MEDISOFT PATIENT ACCOUNTIN

MEDICAL BILLING SOFTWARE EXERCISES


PRACTICE CASE DOCUMENTS (CLICK HERE AND PRINT FORMS)

SOFTWARE DEMO LINK

You may use the MediSoft installed in the computers in the classroom, or you can search the internet for vendor sites that offer downloadable MediSoft Demo software.  The link below is to one such site, you download at your own risk.  The installer is about 110 megabytes. 

CLICK HERE for installer/demo of MediSoft (you are downloading this from a private vendor and you download at your own risk!!)

**** Please Read Before You Begin ****

 PRELIMINARY INSTRUCTIONS

Default:  certain fields in the software program have information already input according to what is most commonly used.  For example, POS (place of service) defaults to “11” (office) so it is not necessary to input the POS unless you need to change it from “11” to some other value.

Red “X” A red “X” means to close a window or cancel the input information.  IT DOES NOT SAVE YOUR ENTRIES (with one exception we will encounter).  If you want to save your input, don’t use the red “X” without clicking the “SAVE” button.

FOR THESE EXERCISES PLEASE SET YOUR CAP LOCK AND TYPE IN ALL CAPS, DO NOT ABBREVIATE AND DO NOT USE ANY PUNCTUATION AND INPUT NUMBERS WITHOUT SPACES OR HYPHENS.

 USE THE TAB KEY TO MOVE FROM ONE ENTRY FIELD TO THE NEXT.  YOU MAY ALSO USE THE MOUSE TO CLICK ON THE DESIRED ENTRY FIELD.

 OPEN MEDISOFT

Open the MediSoft Advanced Patient Accounting Program by double clicking on the M icon for MediSoft.

I. PATIENT LIST

Click on the “People Icon Button” on the tool bar to access the Patient List screen (there are also short cuts and pull down menu options available).  Click NEW PATIENT button at the bottom of the window.

 1. Patient/Guarantor (New)

Chart Number:  If you leave this blank, MediSoft will create a chart number consisting of the first three letters of the last name and the first two letters of the first name with three digits (e.g., Ima B. Hurt = HURIM000).  If your patient already has a chart number, you would input the number from the patient chart.

 Last Name: Input YOUR OWN name and use the information from the Patient Information Form to input all other fields.  You can press TAB key, the ENTER key or use the mouse to advance from field to field.

 Birth Date: Either type in the patient birth date or you can click on the small calendar at the left of the field and select the month and year.  Use the arrow keys to select the month and year and click on the day of the month to select.  Birth dates are generally entered as four-digit years (to differentiate the century and avoid confusion between infants and centenarians). 

 2.  Other Information

Click the “Other Information” folder tab.

Type:  If the patient  is also the guarantor, select PATIENT from the drop-down list. 

 If the patient is NOT the guarantor: select GUARANTOR and add the guarantor information if it is not already in the database.  You would do this, for example, if the patient is a child, and you need to indicate the parent or guardian as the guarantor.

Click the minus/minimize button (-) in the upper right of the window to resize the window and allow you to view the PATIENT LIST window again.  Input all available guarantor information. 

 Resize/Maximize the previous window by clicking on the two file folders at the bottom of the screen next to the word “Patient.”

 Assigned Provider: Select J.D.Mallard, MD from the drop-down list.  You may add the provider if he is not in the drop-down list.

Patient ID #2: – SKIP this for now, used for patient maiden name or previous names.

Patient Billing Code: Select “P” for PPO patient from the drop down list.  (ADVANCED CASE: Select “M” for Medicare).

Patient Indicator: LEAVE BLANK.  This is another way to categorize patients (by condition treated: Diabetics, Hypertensive, Psych, etc.).

Signature on File: Assigned claims should have a check mark in this box !

Signature Date: Use the calendar to select the current date.

Employer: Select Bean Sprout Express from the drop-down list (or add the employer if not in the drop-down list).  (ADVANCED CASE: Leave blank as the patient is retired.)

