practice would not want to write off all of those amounts.
The Balance Write‐off utility allows practices to specify the exact criteria that the amount must meet, assign the proper adjustment code to the write‐off, and delete the claim, if desired. You can search for sequences by responsibility, range of patients and dates, plan(s), category(ies) and provider(s). You can also edit the description of the adjustment code to clarify the reason for the write‐off.
The Balance Write Off Utility does not write off any of the adjustments to increase charge balances (including finance charges). Also, adjustments to increase charges do not qualify for this utility.
Figure 15‐6 Balance Write‐off Utility
To write‐off account balances:
Procedure
Details
1. Select Utility > Billing and Claims Utilities > Balance Write‐off from the main menu.
STOP | Always verify that you are about to post to the correct day sheet.
The Balance Write‐off Options window opens.
2. Enter all of the criteria that the sequence(s) have to meet to qualify for a balance write‐off.
3. Click Accept.
The system populates the report with all sequences that match the criteria you entered.
4. Place a check mark next to the sequences whose balance you want to write‐off.
Use the Select All and Deselect All icons on the Task Pane to help you select multiple patients.
5. Click the Print icon on the Task Pane.
You must print this report for your records before you can perform the batch write‐off. It gives you an audit trail of those patients you selected to write‐off their balance.
6. Once you print this report, click the Update icon on the Task Pane.
Balance Write‐off
15.7
Billing and Claims Tools
7. Confirm that you want to write‐off the selected The system posts the write‐off to the sequences you chose.
balances.
Options Available for the Balance Write‐off Utility:
Field
Description
Responsibility
Select the type of sequence balance you want to search. You have three options:
 If you select Patient, MicroMD PM returns patient‐responsible sequences for patients whose total patient‐responsible due on the account is less than the amount in the Max Patient Due field and the balance on the sequence is less than the amount in the Max Seq Balance field.
 If you select Insurance, the system returns insurance‐responsible sequences where the sequence balance is less than the amount in the Max Seq Balance field.
 If you choose Both, the system returns any sequence for patients whose total patient‐responsible due on the account is less than the amount in the Max Patient Due and where the sequence balance is less than or equal to the amount in the Max Seq Balance field.
When you select Insurance or Both, the system enables the Plan drop‐down list and the Plan Type options to narrow the search even further.
Patient ID
To search for eligible sequences of specific patients by ID, enter the ID or range of IDs here. Leave the default value if you want to search all patients. For a single patient, enter the patient’s ID in both the From and the To field.
Patient Name
To search for eligible sequences of specific patients by name, enter the name or name range here. For a single patient, enter the patient’s last name in both the From and the To field. Leave the default value if you want to search all patients. For a range of patient names (e.g., patients from Abercrombie to Connor or all patients from N through T), enter the range here.
Posting Date
To search for eligible sequences of specific patients that were posted within a specific date range, enter that range in these fields.
Plan
If you select either Insurance or Both in the Responsibility section, the system enables this drop‐down and you can choose to search for sequences posted to specific plans. Select the plan(s) from this list.
Category
To search for eligible sequences for patients within a certain Patient Category, select the category from this drop‐down list.
Providers
To search for eligible sequences posted to certain providers, select the provider(s) from this drop‐down list.
Write‐off Code
Choose the write‐off code or other adjustment code you want the system to use when it posts the balance write‐offs. You must select a code for the system to use in order to use this utility.
15.8
Balance Write‐off
Billing and Claims Tools
Description
When you select a code from the Adjustment Code drop‐down, the system automatically enters the code’s description in this field. You can then edit that description to reflect the reason for the write‐off.
Max Seq Balance and Max Patient Due
In the Max Seq Balance field, enter the maximum amount an individual sequence balance must be equal to or less than in order to appear on the report. This field works in conjunction with the Max Patient Due field, which indicates the portion of the patient’s account that is their responsibility to pay.
For example, a practice wants to write off any patient balances of $5.00 or less. What would happen if a patient had two (2) sequences of $5.00? The balance of those sequences would be $10.00 and larger than the practice wants to write off. The Max Seq Balance allows you to tell the system to write off a total sequence balance of $5.00 or less. The Max Patient Due field limits the total amount written off per patient.
Plan Type
If you select either Insurance or Both in the Responsibility section, MicroMD PM enables the Plan Type section, and you can further narrow your sequence search by indicating if the claim on the sequence is for the primary, secondary or tertiary carrier.
Delete Claim
If you select either Insurance or Both in the Responsibility section, the system enables the Options section and you can choose to delete any claim attached to the sequence once the system writes off the balance.
CHANGING SEQUENCE RESPONSIBILITY IN A BATCH
You learned earlier that the system keeps all unpaid claims in the system until staff members post payments from the carrier. During the billing process, the system automatically changes the responsibility of the sequence to the patient’s supplemental carriers, if the patient has any. If they do not have supplemental insurance, the system transfers the responsibility for payment to the patient.
You also learned that you can change the responsibility of a sequence manually on an individual basis if needed. If you need to change the responsibility for sequences of different patients or for multiple sequences for the same patient, you can use the Batch Responsibility Change utility to do this quickly. This utility even lets you post a transaction note item to indicate that the change was made. You can also delete any open claim attached to the sequence, if needed. This is particularly useful for those insurance carriers that send payments directly to the patient. To access this utility, select Utility > Billing and Claim Utilities > Batch Responsibility Change from the main menu.
Changing Sequence Responsibility in a Batch
15.9
Billing and Claims Tools
Figure 15‐7 Batch Responsibility Change Utility
Before using this feature, you must have the plans set up correctly. The system includes only those plans with the Change Resp checkbox marked on their Plan Detail window. You must also indicate in the # of days field on the Plan Detail window how many days should pass without a payment to a patient’s claim to this carrier before MicroMD PM includes the sequence in the Batch Responsibility Change utility.
STOP | You must use this feature CAREFULLY. Once you change the responsibility of a sequence to “Patient,” you can only change it back to “Insurance” one patient at a time.
To use the Batch Responsibility Change utility:
Procedure
Details
1. Select Utility > Billing and Claims Utilities > Batch Responsibility Change from the main menu.
STOP | Always verify that you are about to post to the correct day sheet.
The Batch Responsibility Change Options window opens.
2. Enter all of the criteria needed to return the sequences that you want to change responsibility.
3. Click Accept.
The system populates the report with all sequences that match the criteria you entered.
4. Place a check mark next to the sequences for which you want to change responsibility.
Use the Select All and Deselect All icons on the Task Pane to help you select multiple patients.
5. Click the Print icon on the Task Pane.
You must print this report for your records before you can change the responsibility of these sequences. It gives you an audit trail of those patients you selected to change responsibility.
6. Once you print this report, click the Update icon on the Task Pane.
15.10
Changing Sequence Responsibility in a Batch
Billing and Claims Tools
7. Confirm that you want to change the responsibility on the selected sequences.
The system changes the responsibility on the selected sequences from “Insurance” to “Patient.”
Even though the responsibility has changed, unless you chose the Delete Claim option, the claim remains with the insurance carrier. Only the responsibility changes so the patient receives a statement showing the amount as their responsibility or the patient receives a bill for the remaining balance, depending on the type of billing document they receive. Options for the Batch Responsibility Change Utility:
Field
Description
Patient ID
To search for sequences for specific patients by ID, enter the ID or range of IDs here. Leave the default value if you want to search all patients. For a single patient, enter the patient’s ID in both the From and the To field.
Patient Name
To search for sequences for specific patients by last name, enter the last name or range of names. Leave the default value if you want to search all patients. For a single patient, enter the patient’s last name in both the From and the To field.
Posting Date
To search for sequences posted within a specific date range, enter that range in these fields.
Balance Range
Enter the minimum and maximum balance you want the sequence balance to fall within to be included in the list the system returns when you click Accept. For example, if you want to include accounts with a balance no less than $5.00 and no greater than $50.00, you would enter 5.00 in the From field and 50.00 in the To field. Mr. Smith’s sequence that has a credit of $10.00 (which is a negative balance amount and less than $5.00) does not appear in the list.
Plan
To search for sequences posted to certain insurance plans, select the plan(s) from this list. The insurance plan must have the Change Resp box checked on its Plan Detail window. The system only includes those sequences posted to that plan if the number of days since a payment was posted exceeds the number in the # of days field on the Plan Detail window.
Category
To search for sequences of patients within a certain Patient Category, select the category from this drop‐down list.
