MEDfx PM Training Session 3: Live Day 1 MEDfx Training and Implementation January 2014 Doc ID 21-1402-046
CONTENTS 1 Optional Table Setup... 3 Case Type Table Management... 3 Payment Type Table Management... 4 Setting Up Default Fields for Charge Entry... 4 2 Charge Entry... 5 Performing a Charge Entry from the Patient Chart... 5 Case Summary... 6 Visit Pane... 6 Charge Summary... 7 3 Patient Payment... 7 4 Batching Claims... 8 Managing Claim Batches... 10 5 Reports... 11 Deposit Slip Report... 11 Balance Before Closing... 11 Page 2 of 11
This session covers: 1. Optional table setup 2. The charge-entry process 3. The patient-payment process 4. How to batch claims and manage claim batches 5. Running reports 1 OPTIONAL TABLE SETUP In the Advanced Setup pane under Administration, there are two tables that can be set up with defaults that make charge entry easier. They are: Case Type Table Management Payment Type Table Management Case Type Table Management Information fields can vary depending on type of charge entry. For example, entering charges for an office visit requires different input than for other types of visits, such as hospital visits or workers compensation visits. Case Type Table Management allows you to customize fields used in charge entry so that each set of fields is appropriate to the type of visit. Customizing fields using Case Type Table Management is optional, but it will make entering charges go much more quickly. To set up default fields in Case Type Table Management: In the Advanced Setup pane under Administration, select Case Type Table Management. Scroll to the top and select a case to edit. This takes you to the appropriate set of screens below. Read the field names in the three sections. If you want a field to be available, visible should equal true. See below example. If you want a field to be unavailable, visible should equal false. See below. Cases that will not be used may be deleted. Page 3 of 11
Payment Type Table Management This table is for customizing payment types. To set up the fields in Payment Type Table Management: In the Advanced Setup pane under Administration, select Payment Type Table Management. Edit the existing entries and or add new ones. Set the field Apply to charge to Yes unless the payment is for the practice and not associated with any patient charges. Setting Up Default Fields for Charge Entry In the charge-entry process you will encounter different fields for different types of visits. You can set specific fields to display for specific types of charge entry. These fields include Billing office, Service location, Billing provider and Date of Service (DOS). Optional fields that you can set are referred to as Defaults. Setting up defaults will save time when billing for a single location or provider. The more defaults you set up, the faster the charge process will be. Note: These defaults are temporary, and are only for the computer on which they are set. The next time you log in to MEDfx PM, these defaults will no longer be set. Bookkeeping defaults From the Navigation pane select Bookkeeping > Bookkeeping Defaults pane. For each field you want to include as a default, click on the empty space to the right of the field s description (below) to reveal the down-arrow. Select from the drop-down menu. Page 4 of 11
2 CHARGE ENTRY Charge Entry is the process of entering a charge and creating a visit on the patient chart. There are three locations in MEDfx where a charge may be created: Front Desk > Front Desk Activities Pane > Charge Entry (under the Enter Transactions heading) Bookkeeping > Bookkeeping Activities > Charge Entry (under the Enter Transactions heading) Front Desk > Patient Search pane. Search for a patient chart. In the Account pane choose Charge Entry. This is the recommended method for charge entry. Follow the steps below to do a charge entry from a patient chart. Performing a Charge Entry from the Patient Chart Click on the Charge Entry link. The Charge Processing screen appears showing four fields: Patient, Account, Case and Visit. (See below.) Verify that the populated information is correct. Select a Case if different from the default. The case will determine what data will be collected during the charge process. Page 5 of 11
The visit field will default to New Visit. After entering information press F2 to Save and access the fields for Case Summary. Case Summary The fields appearing in the Case Summary pane are customizable based on the case selected in charge entry. The information entered in the Case Summary section will be stored. The next time a charge is entered for the same case, this information will automatically populate. Once the necessary fields are completed, press F2 to move to the Visit Pane. Visit Pane The information entered from the Case Summary, as well as information selected in Bookkeeping Defaults, will automatically populate here. Continue entering the necessary information. Mandatory fields are Billing Provider and Diagnosis. Billing office, Service Location and Accepts Assignment will turn yellow if they are skipped. If a claim is to be generated these fields must be filled in. Page 6 of 11
Once the necessary fields are completed, press F2 to move to Charge Summary. Charge Summary Several fields in this pane will populate based on selections made in previous sections, as well as the Bookkeeping defaults. Any defaults may be changed if needed. Enter the procedures that took place during the visit. Select any modifiers and select the correct diagnosis pointer for the procedure. The units will default to 1; the amount defaults from the Usual Charge table; and the payer defaults from the account. If there is a copay to be charged press F9 to charge the copay. Three new fields come up and the copay automatically populates from the insurance information. If the copay was not added when the insurance was entered, it can be added now. (See below.) Once all fields are complete and a copay is charged, press F2 to save. This will save this entry and put the cursor back in the procedure field to enter the next one. Continue this process until all procedures have been entered and are listed in the Charge Summary. After saving your last procedure your cursor should be back in the procedure field. Press F2 again. You are now in edit mode. The last procedure entered is now highlighted in the list box above. Highlight any item and make any necessary changes. Pressing F2 from this edit mode will save the entry and exit back to the patient chart, or to the payment entry screen if there is a patient balance. Below is a screen shot of the procedure list in add mode: Below is a screen shot of procedure list in edit mode: 3 PATIENT PAYMENT If there is a patient balance on the visit, a payment screen pops up. Caution: If the patient has not made a payment, do not continue. Press Escape or close Charge Processing. There will be a patient balance on the account. If the patient has made a payment, continue to payment entry. Page 7 of 11