Status: FULL TIME employment. (ADVANCED CASE: indicate RETIRED.)

Work Phone: from the Patient Information Form 602 453 9988 – you do not need to put spaces, parentheses or hyphens in phone numbers.  (ADVANCED CASE: Leave blank.)

Location: SKIP (this is for multiple clinic locations).

Retirement Date: SKIP (ADVANCED CASE: give retirement date.)

 VERIFY YOUR ENTRY INFORMATION AND CLICK SAVE!!!  Then close the patient/guarantor screen.

3. PATIENT LIST – Cont’d

Click “CASE” button in the upper right corner of the window.

Click “NEW CASE” or F* at the bottom of the screen to open a new case (encounter).

A. PERSONAL FILE TAB:

Description: Input the Chief Complaint.  Hemorrhoids (ADVANCED CASE: Input “Chest Pain.”)

Case case: Leave blank (this is for cash cases where there is no insurance coverage.)

Guarantor: Leave as Indicated (ADVANCED CASE select guarantor from list.)

Print Patient Statement:  Leave default marked.

Marital Stauts: Mark as indicated on the Patient Information Form. (ADVANCED CASE Mark as applicable for person you are using.)

Student Status: Non-Student.

Employment: Leave default value.

Status: Default value.

Retirement Date: Leave blank.

Location: Blank

Work Phone/Extension:  fill in the information from the Patient Information Form.

 B. ACCOUNT FILE TAB:

Leave default values for this entire screen (ADVANCED CASE: select referring provider found on the Patient Information Form.)

C. DIAGNOSIS FILE TAB:

Select Code 455.6 (on Encounter form) from drop-down list (or add the code if not found).

D. CONDITION FILE TAB

Injury/Illness/LMP Date: List date of first encounter for injury, illness, or LMP for pregnancy (use CURRENT date).

Illness Indicator: Select Illness, LMP, or Injury from drop-down list.

First Consultation Date: Use this ONLY if the visit is a CONSULTATION code.

NOTE: Other fileds on this screen do not apply to this case but would be used for Worker’s Compensation information and other information related to CMS 1500 blocks 10a, b, c; 14, 15, 16; 18 and 19 (the comments block) on the claim form.

E. MISCELLANEOUS FILE TAB

This screen is for billing outside lab work or anesthesia start and stop times, and to indicate CLIA certification number and Authorization Numbers.  Leave these blank for this claim exercise.

F. POLICY “1” FILE TAB

Select the primary INSURANCE COMPANY OR TYPE OF INSURANCE from the drop-down list.  Again, if the insurance company is not on the list, you may add it.

Relationship to Insured:  Self, Spouse, Child or Other (select according to Patient Information Form).

Policy Number: For this exercise input 67890 (ADVANCED CASE: Type the policy number from the Patient Information Form.)

Group Number: For this exercise input ABC (ADVANCED CASE: Leave blank.)

Accept Assignment: this should be checked if the claim is assigned and is a government (Medicare or Tricare) claim.

Annual Deductible: (ADVANCED CASE: Input Medicare’s $135.00 annual deductible.)

Copayment Amount: For this exercise input $10.00

Allow all other selections to default for this exercise.

 G. POLICY 2, POLICY 3 and MEDICAID/TRICARE FILE TAB

These are used when there are secondary and tertiary insurance coverages.  Leave blank for this exercise.

 SAVE your work!!!!!!  Close the Patient List.

 II. ACTIVITY SCREEN

Click ACTIVITIES to input patient charges or click the short-cut button with the $ sign. Click ENTER TRANSACTION

TRANSACTION ENTRY

Chart: Select patient from chart drop down list (for this exercise, look for YOUR NAME).

Transactions: CLICK THE “NEW” BUTTON.  An allergy alert will appear, click OK after you have read it.

A. CHARGE TAB

Date: Current date will automatically appear; DEFAULT

Document: A document number will automatically appear; DEFAULT

Procedure: Select Procedure Code(s) from Encounter form (99202) using the drop-down list (ADVANCED CASE: Enter one procedure/service at a time).