Provider
To search for sequences posted to certain providers, select the rendering provider(s) from this drop‐down list.
Line Item Note
Choose the note procedure code you want the system to use if you want it to post a transaction note indicating that the responsibility on the sequence was changed. If you do not want to post a transaction line note, leave this drop‐
down set to (NONE).
Changing Sequence Responsibility in a Batch
15.11
Billing and Claims Tools
Description
When you select a code from the Line Item Note drop‐down, the system automatically enters the code’s description in this field. You can then edit that description to reflect the reason for the change if you want.
Plan Type
This section allows you to narrow your sequence search further by indicating if the claim on the sequence is for the primary, secondary or tertiary carrier.
Delete Claim
Check this box to delete the claim attached to the sequence once the system changes its responsibility.
DELETING CLAIMS
A sequence in MicroMD PM can have different aspects. One of the aspects of a sequence is that is can have a claim associated with it. If the practice has open claims with a zero balance or outstanding claims that have been in the system for a long time, you can clean up the database a bit using the Claims Delete utility.
Figure 15‐8 Claims Delete Utility
To use the Claims Delete Utility:
Procedure
Details
1. Select Utility > Billing and Claim Utilities > Claims Delete from the main menu.
The Claims Delete window opens.
2. Enter the appropriate information to return the claims you want to delete.
3. Click the Search icon on the Task Pane.
A list of open claims that match the criteria you entered appear in the window.
4. Remove the check mark from any open claims that you do not want to delete.
Use the Select All and Deselect All icons on the Task Pane to help you select multiple claims.
5. Click the Delete icon on the Task Pane.
6. Confirm that you want to delete the selected claims.
This only deletes the claim attached to the sequence, not the sequence itself.
7. Confirm whether you want to print a report listing the selected claims.
Once you make your choice, the system deletes the selected claims and transfers the responsibility of the sequence to the patient. The system then returns you to the Claims Delete window so you can delete more claims if needed.
15.12
Deleting Claims
Billing and Claims Tools
Options for the Claims Delete Utility:
Field
Description
Form Type
Select the Form Type used to submit the claims you want to delete. Remember that the sequence and the claim must also meet the rest of the criteria on this window.
Posting Date
To search for sequences posted within a specific date range, enter that range in these fields.
Claim Type
This section allows you to narrow your sequence search further by indicating if the claim on the sequence is for the primary, secondary or tertiary carrier.
Claim Status
You can search for only those claims of a certain status by indicating if the status on the claim is Print, Hold and/or Processed.
Paid Claims
Check this box to display only those sequences that are fully paid but that still have a claim associate with them in the system. The sequences also have to match the rest of the criteria established on the window.
Deleting Claims
15.13
USEFUL TOOLS
The system contains multiple utilities to help you work with your database, perform necessary functions, and monitor your database connections. Many of these utilities are not for the average staff member to perform so please be aware of the security options available to avoid inadvertent changes in data. IN THIS CHAPTER
In this chapter, we cover how to:
 Use reports to streamline workflow
 Tips and tricks with instructional video snippets
 Manage the practice’s business contacts
 Update contracted and allowed amounts in the system
 Archive a payment profile
 Copy a payment profile to create new plans quickly
 Update the fee for multiple procedures at once
 Use the system to help you comply with HIPAA regulations
 Track inventory
 Review the practice log and the system log
 Reconstruct database numbers
 Review a variety of documents recently printed
 Scan insurance cards and patient pictures into the system
 Quickly switch between practices and users
 Customize your workstation interface
REPORTS
From the main Menu, select Reports. A large menu of reports will be displayed. To learn more about the details of each report, please reference the MicroMD PM Reports Guide.
All reports previously including a drop‐down menu for diagnoses have been enhanced to include ICD‐10 codes as well as maintaining ICD‐9. Reports affected by this change are: Diagnosis History Report, Diagnosis Procedure Plan History Report, Referral History Report, Outcome Report, Diagnosis Report, Planned Visits Report, Last Visit Report, and Report Queues.
A sample can be seen in the screen shot below. Notice the user has the option to choose ICD‐9 or ICD‐10 codes.
In This Chapter 16.1
Useful Tools
Figure 16‐1 Choice of ICD‐9 or ICD‐10 on a report options window
The report results windows have also been modified to accept and display ICD‐10 codes.
Figure 16‐2 ICD Codes on the Diagnosis History Report
16.2
Reports
Useful Tools
CHC reports have also been modified to display ICD‐10 codes.
INSTRUCTIONAL VIDEO SNIPPETS
A series of short instructional video clips has been added to the PM to assist users with common tasks. Videos are signified by a green “Play” icon . Click the icon and the video will open up a media player and begin to play.
CONTACT MANAGER
MicroMD PM provides practices with a central phone book to house their business contacts. This list can contain global entries for all practices in the database and also entries specific to the practice. There is also a Contacts tab on the windows in the Maintenance Module and in each user’s Task Management account.
Contact List for the Practice
To access the practice’s Contact Manager, select Misc > Contact Manager from the main menu. This displays the Contact Manager window. You can search this window just like searching plans in the system. Click the New icon on the Task Pane to add a new business.
Figure 16‐3 Global Contact List
When you add a new entry to the Contact Manager, the system displays the Contact Detail window. This window allows you to enter as much or as little information as you need about the business on the Detail tab. Once you save your changes, the system enables the Contacts tab.
Figure 16‐4 Contact Detail Window
The Contacts tab allows you to record a list of people with whom you work at the company. To view details about a contact, highlight the contact in the upper portion of the window. The Contact Instructional Video Snippets
16.3
Useful Tools
Information section in the bottom portion of the window changes to reflect that contact’s details. Click the New icon on the Task Pane to add a contact to your list. Remember to save your changes.
Figure 16‐5 Contacts Tab
Phone Number Fields for Contacts
The phone number fields on the Contacts tab provide staff members with the ability to indicate the type of phone number they want to enter for this contact. The labels for the Business, Cell, Home and Fax are drop‐down lists with additional labels you can choose to identify the phone number more precisely.
This feature also stores the numbers you enter under each label. Even if you do not have them displayed, the system has saved the number you entered under the selected label. For example, you can save the contact’s home phone number under the Home label but choose not display it. Figure 16‐6 Phone Field Drop‐down
Simply click the label to access the drop‐down list. The system displays a check mark next to the phone number field labels that you have already used to store a number for this contact. Any label without a check mark is an empty slot. Select the label you want to use and enter you number.
NOTE | Changing a label only changes the label for that contact.
16.4
Contact Manager
Useful Tools
FEE UPDATE UTILITIES
Throughout the life of your system, you will need to update your fees, either because you raise rates or insurance companies raise (or lower) the amount they allow for procedures. The system allows you to perform mass fee updates, keep an archived copy of the last payment profile, and reset fees to the archived profile.
Allowed Amount Update
This utility allows the practice to update the contracted and/or allowed amounts in the same manner as the Procedure Fee Update utility allows you to update the procedure fee. You can update the amounts for a single plan or insurance class, or you can update multiple plans or classes. You can also restore the selected amounts (contractual or allowed) to the archived profile amount. To access this tool, select Utility > Fee Update > Allowed Amount Update from the main menu.
Figure 16‐7 Allowed Amount Update
Remember: MicroMD PM stores contracted and allowed amounts on two linked tabs. You can find those amounts on the Procs Allowed tab of the Plan Detail window (Maint > Plan) and on the Plan Allowed tab of the Procedure Detail window (Maint > Procedure).
To update contractual and/or allowed amounts with this utility:
Procedure
Details
1. Select Utility > Fee Update > Allowed Amount Update from the main menu.
The Allowed Amount Update Options window opens.
2. Choose the plan(s) or insurance class(es).
Choose whether you want to update allowed amounts for individual plans or for plans within certain insurances classes. Then select the plan(s) or class(es) from the drop‐down list.
3. Leave the Include Common Codes box checked To update contracted and/or allowed amounts on only those procedures specific to this practice, if you want to update contracted and/or remove the check mark from this box.
allowed amounts on procedures common to all practices.
Fee Update Utilities
16.5
Useful Tools
4. Place a check mark next to the action(s) you want MicroMD PM to take regarding the update.
The checkboxes in this bottom section of the window are the updates you want the system to perform. You must check one of these items to enable Based On fields and the Accept button.:
 Update Allowed Amount: Check this box to update the amount listed in the Allowed column on both the Procs Allowed and Plan Allowed tabs.