Enter the payment type or select from the dropdown. Verify the amount in the payment field is the amount collected. The date can be changed if needed and the note field is optional. After completing the necessary fields press F2 to save. A payment application screen appears (below). This screen shows to which visit the payment is being applied. MEDfx PM always applies a payment to the oldest visit. At this screen the payment can be moved to any other visit. If the application step is not completed the payment remains on the account unapplied. When a payment is collected but there is no patient balance, there will be no place to put the payment. In this case you must exit out of the payment application screen and the payment will remain on the account as unapplied. Unapplied money in a patient account appears next to the responsible party name in goldcolored type. When a charge is done (creating a patient balance), MEDfx PM will skip the payment entry screen and go directly to the payment application screen, where the money can be applied. Use the link in the account pane labeled Patient Payment Entry to enter payments that are being applied after a charge has been done (for example, a payment that was mailed). Clicking on this link will display the same payment entry and payment application screens described above. For more information on Charge Entry please see Chapter 6 of the MEDfx PM User Guide. For more information on Patient Payments please see Chapter 7 of the MEDfx PM User Guide. 4 BATCHING CLAIMS Select Billing in the left navigation pane. The top-left pane is the Billing Activities pane. Under Insurance Claims, choose Select Claims to begin the claim-selection process. Page 8 of 11
Claims may be batched by one or more criteria. Claim date is the only mandatory field in this pane. Leaving all the other fields blank assumes all claims for all criteria. This will pull all new charges and any claims being resubmitted. Once you have selected your criteria, press F2 or click Save to begin pulling the charges together. The Refine Claims Selection pane will load all the charges to be claimed. If there is a problem with any of them they can be toggled out of this batch. To toggle out a charge, highlight the patient and click on Toggle Selection at the bottom of the screen, or press F9. You will see that Yes changes to No (or vice versa) under the column titled Selected. Once you have reviewed the list press F2 to create claims. A Create Claims Result Summary will appear, showing how many claims have been created. Note: If there are many claims, it will take longer for the summary to load. While waiting, do not press F2 or Save again; it will only re-send your command and start over. Another pane appears called Create Claims Auto-rendering Summary. Check that the number of auto-rendered claims matches the number created by looking at the number at the bottom of each of the two summary panes. If these numbers do not match, call MEDfx Support for help. Press F2 to close out of claims processing and return to the Billing screen. Page 9 of 11
Managing Claim Batches To work with all claim batches go to the Manage Claim Batches pane under Billing. This pane by default is set to search by Electronic-Not transmitted batches. Click Search to pull up all the electronic batches created. The search results show all created electronic batches; how many claims are in each batch; the claim date; the provider; and options available in the Action column. In the Action column, click on Validate to open the validation report. This report shows all the patients and visits in the batch. Any claim errors are in bold. If there are errors, click Delete. This does not delete the charges; it deletes only this batch. Fix the errors, then go through the batching process again. If there are no claim errors, a Transmit option will appear under the Actions column. After it is in the transmitted state, a new link, Summarize, brings up the same report that the Validation link did. For paper batches, click into the By field and from the drop-down select Paper Unprinted, then Search. This shows the same information and is done in the same way as the electronic batches in the previous step. Once the paper batch has been validated successfully the actions will change to Print, Print w/form, Complete, Delete, Align and Summarize. To print the batch on pre-printed claim forms, select the Print action. Use the Align action if the print does not line up correctly in the boxes. Use Print w/form if using plain white paper. Be sure those payers accept the claims in black and white. Delete and Summarize are the same as in electronic claims. The Complete action is used to mark the batch as printed. All batches done previously, whether paper or electronic, may be searched by using the dropdown in the By field and selecting a search option. The batches will remain in MEDfx PM. For more information on batching claims refer to Chapter 8 of the MEDfx PM User Guide. Page 10 of 11
5 REPORTS From the navigation pane, click on Reporting. To run any report, click on the report name. This opens a selection criteria pane where you enter criteria for the report. Blank fields will generally consider all possible criteria for that field (for example, a blank Payment type field will consider cash, checks, credit cards and other types of payment. A blank Provider field will consider all providers). Once you have selected your criteria, press F2 to create the report. A printable report will open in a separate browser window. Generally there are two methods for running reports: 1. By transaction date, which is the date the data was entered, or 2. Date of service Many reports are identified by the person who is logged in and running the report. These reports reflect the criteria and identifying information of the individual initiating it. This allows individual users to balance the day s financial transactions. To balance the entire day s transactions for the entire practice, remove the identifying user. MEDfx PM has several balancing reports that may be run at the end of the day. Note: Financial reports must be run by the same date range and method if they are to balance against each another. If all payments have been applied, the total payment on compared reports should balance. Deposit Slip Report The Deposit Slip report shows all money posted to MEDfx PM by selected user, payment type and date range. This report shows both applied and unapplied payments. Balance Before Closing The Balance Before Closing report shows all patients and transactions posted by the person currently logged in. This report shows only payments that have been applied. For more information on reports please see Chapter 10 of the MEDfx User Guide. Next Session: 4 Live Day 2 Page 11 of 11