NOTE: You can right click a transaction line to delete it.

TOS: DELETE 1 from this field (nobody uses type of service anymore).

Delete EMC Assignment to PRINT A PAPER CLAIM.  (ADVANCD CASE: Check EMC assignment to sent an Electronic Claim to Medicare.)

Diagnosis: (ADVANCED CASE: Link the procedure code you have just entered with the correct diagnosis code appearing at the top of the screen indicating if it is the 1st,  2nd,  3rd,  or 4th position.  This is very important when there are multiple ICD-9 codes!

PROOF your input.

LOOK AT THE THREE ICONS ON THE RIGHT.  THEY ARE:

First ICON: SAVE this transaction and OPEN another transaction

Second ICON: SAVE this transaction and CLOSE/Finish.

Third ICON: CANCEL (Careful: this button DELETES the transaction)

Fourth ICON: Transaction Documentation: Notes may be typed regarding this transaction.

When you are all done (be sure you are done!) click on the SECOND (MIDDLE) ICON on the right side of screen. (ADVANCED CASE: Click on  FIRST ICON to enter additional procedures/services. When the last one has been input and you are done, click on the SECOND ICON). All procedures/services input will appear at bottom of screen.

 NEXT TRANSACTION: POSTING THE COPAY

Click the NEW button from transactions “new” “edit” “multilink”. 

PAYMENT TAB

Select “Payment Tab”

Default to Pay Code: Select $10.00 COPAY from Drop Down List

(ADVANCED CASE: Select PERSONAL CHECK from Drop Down List).

Who Paid: Default (patient) (ADVANCED CASE: Select GUARANTOR)

Description: LEAVE BLANK (other notes may be added in this area)

Check Number: 6335 (ADVANCED CASE: Input CHECK NUMBER from

Check.)

Amount: $10.00 (ADVANCED CASE: input amount of check.)

DEFAULT the rest of options

Click “APPLY PAYMENT TO CHARGES”

Apply Payment to Charges

Apply Payment to Charges Screen

Put cursor into THIS PAYMENT, enter $10.00 amount and CLOSE

(ADVANCED CASE: Divide and apply the $100.00 to each line of service as

appropriate.)   CLOSE

Select SECOND ICON on right (Save and Close)

PRINTING FROM TRANSACTION ENTRY

 PRINTING INSTRUCTIONS: Please be sure the correct paper or CMS 1500 form is in the printer before you print… communicate and take turns printing if you share a printer with others.

1) Click PRINT RECEIPT (Top right icon)

Click OK to iñdicate you want a “walkout receipt” for the patient.

PREVIEW before you print!

Select PRINT REPORT ON PRINTER

MAKE SURE NOBODY ELSE IS PRINTING!!

Load printer with plain paper and click START.

Retrieve hard copy from printer.

2) Click PRINT CLAIM (Middle icon)

Open Report: Select the first “CMS-1500 (Primary) Medicare OCR format option if you have 1500 forms in the printer.  If you are using plain paper, select the Laser CMS (primary) Medicare W/ Form.  This should print a full form, but is not OCR compliant.

Click OK (green check mark)

Select PREVIEW THE REPORT ON SCREEN

Click START

Proof your claim on screen.  Look for errors and omissions.

Load the printer with a CMS-1500 form (if you have one).

Clcick “PRINT ICON” at the top of the screen and print on CMS-1400 form ONLY if NOBODY ELSE IS PRINTING!

Retrieve your print-out from the printer.

Proof Claim—Proofread the claim and highlight all areas where the computer generated copy is not compliant with OCR guidelines. Hand in the claim and walk-out slip for credit. CLOSE

Claim Management

ACTIVITIES

1. Click ACTIVITIES from the menu and CLAIM MANAGEMENT from the drop-down list. Note claim status (sent/ready to send) and billing method (paper or EMC/electronic).

You may also use the short-cut button that looks like a claim form to access this feature.

 Locate your claim and.highlight it. Note the claim may be reprinted or resent by clicking the “REPRINT CLAIM” button at the bottom of the screen. Select the type of claim (format) and click OK.