 Update Contractual Amount: Check this box to update the amount listed in the Contracted column on both the Procs Allowed and Plan Allowed tabs.
 Reset Contractual Amount to Allowed: Check this box to change the amount in the Contracted column to match the amount in the Allowed column.
5. Select the method you want to use to update the amounts you chose to update: by a specific amount or by a percentage.
The Based On fields are where you tell MicroMD PM whether to update the amounts by a specific amount (Flat Fee fields) or by a percentage (% Fee fields).
The system enables these options once you choose an action from the checkboxes at the bottom of the window.
When you choose the % Fee option, the system also enables the Round to Nearest Dollar checkbox so you can have the system round the resulting fee to the nearest dollar.
6. Enter the calculation amount in the Flat Fee or For example, increase the allowed amount by $10.00 or increase the allowed amount by 10%.
% Fee field as appropriate.
7. Click Accept.
The system populates the Allowed Amount Update window with a list of the items it is going to update. This is for review only. If you need to make adjustments to your options, click the Options button.
8. Once you are satisfied with the options you have made, click the Accept button on this window.
The system updates the amounts you indicated by the amount or percentage you indicated.
Payment Profile Archive
Practices have the ability in MicroMD PM to archive a payment profile. A payment profile is all of the contracted and allowed amounts per plan, per provider and per procedure in the system. The system 16.6
Fee Update Utilities
Useful Tools
keeps these in two places: on the Procs Allowed tab of the Plan Detail window and on the Plan Allowed tab of the Procedure Detail window.
When you archive the profile(s), the system assigns an effective date for that profile and maintains the new contract amounts while still posting payments with the archived profile without overwriting the new amounts. When staff members post payments, the system checks the service date of the procedure and uses the appropriate payment profile.
To access this utility, select Utilities > Fee Update > Payment Profile Archive from the main menu.
Figure 16‐8 Payment Profile Archive
Archive a Payment Profile:
Procedure
Details
1. Select Utility > Fee Update > Payment Profile Archive from the main menu.
The Payment Profile Archive window opens.
2. Leave the Include Common Codes box checked if you want to archive the profile for procedures common to all practices.
To archive the profile on only those procedures specific to this practice, remove the check mark from this box.
3. Choose the plan(s) or insurance class(es).
Choose whether you want to archive the payment profile for individual plans or for plans within certain insurances classes. Then select the plan(s) or class(es) from the drop‐down list.
4. Click the Options button.
A new window opens with the effective dates listed.
5. Verify the current profile and the new profile date for the plan(s) you chose. 6. Click the Accept button.
The system has now enabled the Accept button on the Payment Profile Archive window.
7. Click the Accept button on the Payment Profile Archive window.
Fee Update Utilities
16.7
Useful Tools
8. Confirm that you want to archive the payment profile(s).
The system archives all amounts for procedures posted to the plan, assigning the appropriate effective dates.
Remember: The system maintains the new contract amounts while still posting payments with the archived profile without overwriting the new amounts. When staff members post payments, the system checks the service date of the procedure and uses the appropriate payment profile.
Restore a Payment Profile
You can reset the payment profile of all the plan(s) in the system to the amounts in the archive. You must be careful, however, because you cannot undo this action. The system removes the current profile and replaces it with the archived copy.
To make the archived payment profile the active profile:
Procedure
Details
1. Select Utility > Fee Update > Payment Profile Archive from the main menu.
The Payment Profile Archive window opens.
2. Leave the Include Common Codes box checked if you want to restore the profile for procedures common to all practices.
To restore the profile on only those procedures specific to this practice, remove the check mark from this box.
3. Choose the plan(s) or insurance class(es).
Choose whether you want to restore the payment profile for individual plans or for plans within certain insurances classes. Then select the plan(s) or class(es) from the drop‐down list.
4. Click the Options button.
A new window opens. There is no need to change the effective date since the profile will be the current profile and there will be no archived copy.
5. Click the Restore button.
The system has now enabled the Accept button on the Payment Profile Archive window.
6. Click the Accept button on the Payment Profile Archive window.
STOP | You cannot undo this action. Be sure that you want to remove the current profile and replace it with the amounts in the archive.
7. Confirm that you want to restore the payment profile(s).
16.8
Fee Update Utilities
Useful Tools
Payment Profile Copy
Since many plans use the same payment amounts, MicroMD PM allows you to copy the payment profile information from one plan to another plan or to a group of plans.
Figure 16‐9 Payment Profile Copy
NOTE | This utility removes all existing payment profile information from the destination plan(s) and then copies both current and archived information from the source plan.
To copy a payment profile from one plan to another:
Procedure
Details
1. Select Utility > Fee Update > Payment Profile Copy from the main menu.
The Payment Profile Copy window opens.
2. Leave the Include Common Codes box checked To copy the profile on only those procedures if you want to copy the profile for procedures specific to this practice, remove the check mark from this box.
common to all practices.
3. In the Source Plan section, select the plan whose payment profile you want to copy to the other plan(s).
4. In the Destination Plan/Insurance Class section, choose whether you want to paste the payment profile to individual plan(s) or for plans within certain insurances classes.
5. Choose the plan(s) or insurance class(es) from the drop‐down list.
6. In the Information Selection section, place a check mark next to each amount you want to copy to the selected plan(s).
7. Click Accept.
Fee Update Utilities
16.9
Useful Tools
Procedure Fee Update
The Procedure Fee Update utility allows you to update the standard and/or Medicare fees by dollar, percentage, or relative value unit for all procedures. You can also update the fees listed on the Charges tab for the procedure to encompass those practices that charge different fees.
To access this utility, select Utility > Fee Update > Procedure Fee Update from the main menu. Figure 16‐10 Procedure Fee Update Utility
NOTE | This utility does not update the Fee column on the Plan Allowed tab of the Procedure Detail window. Please use the Allowed Amount Update utility to update that amount.
To update procedure fees:
Procedure
Details
1. Select Utility > Fee Update > Procedure Fee Update from the main menu.
The Procedure Fee Update Options window opens.
2. Leave the Include Common Codes box checked if you want to update fees for procedures common to all practices.
16.10
To revert all fees back to the value before you last updated fees, click the Restore button on this window. (There are no other options to select.) Skip to step 6 to finish.
To update fees for only those procedures specific to this practice, remove the check mark from this box.
Fee Update Utilities
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3. Select the method you want to use to update the amounts you chose to update: by a specific amount, by a percentage, or by the relative value unit (RVU).
The Based On fields are where you tell MicroMD PM whether to update the fees by a specific amount (Flat Fee fields), by a percentage (% Fee fields), or by the procedure’s relative value unit (RVU option).
For the RVU option, the system uses the RVU Multiplier drop‐down and the RVU field on the Procedure Detail window. When you choose the % Fee option, the system also enables the Round to Nearest Dollar checkbox so you can have the system round the resulting fee to the nearest dollar.
4. Enter the calculation amount in the Flat Fee or % Fee field as appropriate. (If you chose RVU in step 3, skip to step 5.)
For example, increase the allowed amount by $10.00 or increase the allowed amount by 10%.
5. Place a check mark next to the action(s) you want the system to take regarding the update.
The checkboxes in this bottom section of the window are the updates you want MicroMD PM to perform. You must check one of these items to enable Based On fields and the Accept button:
 Update Standard Fee: Check this box to update the Standard Fee field on the Procedure Detail window for the codes selected.
 Based on Medicare Fee: When you place a check mark in the Update Standard Fee field, the system activates this field. Check this box to update the standard fees on the Procedure Detail window based on a percentage of the current Medicare fees.
 Update Medicare Fee: Check this box to update the Medicare Fee field on the Procedure Detail window for the codes selected.
 Update Charges Tab: Check this box to update the appropriate fee field(s) on the Charges tab of the Procedure Detail window. If you check only the Update Standard Fee box, the system only updates the Standard Fee column on the Charges tab. The same is true with the Update Medicare Fee checkbox and the Medicare Fee column. This allows you to keep the rates of all practices in the system in sync.
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6. Click Accept.
The system populates the Procedure Fee Update window with a list of the procedures in the system. There is a check mark in the Update column for procedures the system will update when you click the Accept button.
You can remove the check mark from any procedure you do not want to update. You can also edit the New Standard Fee and the New Medicare Fee column per procedure if necessary.
If you need to make adjustments to your options, click the Options button.
TIP | If you have the Procedure List window open (Maint > Procedure) while you use this utility, MicroMD PM automatically selects only those procedures displayed in the list and deselects all other procedures.