Note Change Status button at top and click. This is where the status of all claims in a batch may be changed and/or resent.  You cannot send twice or change claim status in Transaction, you much go to Claim Management once a claim is generated.

Click EDIT at bottom of screen.

Carrier 1: Claim status and billing method may be changed.        If you need to change from electronic (EMC) to paper you can do it here.

Transactions: Insurance responsibility may change as money is posted and the balance is rebilled to a secondary or tertiary carrier. You may also select a single transaction from a claim to resend.

 F. Comments: Notes may be entered specific to claim and follow up information.

SELF-PACED ACTIVITIES

Students who have completed their work may continue at their own pace inputting the ADVANCED CASE (see 2 Patient Information form/Encounter form and patient check).

 DIRECTIONS FOR CORRECTING ERRORS

If you have made typos or input errors you will need to edit patient information and/or transactions.

Patient Information Select PEOPLE Icon (Patient List)

Highlight PATIENT to be edited.

Click on EDIT PATIENT button at bottom of screen.

Select the correct tab for information to be edited (Name/Address or Other

Information).

Go to the field with the incorrect information and change it.

SAVE

Transactions: Select ACTIVITIES from the Menu and Enter Transactions

OR Select the TRANSACTION ENTRY ICON (first icon)

Select CHART of patient to be edited.

Select CASE to be edited (make sure you verify the case number and/or

chief complaint, and/or date of service).

Highlight line of service to be edited and RIGHT CLICK MOUSE.

Select EDIT and go to the field to be edited and change the information.

Click mouse or enter to delete a complete line of service.

A CONFIRMATION statement will appear. Verify and select “yes’ or “no.”

CLOSE

 Entering Insurance Payments in Medisoft


Payments and Adjustments to the allowed amount are listed on the Remittance Advice (RA).  The RA has a single check with a lump sum payment for multiple patients.

The first step is to indicate the deposit of the check; the second step is to apply the appropriate credits (payments or adjustments) to the individual patient accounts listed on the RA.


DEPOSITS DATABASE

Make sure you are in the right Practice Database. You should be in the Tutorial. From the Activities menu, select ENTER DEPOSITS/PAYMENTS (or you can click the Enter Deposits and Apply Payments shortcut button).

DEPOSIT LIST dialog box. Note there is no field for CHART number here, as this is Not specific to any single patient.

Deposit Date: Default to current date, but the date may be changed as necessary.

Show All Deposits: Un-check this box. If this is checked all deposits for all dates display at once.

Show Unapplied only: Un-check this box at this time. If this is checked you will see all deposits that have monies that have not been credited to patient accounts.

Sort By: Allows several choices for sorting payment information. The default is by amount, lowest to highest.

Locate Buttons: Allows you to search for deposits made.

Detail: lf a deposit is highlighted and this button is clicked, a dialog box with additional

Information will display.

Deposit Date: Lists deposit dates.

Description: Displays any descriptions entered.

Payor Name: Name of the insurance or individual who made the payment.

Payor Type: Allows you to switch between

1) Insurance Payments  2) Patient Payments  3) Capitation Payments.

Payment: Lists the payment amount.

BUTTONS:

Edit: opens the highlighted payment or deposit for editing.

New: opens the Deposit dialog box where new payments and deposits are recorded.

Apply: Applies payments to specific patient charge transactions.

Print: Prints the Deposit List.

Delete: Deletes the highlighted transaction.

Export: Exports the data in either Quicken or QuickBooks format.

Close: Closes the Deposit List. 

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ENTERING A DEPOSIT

From the DEPOSITS LIST you will need to click the "NEW" button at the bottom to open the Deposit dialog box.

DEPOSIT DATE: Defaults to the CURRENT date. If the deposit was on another date,

You may change this. For this exercise allow it to default to the current date.

PAYOR TYPE: Drop down menu options to select Insurance, Capitation, or Patient

Payment. For this exercise please select INSURANCE.