7. Once you are satisfied with the options you have made, click the Accept button on this window.
The system updates the amounts you indicated by the amount or percentage you indicated.
HIPAA COMPLIANCY TOOL
With enforcing patient privacy rights an essential part of the medical industry, MicroMD PM provides a central location for you to manage your patient privacy standards within the system. The system allows you to establish an alert system for managing the privacy of each patient’s information, as well as printing documents patients need to sign. Once everything is set up, staff members start seeing an alert window popping up in the specified modules for patients regarding the specified categories.
The HIPAA Categories tab (under Setup > Practice Preferences) is the central setup location for enabling alerts and associating documents. The system comes installed with several standard HIPAA‐related categories. The HIPAA categories are completely user‐definable, can be used for any type of issue or item, and are not restricted to privacy issues.
Figure 16‐11 HIPAA Categories Tab
This feature is not restricted to use with privacy issues either. You can use this feature to create patient reminders for information you need to convey to the patient next time they make an appointment. For example, you can create a REMINDER category and then assign that category to Mrs. Smith and have it 16.12
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pop‐up only in appointments to remind her to bring her insurance card with her next time. You could also assign that category to Mr. Jones and have it alert the billing staff of a special issue with his claim.
To set up the HIPAA Categories:
Procedure
Details
1. Select Setup > Practice Preferences from the main menu.
2. Click the HIPAA Categories tab.
3. Either highlight an existing category to edit or click the New icon on the Task Pane to create a new one.
4. In the Category Description column, enter a This description appears in the alert pop‐up and should be brief.
useful description for the category.
5. From the Alerts & Sort Orders drop‐down lists, choose the modules you want staff members to be alerted and in what order.
6. From the Document Type drop‐down list, select whether the document is a text or mail merge document.
You can create a simple text document (i.e., files ending in “.txt”) or a mail merge document. 7. Click the Document Name field’s navigation button to select the document you want to print.
8. Repeat steps 3 through 7 for each category You can delete any categories you do not need. Just highlight the category and click the Delete icon on you want to edit or create.
the Task Pane.
9. Click the Save icon on the Task Pane to save Now when staff members enter the indicated modules for a patient, they will receive the your changes.
appropriate alerts.
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Columns on the HIPAA Categories Tab:
Field
Description
Category Description
This field displays the name of the HIPAA category defined for practice. When creating a new category or editing an existing one, be sure to use meaningful titles for users to understand quickly.
Alerts & Sort Orders
Practices can select the order in which the categories display in the alert window, instead of just Yes or No (with 1 appearing in the list first and 5 appearing last in the list).
 Billing: Turns on the HIPAA alert when a user accesses the patient in the Patient, Billing Inquiry and Charges/Payments Modules.
 Appt: Turns on the HIPAA alert when a user accesses the patient through the Appointment Module.
 Checkin: Turns on the HIPAA alert when a user checks in a patient in the Check‐In/Check‐Out Module using either the Arrival or Check‐in checkbox.
Reset Patients
Administrators can clear all patients of any alert by using the Reset Patients checkbox. Check this box for the category you want to change for all patients and save your changes. The system changes the alert(s) as you’ve indicated and then clears the Reset Patients box automatically.
Document Type
Choose between a text document or a mail merge document if your practice requires patients to sign a form or receive a specific document regarding the selected category. Users can print this document directly from the alert window.
When the user selects Mail Merge from the Document Type drop‐down, the system automatically selects the default HIPAA document in the Document Name column if no document has been selected already. Document Name
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Enter the path or filename of the text or mail merge document for this category. Use the browse button to navigate to the appropriate file.
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Using the HIPAA Alerts
The alert window appears at various points within MicroMD PM, depending on the options selected when setting up the category on the HIPAA Categories tab (under Setup > Practice Preferences). Green alerts are specific to the current patient and were set from within the patient’s account, while yellow alerts apply to all patients and were set from within the Setup Module.
Figure 16‐12 HIPAA Alert Window
If an alert category has a document attached to it that staff members must print, the system enables the Print button at the bottom of the alert window. Click a category row to make it the active category (indicated by bold text) and click the Print button. The document associated with the category automatically prints to your default printer.
NOTE | If you close the alert window without opening the alert, the system continues to display the alert until someone addresses it.
To mark a category as addressed, click the Open button on the alert window to access the patient’s HIPAA window. You can also access the HIPAA window from the floating toolbar throughout the program. Click the HIPAA icon to open the window for that patient.
Figure 16‐13 Patient’s HIPAA Window
The HIPAA window for the patient opens. For yellow alerts (those that apply to all patients), you mark the category as addressed by placing a check mark next to the appropriate category. The system automatically displays options on the right side of the window (just like those found on the HIPAA Categories tab) and enters today’s date. For yellow alerts, you do not have to do anything with the drop‐
downs that appear. These are mainly for the green individual patient alerts. For green alerts (those created for only that patient), you mark the category as addressed by removing the check mark from the appropriate category. Please see Creating an Alert at the Patient Level for more information on creating individual patient alerts.
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NOTE | Depending on the purpose of any alert, it may be for a constant reminder and does not need to be marked as addressed. Confirm this with your supervisor.
Once you mark a category, the system enters the user name and date addressed under the drop‐downs on the right side of the window.
Creating an Alert at the Patient Level
You can access the HIPAA window for a patient through the pop‐up alert window, or you can access the HIPAA window from the floating toolbar throughout the program. Click the HIPAA icon to open the window for that patient.
If you want to set the module to alert staff members to a category for this individual patient (appear as green alerts), place a check mark next to the appropriate category. The system displays the Alerts & Sort Orders drop‐down lists where you can tell MicroMD PM where to display the alert and in what order with any other alerts that occur. Once you save your changes, the system adds the user name and date created to the alert.
Adding an Alert to Your Task List
If you need to add a task to your list that relates to a patient’s HIPAA category, you can easily create a new task from within the patient’s HIPAA window. When you place a check mark in any category to either mark a yellow alert as complete or create a new green alert, you can then click the To‐Do button. This launches a new task item that you can then save to your list. Resetting Category Alerts
Administrators can clear all patients of any alert by using the Reset Patients checkbox. Check this box for the category you want to change for all patients and save your changes. The system changes the alert(s) as you’ve indicated and then clears the Reset Patients box automatically.
For example, Advanced Family Practice needs all of their patients to sign another notice of privacy policies this year. Everyone signed one last year, so rather than going into every patient’s HIPAA window to clear the check mark from the appropriate category, Jennifer simply checks the Reset Patients box for that category and saves her changes.
HIPAA Report
The system provides practices with a helpful report to show which categories have been fully implemented and for which patients. You can also view any notes entered for each patient regarding the categories. To access the report, select Reports > Miscellaneous > HIPAA Report from the main menu. Once you have a list of patients, you have the ability to print address labels and then export the data to use in Patient Letters. Please refer to the MicroMD PM Reports Guide for more information on the Patient Letters Report.
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TIP | You can also use this report to compile a mailing list for marketing materials. Be sure you use a category specifically for excluding a patient in marketing materials or fundraising. When you generate the report for this individual category, the system does not include patients with a check mark next to this category.
Report Options Available for the HIPAA Report:
Field
Description
Patient ID
To search for HIPAA category information of specific patients by ID, enter the ID or range of IDs here. Leave the default value if you want to search all patients. For a single patient, enter the patient’s ID in both the From and the To field.
Patient Name
To search for HIPAA category information of specific patients by name, enter the name or name range here. For a single patient, enter the patient’s last name in both the From and the To field. Leave the default value if you want to search all patients. For a range of patient names (e.g., patients from Abercrombie to Connor or all patients from N through T), enter the range here.
HIPAA Category
To review a list of those patients who have had a category addressed (e.g., they have received your Notice of Privacy Policies document and a staff member has placed a check mark next to that category for the patient), select the category(ies) from the drop‐down list. When you select a single category, the system allows you to view either those patient who have replied or those who have not.
Report Options
By default, MicroMD PM includes on the report only those patients who have had the selected HIPAA Categories addressed and any notes associated with the category for the patient. To enable the Patients Who Have Not Replied option, you must choose a single category in the HIPAA Category drop‐down list.
Group By
You can organize the information in the report either by Category or by Patient.