PAYMENT METHOD: For this exercise select CHECK. Other options are Cash,

Credit Card, or Electronic Payment (Electronic Funds Transfer/EFT).

CHECK NUMBER: For this exercise the check number will be 10025.

DESCRIPTION / BANK NO.: For this exercise we will put B. of A. This is a free form description of the payment or listing of the banking institution.

PAYMENT AMOUNT: Total amount of the lump payment is entered here. For this exercise, enter $246.51.

DEPOSIT CODE: This can be used to sort deposits to different bank accounts if necessary. Leave this blank for this exercise.

INSURANCE: Indicate the Insurance carrier or plan making the payment.

For this exercise enter AETNA PPO.

PAYMENT CODE, ADJUSTMENT CODE, WITHHOLD CODE DEDUCTIBLE CODE will all populate with the appropriate codes for the AETNA PPO we selected.

CHECK YOUR ENTRIES AND THEN CLICK ‘SAVE’

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APPLYING INSURANCE PAYMENTS TO CHARGE TRANSACTIONS

Now, from the DEPOSIT LIST, locate and highlight the payment we just entered.

CLICK the APPLY button.

The Apply Payment/Adjustments to Charges window opens.

This window should display the insurance company, as well as the total Unapplied Amount of the deposit.

FOR: in the “FOR” box you will select the appropriate patient chart/account. The

Patient name will display. In this exercise, please SELECT YOURSELF AS THE PATIENT.

Note: If the patient account does not have the insurance that made the deposited

payment, you will get a SELECT PAYOR window.

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APPLYING TO INDIVIDUAL TRANSACTIONS/CHARGES

The DATE, PROCEDURE, CHARGE, AND REMAINDER fields show the data about the transaction for which you will be applying the payment.

PAYMENT: Be sure to only apply the amount from the RA that was paid for this patient. For this exercise our RA shows a payment of $28.00 for the office visit.  Remember, if you have multiple transaction lines, you will need to split the payment up on to the appropriate lines.

DEDUCTIBLE: This is where a deductible amount would be added, as in the Advanced case. Let this field default for this exercise. Remember, if you have multiple transaction lines, you will need to split the deductible amount to the appropriate transaction lines, but only up to the amount of the deductible taken.

WITHHOLD: Some insurances may withhold money for multiple charges and then pay out all at once. Let this field default for this exercise.

ALLOWED: Input the RA's ALLOWED AMOUNT or “COVERED CHARGES.” For this exercise, input $38.00.

ADJUSTMENT: The program calculates the difference between the BILLED and ALLOWED charges to create the ADJUSTMENT which is the discount or write-off. If you CHECK the last check box at the bottom of the window, "WRITE OFF BALANCE NOW," Medisoft will automatically write off the adjustment amount. (See OPTIONS below.)

TAKEBACK: Sometimes an insurance may withhold money as an offset (‘clip’) for previous overpayments as well.  Let this field default for this exercise.

COMPLETE: The program checks this box when the payor has completed their

Obligation for payment and now any balances may either need to be written off, billed

To the patient on a statement, or billed to secondary insurance if there is secondary insurance. Let this field default for this exercise.

REJECTION: RA rejection messages may be entered here if needed. Let this field default for this exercise.

PROVIDER: Lists the provider on the claim,

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OPTIONS

ALERT WHEN CLAIMS ARE DONE: If checked this will generate an alert message when the claim is completed for a payor.

ALERT WHEN STATEMENTS ARE DONE: If checked, this will generate a message when a statement is done for a patient.

BILL REMAINING INSURANCES NOW: lf there is any unpaid balance and there are other insurances in Insurance 2, Insurance 3, etc., this will create a secondary or tertiary insurance bill.

WRITE OFF BALANCE NOW: Checking box will cause the balance to be written off.

SAVE PAYMENTS/ADJUSTMENTS: Checking this saves the payment currently being applied. Once the payment is saved, another patient can be selected in the FOR field to allow applying unapplied payments to that patient's unpaid balance. 

 Instructions in RTF format HERE

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