Sample Report
Family Planning Center has fully implemented their HIPAA policies, and now they have some fundraising materials that they want to send to all of their patients. They have a mail merged introduction letter they are going to send along with incentive information and invitations to a information event in a month. When they generated this report, they chose the following options and left all others at their default values:
 HIPAA Category: They chose the HIPAA Category they created called EXCLUDE FROM FUNDRAISING. Those patients with this category checked on their account have requested (or “replied”) not to receive any materials or phone calls regarding fundraising.
 Report Options: They chose the Patients Who Have Not Replied option. Since the practice has marked all of the patients in their system that have elected not to have fundraising materials HIPAA Compliancy Tool
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sent to them, those patients with this category unchecked have not requested (or “replied”) to be excluded from fundraising efforts.
When the practice generates this report, they then use this report to print address labels and then export the data to a temporary holding area. They have created two mail merge documents: an introduction letter they want to print on their letterhead and a personalized invitation to the event. They want to include both of these documents in a packet they are sending to each patient.
To print the address labels, simply click the Print Labels icon on the Task Pane. To export the data to the Patient Letters report, click the Mail Merge Export icon on the Task Pane. Open the Patient Letters report (under Reports > Correspondence/Letter > Patient Letters) and click the Mail Merge Import icon on the Task Pane. (Refer to the MicroMD PM Reports Guide for more details on the Patient Letters report.)
INVENTORY TRACKING
The system can help you keep track of your inventory items. Once you have the system set up to help you out, you can generate an inventory report to see what you have in stock, what you need to re‐order, which patients were charged for the inventory items, and how much was charged to the patient.
Setup and Posting
First, you need to create procedure codes in the system for those items you want to track. When you create procedure codes for inventory items, make sure you place a check mark in the Inventory box and enter the number of units you have in stock for that item in the Qty field.
TIP | If you need to charge sales tax for an inventory item, also remember to place a check mark in the Taxable box for the procedure. When staff members post an inventory procedure, the system displays the current number of items in inventory. When they save their posting activity, MicroMD PM subtracts the number of units posted from the procedure’s Qty field.
You can edit the Qty field at any time. This allows you to adjust the quantity if someone made a posting error and adjusted off an inventory procedure, if an item is returned, or if you receive a shipment of supplies.
NOTE | Adjusting off an inventory item does not add that item back into the inventory count. You must manually adjust the inventory count in the Procedure Detail to add the item back into inventory.
Inventory Report
Once you have your inventory established and are using MicroMD PM to help you track it, you can generate the Inventory Report. This report provides a way for practices to quickly see supplies they have in stock, aside from any items recently adjusted that have not been added back into the inventory.
NOTE | The report lists the number that appears in the each procedure’s Qty field.
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To generate this report, select Reports > Miscellaneous > Inventory Report from the main menu. Select your options and click Accept.
Report Options Available for the Inventory Report:
Field
Description
Service Date
The system enables this field when you choose the Detail option in the Report Type section. To view an inventory of those items posted to patient accounts for services rendered during a specific date range, enter that range in these fields.
Procedure
To view an inventory status of certain inventory procedures, select the procedure(s) from this list.
Report Type
The options in this section allow you to choose the kind of report to generate.
 Summary: Select Summary to display a simple list of inventory procedures and the current quantity in stock.
 Detail: Select Detail to show a list of inventory procedures, the patient accounts to which the codes were posted, the number of units posted and the charge associated with the posting. A Detail list also shows the current quantity in stock for each item. When you select Detail, the system enables the Service Date fields.
Sample Report
Advanced Family Practice is doing their month‐end inventory so they can restock their shelves. Since they track all of their inventory through MicroMD PM, they simply have to generate a summary report and compare the list with how much they normally keep in stock. When they generated this report, they left all fields at their default values and clicked the Accept button.
Figure 16‐14 Sample Inventory Report
PRACTICE/SYSTEM LOG
The system keeps a set of audit logs for you: the Practice Log and the System Log. Select Misc > View Practice/System Log from the main menu. When you first open this set of logs, MicroMD PM displays the Practice/System Log
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interface for the Practice Log. To toggle to the System Log, click the System button at the top of the window. This button then changes to Practice. Click the button again to go back to the Practice Log.
Figure 16‐15 Practice/System Log
You can print any of the windows if necessary. Click the Print button at the top of each window to print the displayed information.
Information Tracked
The Practice Log tracks and displays information relating to changes made within the individual practice in the database. This log tracks the following information for each practice:
 Deleting a patient account, including when someone deletes a sub‐account
 Deleting a procedure code specific to the practice
 Deleting a diagnosis code specific to the practice.
The System log tracks and displays information relating to changes made to the entire system that affects all practices in the database. This log tracks the following information:
 Deleting a plan
 Deleting a procedure code universal to the system
 Deleting a diagnosis code universal to the system
 Deleting a service facility
 Deleting a referring doctor
 Deleting an explosion code
 Deleting an employer
Searching the Logs
You have the ability to search each log for those entries created within a specific date range. In the Dates fields, select the starting date and ending date for the range you want to search. The system defaults to the past year, with the current system date as the To date.
TIP | Click the (RANGE) button to set the From field to 01/01/
1900 and the To field to 12/31/2050. This searches all entries created in the system from the earliest possible date to the latest possible date.
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You can also search for those entries that contain specific words or phrases. In the Note Text field, simply type the text you want to find and press Enter. The window sorts itself and displays only those log entries that contain the text you entered.
TIP | If you need to see log entries related to actions taken by a certain system user, type their user name in the field as the text you want to find.
Viewing Deleted Transactions
While you are in the Practice Log, you can view transactions deleted for patients in the current practice. Click the View Trans button. This opens the Deleted Transactions window that displays all line items deleted from this practice’s patient accounts. These deletions can happen for any number of reasons, including when staff members correct posting mistakes.
RECONSTRUCT NUMBERS
There could be times throughout the life of your database (e.g., after your initial data conversion, after a database split when a provider leaves) that you need to have the system give the data identifier numbers in the database a “shake.” When a staff member tries to create a new patient account, employer, class, plan, etc. in the system after such an event, the system could try to assign an identifier that already exists. Look at it as a column of data that is sorted out of order. In the screen shot below, the last patient identifier in the list isn’t actually the last one.
Figure 16‐16 Reconstruct Numbers Analogy
Reconstruct Numbers
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The Reconstruct Numbers utility is like clicking the column header to resort that column of data in ascending order so the system knows what the last account number really is. Then when the system tries to assign the next account number, it is a valid number.
STOP | Only run this utility when instructed to do so by the system or your local authorized reseller. You must make sure that all users have exited all modules of the system before you run this utility.
To access the utility, select Utility > Reconstruct Numbers from the main menu. Once all users have exited all modules, click the Reconstruct icon on the Task Pane. The system displays the status in the window, and you can close it when finished.
REVIEW MOST RECENT
The Review Most Recent utility provides extreme flexibility in viewing a history of certain printed items. You can view and print the most recent Claims Report, Day Sheet, Deposit Slip, and EOB. Most popular, though, is the ability to view the most recent Statements/Bills and Statement/Bills Summary of the last billing period. All of these items can be viewed in PDF format in a web page environment, allowing you to search through a history of previous reports. This electronic document format maintains a history of the PDF files generated during the prior 35 days. The layout is the same for all.
STOP | You must click Yes when prompted to save the report for later viewing as you generate the documents in the first place. This is when the system saves the PDF file for you to display with this utility.
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Figure 16‐17 Review Most Recent Utility
To use this utility, select Utility > Review Most Recent and select the type of documents you want to review. The left pane of the window displays the system name for the PDF to help you identify the printout you want to view. The Created column is the date you printed and saved the item for later viewing. Click any link to view that document.
MicroMD PM separates statements/bills into individual PDFs. When you print a batch of statements/
bills, the system labels the main link with a name for the batch of documents and then displays a triangle next to the link. Click this triangle or the link to expand the list. You can then click the statement/bill you want to view.
If you want to print the selected report again, click the Print icon in the PDF section of the page. DO NOT select File > Print from the main menu. This will only print the left pane of the web page window. You must print from the PDF window in the right pane.
SCANNING
With ever‐increasing patient privacy issues, MicroMD PM provides practices (and their remote sites) with a way to scan insurance cards and identifying pictures to avoid copies of the card floating around the Scanning
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office with the chart and to verify the patient you are speaking to is, in fact, the patient. This feature is already in your system and just needs a scanner to recognize.
NOTE | You can use any TWAIN‐compliant flatbed or business‐
card scanner.
You can find the scanning feature in the Patient Module. On the Patient Detail window for the patient, there is a Patient Picture icon at the top of the window. On the Plan Sets tab, there is an Insurance Card icon to the right of the effective To date field. These icons turn yellow when there is a scanned image available for the patient.
Setting Up Scanning Module
Unless you have multiple scanners or cameras on your network, or you want to change the location where MicroMD PM stores your images, there is no set up you need to do to use the Scanning Module. The system automatically sets the path of all stored images to the same directory as the database and automatically finds the scanner connected to your computer.
If you do want to make changes, the setup options are workstation‐specific and can be changed by the user if needed; however, if you need to change the storage location, only a supervisor or equivalent can change the path and save that change. To access the setup options for the Scanning Module, open either the Patient Picture window or the Scan Insurance Card window. Click the Setup icon on either window.
Figure 16‐18 Scan Setup Window
You can set the following options from the Scan Setup window:
 To choose a specific scanner or camera, click the Select Scanner icon. Choose the appropriate device and click Select. Be sure to save your changes before closing the main setup window.
 If you ever want to print the patient picture or insurance card, you can tell the system a little about how to print the images. Click the Print Options icon on the Scan Setup window. This opens the Print Sizing window with the following options:
• Print Size Multiplier: Choose the magnification at which you want MicroMD PM to print scanned images in the system when a user prints them. For example, choose 2 from the drop‐down to print any images at twice their original size when anyone prints them.
• Landscape: Check this box to print any images in landscape mode (i.e., 11” x 8½”).
• One Page Print: Check this box to print both sides of an insurance card on one side of a single sheet of paper.
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• OCR Patient Picture When this option is selected, scanning a driver’s license will return only the photo, not the entire license.
TIP | Be sure to save your changes before closing the main setup window.
 To get the latest version of you scanning software, click the OCR Update icon. The system will open an update window.  To change the storage location for stored images, click the Select Path icon next to the displayed path. Navigate through the network tree to point MicroMD PM to the appropriate folder and click OK. Make sure you click the Save icon to commit your changes before you close the setup window.
Attaching Previously Scanned Images
If there is already a scanned image already available for the patient’s insurance card, you can link it to the patient’s account. Click the Select Image icon at the top of both the Scan Insurance Card window and the Patient Picture window. Browse to the appropriate image and click Open. NOTE | Scanned images must be in the PNG format. The system does not support any other image file format.
Viewing and Printing Images
The system changes the Patient Picture icon and the Insurance Card icon to include a yellow background when there is an image attached to the patient’s account. Simply click the icon to view the image(s). You can zoom in on the picture. Just click the image to zoom. Click again to zoom in closer.
If you want to print the image, click the Print icon at the top of the image window you have open. The system prints the patient’s picture or insurance card with their name and account number included at the top of the page.
Scanning
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Insurance Cards
When you scan a patient’s insurance card, the system allows you to scan both sides of the card, whereas you only need to scan a single image for a patient picture. When an insurance card exists for that plan, the background color for the icon on the Plan Sets tab of the Patient Detail window changes from gray to yellow. Click the icon to view the associated image(s).
Figure 16‐19 Scan Insurance Card Window
To scan an insurance card from within MicroMD PM:
Procedure
Details
1. Open the Patient Detail window for the appropriate patient.
2. Select the Plan Sets tab.
3. Click the appropriate plan on the left side of the tab.
4. Click the Insurance Card icon.
This icon is next to the Effective date fields. The Scan Insurance Card window opens.
For instructions on using your scanner, please 5. To scan the front of the card, click the Acquire Image icon at the top of the left panel and follow refer to the reference materials provided by the manufacturer.
the instructions for your scanner.
6. To scan the back of the card, click the Acquire Image icon at the top of the right panel and follow the instructions for your scanner.
7. When you have the card scanned the way you want, click the Close icon.
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The system automatically saves the image for you in the path indicated in the setup window.
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Patient Pictures
To help you identify patients you see in the office, the system provides the ability to scan and store patient pictures. You can scan a picture provided by the patient when they register the first time (e.g., scan their driver’s license). You can also use a digital camera and retrieve the picture from the camera.
Figure 16‐20 Scan Patient Picture Window
To enter a patient’s picture into their account:
Procedure
Details
1. Open the Patient Detail window for the appropriate patient.
2. Click the Patient Picture icon.
This icon is at the top of the Patient Detail window next to the floating toolbar.
The Patient Picture window opens.
3. To scan a patient’s picture or retrieve the image For instructions on using your scanner or camera, please refer to the reference materials from a digital camera, click the Acquire Image provided by the manufacturer.
icon at the top of the window and follow the instructions from your scanner or camera.
4. When you have the picture in the system, click the Close icon.
The system automatically saves the image for you in the path indicated in the setup window.
OCR Scanning
With the proper hardware and software specifications, MicroMD PM can populate some demographic and plan data into the Patient Module when you scan a patient’s driver’s license and insurance card. Scanning with an optical character recognition (OCR) scanner saves time and reduces potential errors Scanning
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when entering information. The system can also capture the photo on the license and save it as the patient picture.
NOTE| Contact your local reseller for more information on OCR compliant scanners. You will also need to obtain a key code to take full advantage of these features.
For example, when a patient comes into the office for the first time, staff at the front desk can take the patient’s insurance card and driver’s license and quickly populate some demographic and insurance plan fields by simply using OCR scanning.
Scanning Insurance Cards
If you click the Acquire/OCR Image icon on the Scan Insurance Card window to scan the card of a patient with no plan information in the system, the system populates data in the Plan Sets tab when you click the Update Patient Information icon. NOTE | You also need to complete at least two fields on this tab after the scan is complete: Plan ID and Relationship. The system displays a warning if you try to navigate away from this tab without filling out these fields.
If you click the Acquire/OCR Image icon to scan the insurance card of a patient with insurance information already saved, the system warns you that the new scanned information will replace the information already saved for the patient.
To use OCR scanning on an insurance card:
Procedure
Details
1. Open the Patient Detail window for the appropriate patient.
2. Select the Plan Sets tab. 3. Click the appropriate plan on the left side of the tab.
NOTE | You need to create and save a plan before scanning the card of a patient with no plan information already saved.
4. Click the Insurance Card icon.
The Scan Insurance Card window opens.
5. Click the OCR icon at the top of the left panel and follow the instructions for your scanner.
For instructions on using your scanner, please refer to the reference materials provided by the manufacturer.
6. When you have the card scanned the way you want, click the Close icon.
The system automatically saves the image for you in the path indicated in the Scan Setup window and populates the data into the Plan Sets tab.
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Scanning Driver’s Licenses
If you click the Acquire/OCR Image icon on the Scan Patient Picture window to scan a patients’ driver’s license, the system populates select demographic data into the Detail tab of the Patient Detail window when you click the Update Patient Information icon.
NOTE | If you use the OCR option to scan the driver’s license of a patient with demographic information already saved, the system replaces some fields with information from the card. The system will not delete other demographic information not identified from the scan.
Saving a Patient Photo from a Driver’s License
Using OCR scanning, you can save the photo from a driver’s license as a patient photo. For practices with MicroMD PM + EMR, the system also saves the patient photo in MicroMD EMR. To scan a patient picture from a driver’s license: Procedure
Details
1. Open the Patient Detail window for the appropriate patient.
2. Click the Patient Picture icon located to the left of the floating toolbar. The Scan Patient Picture window opens. 3. Click the Setup icon.
The Scan Setup window opens. 4. Click the Print Options icon.
The Print Size window opens. 5. Place a check mark in the OCR Patient Picture checkbox.
6. Click the Save Settings icon. 7. Click the Close icon on the Print Size window. 8. Click the Close icon on the Scan Setup window.
9. Click the Acquire/ OCR icon on the Scan Patient Picture window.
For instructions on using your scanner, please refer to the reference materials provided by the manufacturer.
10. Click the Update Patient Information icon to save the photo in the patient’s profile. The system automatically saves the image for you in the path indicated in the Scan Setup window and populates the data into the Detail tab of the Patient Detail window.
11. When you have the card scanned the way you want, click the Close icon.
Scanning
16.29
Useful Tools
SWITCHING DATABASES
If you have multiple databases, you can switch them while working in MicroMD PM. Select Misc > Set Database from the main menu. The system displays a list of databases in the system. Double‐click the database name. You can also highlight the name and click Accept.
TIP | You can also change the database by clicking the Database button on the Login window. SWITCHING PRACTICES
If you have multiple practices in the selected database, there are probably users who have access to more than one practice. The Set Practice tool allows you to pick the practice in which you want to work. Select Misc > Set Practice from the main menu. The system displays a list of practices in the system. Double‐click the practice name. You can also highlight the name and click Accept.
TIP | You can also press the F9 function key on the keyboard to flip through the practices in the database.
SWITCHING USERS
There are times when multiple users access the system from the same machine. In a busy office, one user hops off, another hops on. The Set User tool allows you to return to the login screen without the need to close MicroMD PM, search for the shortcut on your desktop, and then launch the program again. You can just select Misc > Set User from the main menu. This logs the current user out of the system and displays the login screen for the next user.
TIP | You can also press the Shift + F9 key combination to perform the same action.
WORKSTATION SETUP
The Workstation Setup utility allows you to customize some of the user interface properties of the system for each workstation. You can set the e‐mail and Internet integration options, and you can designate the word processing program, the location of the PDF version of the MicroMD PM manual and the location of the MicroMD PM help file.
16.30
Switching Databases
Useful Tools
Display Properties
You have the following options available to determine what the system displays in terms of pop‐up windows, as well as window resizing, etc. To access a workstation’s display properties, select Utility > Workstation Setup > Display Properties from the main menu. Figure 16‐21 Display Properties
The system saves these settings per operating system user, not by system user. For example, if you set windows to a particular size, when you log into any computer under your username and password, the windows appear at that size.
Options Available for the Workstation’s Interface:
Field
Description
Drop‐down Calendars
Uncheck this box to disable the drop‐down calendar that appears in the date fields throughout the system.
Drop‐down Calculators
Uncheck this box to disable the drop‐down calculator that appears in the amount fields throughout the system.
Flat Look
Uncheck this box to give the system a three‐dimensional look similar to previous versions of the program.
Display Appt Details
Check this box to always view the Appointment Detail window when you double‐click an entry in the Check‐In/Check‐Out Module. Charge Slip List
Check this box to enable the Charge Slips pop‐up window in the Charges Module. Pending Charges List
Check this box to enable the Pending Charges pop‐up window in the Charges Module. This is used with the MicroMD EMR and Henry Schein Secure Chart Patient Portal (available in Version 12).
Temporary Patient List
Check this box to enable the Temporary Patients pop‐up window in the Patient Module. Workstation Setup
16.31
Useful Tools
Appointment Request List
Check this box to enable the Appointment Request pop‐up window in the Appointments Module. This is used in conjunction with the MicroMD family of mobile products. Charges/ Payments Default
From this drop‐down, choose which screen the system displays (Accounts, Charge Slips or Pending Charges) when you when you open the Charges/ Payments window. Automatic Logout in Minutes
Set the number of idle minutes that must pass before the system logs the workstation out. If you enter zero (0) or leave the field blank, MicroMD PM never logs the workstation out automatically.
Datawindow
For those remote users, the connection could distort the color of the window backgrounds in the program, making it difficult to see. To correct this, you can select a better color as the background. Select Custom from the drop‐
down list. The Color window appears. Select a basic color or create a user‐
defined custom color. Reset Window Sizing
Click this button to return all windows that were resized in the program to their default size. You must close all windows at the workstation before you open the utility and click this button.
Documentation Paths
To designate the path to the word processing program, the MicroMD PM User’s Reference Manual or the MicroMD PM help file, select Utility > Workstation Setup > Documentation Paths from the main menu. Enter the path and filename of the program or file. Use the Browse button to find the program, if needed. Click Accept when finished.
Third-Party Applications
The system has e‐mail and Internet address fields where you can double‐click the field, and the system launches the appropriate software program with the address already entered. In these cases, MicroMD PM needs to know which software program to open for you. To access this window, select Utility > Workstation Setup > Third‐Party Applications from the main menu. Make your choices and click Accept.
Figure 16‐22 Third‐Party Applications
In the E‐Mail Integration section, you can indicate that you do not want to use the e‐mail fields to launch a program. Choose the Not Active option. If you have Microsoft Outlook and want to use that program to send e‐mails when you double‐click an e‐mail address field, choose the Outlook option. If you have any other MAPI‐compliant e‐mail software, choose the Other MAPI Compliant option.
In the Internet section, check the Internet Options Active checkbox to enable the ability to double‐click an Internet address field and go straight to that web site using your default internet provider.
16.32
Workstation Setup
Useful Tools
Version Refresh
This utility allows staff members to force the system to update from the server the next time they launch MicroMD PM. To update the workstation from the server the next time you launch MicroMD PM, select Utility > Workstation Setup > Version Refresh from the main menu.
Workstation Setup
16.33
COLLECTION MODULE
Each practice has the ability to make every attempt to collect an amount due from a patient BEFORE they send the patient’s account or sequence to a collection agency; therefore, we call that part of the module “Pre‐Collection.” This involves a series of “pre‐collection” letters. If you choose not to use Pre‐
Collection, you can move patients directly to the Collection Module and turn them over to the collection agency based on account or sequence delinquency.
IN THIS CHAPTER
In this chapter, we cover how to:
 Create and assign pre‐collection note category
 Create billing messages based on the aging of the patient’s account
 Automate the messages
 Create pre‐collection letters
 Print pre‐collection letters
 Set up and use sequence‐based collections
 Set up and use account‐based collections
OVERVIEW
Account‐based and sequence‐based collections work the same right until the point where you refer the patient to the collection agency. You can still send the patient dunning (or warning) messages on their statements/bills and then send them pre‐collection letters when the messages run out, even when you choose sequence‐based collections. STOP | To maintain the integrity of your financial records, you must be careful when choosing to switch your collection method. Carefully plan for implementation before you proceed to make changes.
With the Collection module, you also have the ability to maintain a list of collection agencies with whom you work to recover the money owed to the practice. When you turn sequences over to the collection agency, you have the added benefit of linking the agency with the sequence(s). If you choose sequence‐based collection, you can look at the Patient Sequences window in the Responsibility column to see which sequences are currently in collections. You can also generate a report that lists all patient sequences currently with a certain agency.
PRE-COLLECTION
Pre‐collection works the same as it always has and is the same for both account‐based and sequence‐
based collections. The system provides each practice the ability to make every attempt to collect an amount due from a patient BEFORE they refer the patient to a collection agency; therefore, we call this part of the module “Pre‐Collection.”
In This Chapter 17.1
Collection Module
The first step in the pre‐collection process is warning the patient that they are falling behind on amounts they owe to the practice. Practices can include messages on the patient’s statements/bills as these amounts become more delinquent. After the patient’s account progresses through the all the warning messages, you have two options:  You can send the patient your own “pre‐collection” letter(s) that give the patient additional opportunities to pay the amount they owe before you send their account or sequence(s) to the collection agency. To print letters, you use the Pre‐Collection Process report.
 Or, you can send their account or sequence(s) straight to the collection agency without going through the pre‐collection letters.
The action you take is up to you and the policies established by your practice. To set up the Pre‐Collection Module, you need to do a few things:
 Establish a special note category
 Establish patient warning messages
 Decide if you want to print pre‐collection letters
 Create pre‐collection letters and assign them to a pre‐collection aging bucket
NOTE | At any point in the pre‐collection process, when a staff member posts a personal payment from the patient, their account is brought back up to date and automatically taken out of the Pre‐Collection Module the next time the practice prints statements/bills.
Once the patient has been turned over to the collection agency in an account‐based collections system, you must manually bring their account up to date. In a sequence‐based collections system, the act of posting the payments from the collection agency automatically brings the patient back up to date.
Establish Pre-Collection Note Category
In order to use the Pre‐Collection Module, one of the first steps you need to do is create a Note Category for the system to use for pre‐collection notes (or verify that you have one created in the system) and tell the system which Note Category is your pre‐collection note.
You need to:
 Verify that you have a Note Category created called PRE‐COLLECTION NOTE (or a similar name). If not, select Setup > System Classes/Categories from the main menu. Click the Notes Category tab and enter both new categories.
 Verify that MicroMD PM knows which category it should use with automated pre‐collection notes in the system.
Select Aux > Collection > Setup from the main menu. Click the Pre‐Collection tab. From the Pre‐
Collection Notes Category drop‐down, select the appropriate Note Category for any notes relating to pre‐collection activities. Anytime the system prints a pre‐collection letter for the patient, the system will use this Note Category when it records this activity in the Notes tab of the Patient Detail window.
17.2
Pre‐Collection
Collection Module
Automated Billing Messages
The other major component in the pre‐collection process is the automated billing messages. Statements and bills each contain a billing message that allows you to communicate with the patient regarding the status of their account. These messages appear at the bottom of the statement/bill and are themselves based on the aging of the account. The system automatically progresses through these messages based on the total aging of the account, the last time a statement/bill was generated, and the last time the patient made a payment. NOTE | If you do not want to use the billing message feature, remove the check mark from the Auto Message checkbox on the Billing Preferences tab (under Setup > Practice Preferences). This does not add or remove the check mark from existing patients; however, it sets the default for new patients created in the system and turns the feature on and off.
Creating Patient Messages
You create these messages and assign them to an aging bucket on the Patient Message tab (under Setup > Practice Preferences). Patient messages print on the bottom of statements and bills, depending on the number of aging days specified in the From and To fields for each message on this tab and the patient’s last payment date. There must also be a check mark in the Auto checkbox on the Patient Detail window.
Figure 17‐1 Patient Messages Tab
NOTE | The practice must have at least two messages listed on this tab for the system to progress a patient through pre‐
collection.
To create patient messages, click in the message row and edit the Message Description. This is the actual text of the message that prints on the statements/bills. Set the From and To days, creating a “bucket” that the system uses to determine which message to print. Pre‐Collection
17.3
Collection Module
NOTE | We recommend that you add no more than four messages.
Progressing Through Messages
The system determines when to advance to the next dunning message based on the date of the patient’s last payment and the highest aging bucket in which there is a patient due amount. The system displays the billing message recently sent to the patient in the Message drop‐down on the Patient Detail window.
Figure 17‐2 Patient Message
The system starts with the first message for every new patient. When you print statements/bills, the system prompts you to update patient messages. The system stores the choice you make for the next time you generate statements/bills. When you print the patient’s next statement/bill and the patient has made a payment within that time, the message does not progress to the next message and resets to the first message (message 0) when you print the new statement/bill. If the patient has not made a payment within that time, however, MicroMD PM advances to the next message when it prints the new statement/bill for the patient.
If someone prints a statement/bill for the patient within the same aging bucket as the previous statement/bill, the system does not advance the message. For example, if you print a statement/bill 10 days after printing the previous statement/bill and the due amount is still in the 30‐day aging bucket, the system prints the same message it printed 10 days ago.
NOTE | If a patient receives a statement with no patient amount due, the patient messages do not advance even if no payments have been made.
Final Dunning Message
If your practice does not use pre‐collection letters and MicroMD PM comes across a patient who received the final dunning message the last time you generated statements/bills, the patient continues to receive a statement/bill with the last dunning message.
TIP | On the Statements/Bills Summary report, this message has an asterisk ( * ) next to it. This will print if the practice is not using collections AND if this is at least the second final dunning message the patient has received.
17.4
Pre‐Collection
Collection Module
If your practice does use pre‐collection letters and the system comes across a patient who received the final dunning message the last time you generated statements/bills and they still have not made a payment, it places the patient into the Pre‐Collection Pending status (listed on the Patient Detail in the Pre Collect drop‐down). This indicates that the patient will start to receive pre‐collection letters next month, and the system will advance them through the levels of pre‐collection to help you avoid referring the patient to a collection agency. Anytime a patient makes a payment, MicroMD PM resets both the Message and the Pre Collect drop‐downs on the Patient Detail window the next time the practice prints statements/bills.
NOTE | If you still want the system to generate statements/bills for patients in this category while they receive letters, place a check mark in the Include Pre Collection checkbox on the Billing Options window when you generate statements/bills.
Pre-Collection Letters
Once a patient reaches the final patient message, the system transfers the patient into a “Pre‐Collection – Pending” status, meaning that if you do not receive a payment from them during this month, the system will not print a statement or bill for this patient the next time you generate statements/bills. Instead, you need to print the first pre‐collection letter.
NOTE | If you would like to use the Pre‐Collection Module without the pre‐collection letters, simply check the Skip Pre‐
Collection checkbox on the Collections tab (under Aux > Collection > Setup) and skip the section relating to patient letters.
Creating Pre-Collection Letters
You can use the Create Mail Merge Document utility to create unique mail merge documents for your pre‐collection letters. Some practices create two patient messages (one for current balances and one for patients who did not pay last month) and then create three different pre‐collection letters. They create one for 30 days after the patient goes into pre‐collection, one for 60 days into pre‐collection, and a final warning for 90 days into pre‐collection. You can create as many or as few as you want. Which Pre-Collection Letter to Print?
Now that you have created the letters that you want to send to your pre‐collection patients, MicroMD PM needs to know which document you want to print first, which document you want to print after that, etc. once a patient reaches the Pre‐Collection Pending status. To assign letters for pre‐collection, select Aux > Collection > Setup from the main menu. Click the Pre‐Collection tab.
Pre‐Collection
17.5
Collection Module
Figure 17‐3 Associating Pre‐Collection Letters
When you add letters to the right side of this window, the system recognizes that patients need to receive pre‐collection letters after they receive the final patient message on their statement or bill. If no letters appear in this window, the system continues to print the last patient message on patient statements/bills until the patient makes a payment.
To assign pre‐collection letters:
Procedure
Details
1. Select Aux > Collection > Setup from the main menu.
The Collection Setup window opens.
2. Click the Pre‐Collection tab.
The left side of the tab displays all the documents created for this practice. 3. Click the New icon on the Task Pane.
This creates a new row on the right side of the tab.
4. Double‐click the first pre‐collection document you want the system to send.
The name of the document appears in the Document Name column in the right side.
5. Enter a description for this letter in the Letter Description field.
This description appears as the patient’s Pre‐
Collection Status indicating which letter the patient recently received. This appears in the Pre Collect drop‐down (on the Patient Detail window), on the pre‐collection reports, in patient notes, etc.
The system automatically assigns the letter an ID when you save the record.
6. Repeat steps 3 through 5 for each pre‐
collection letter you want the system to print for a patient before sending them to the collection agency.
17.6
The system prints the letters in the order that you enter them on this tab.
Pre‐Collection
Collection Module
7. From the Pre‐Collection Note Category drop‐down, select the appropriate Note Category for any notes relating to pre‐
collection activities.
The system enters a patient note and assigns this Note Category when you print pre‐collection letters for a patient. Staff members can also use this category when creating notes related to your pre‐
collection efforts with the patient.
8. In the Minimum Account Due field, enter the minimum total amount the patient should have due on their account before they appear in the report.
This sets the default value for the Min Account Due field on the Pre‐Collection Process Report Options window.
This is the total amount on their account for which the patient is responsible. This includes any sub‐
accounts. 9. Click the Save icon on the Task Pane.
How Patients Progress through Pre-Collection Letters
As mentioned earlier, once the patient receives the final warning message on their statement or bill, the system assigns them a “Pre‐Collection Pending” status the next time you generate statements/bills and, if you include pre‐collection patients in the billing cycle, the patient continues to receive that final message while receiving your pre‐collection letters. When you print pre‐collection letters after your statements/bills, this patient appears on the list to start the pre‐collection process. Once you print that letter, their status changes to display the letter they currently have. This status appears on the Patient Detail window in the Pre Collect drop‐down and on the Collection Reports.
Once you print the first pre‐collection letter, MicroMD PM changes the Pre Collect drop‐down of each patient on the list to reflect the letter the you just printed for them. If the patient does not settle their account with the practice and you do not bring their account up to date between the time you print the first pre‐collection letter and the next time you print pre‐collection letters, the patient receives the next pre‐collection letter you have established. The system then changes the Pre Collect drop‐down list to reflect the letter you just printed. The same is true for every letter you have listed on the Pre‐Collection tab (under Aux > Collection > Setup).
Once you print the final pre‐collection letter, the Pre Collect drop‐down displays the description for this letter. If the patient’s account is still not up‐to‐date when you print pre‐collection letters again, the system assigns the “Collection Pending” status to the patient’s account, indicating that you have made every attempt to collect the amount and the patient is ready to be turned over to the collection agency. The system then no longer generates statements/bills for those patients.
Printing Pre-Collection Letters
After you print your statements/bills for this cycle, the next task you perform is printing your pre‐
collection letters for any patients that are due to receive one, regardless of which letter they are about to receive. You use the Pre‐Collection Process Report to print letters all at once.
Pre‐Collection
17.7
Collection Module
Figure 17‐4 Pre‐Collection Process Report Options
Figure 17‐5 Pre‐Collection Pro">