Registering Patients. Module 4

Transcription

1 Registering Patients Module 4

2 Table of Contents REGISTERING PATIENTS WITHOUT POSTING TRANSACTIONS... 4 Patient Reception Workstation... 6 Patient Registration... 9 View/Update Patient Account Tabs that can be utilized from the Patient Insurance Record Scan Insurance Cards Link Images to Insurance Records Precertification Numbers Account Comments Inquiry Check in a Temporary Patient Patient Reception Workstation Additional Tabs Patient Account Patient Appointment Recall Check Eligibility Appointment Scheduling Generate Doctor s Schedule REGISTERING PATIENTS WHEN POSTING TRANSACTION Create a New Batch Querying for an Existing Batch If posting Co-pays at the time the patient checks in Step by Step if only the Copayment is posted at the time the patient checks out If a charge and a true copay are posted at the time the patient checks out Posting true copays at the time charges are being posted Post transactions on accounts not on current day s schedule Step by step to post a patient payment on a past balance Step by Step if the patient payment needs to be applied to specific charge line item(s) and not auto distributed

3 View/Update Copays/Charges Reconciling, Printing and Releasing a batch Step by Step on how to print a batch Step by Step on how to balance and release a batch EXERCISES... 67

4 REGISTERING PATIENTS WITHOUT POSTING TRANSACTIONS Purpose: To check in a patient for their appointment. No Copay/Charges: Post Copay/Charges: MM11.9 for users who do not need to post copays and/or charges. MM9.3 for users who need to post copays and/or charges, which require you to open a batch. *Note: See Registering Patients with Posting Transactions further in this document. Check in Only No Transactions to Post For users who do not need to post copays and/or charges. This method does not require opening a batch. At the Master Menu, the user selects 11 Appointment Scheduling with the mouse or by entering 11 in the Enter Selection field. 4

5 After selecting 11 Appointment Scheduling the Appointment Scheduling Menu displays: The user selects 9 Patient Reception with the mouse or by entering 9 in the Enter Selection field and Patient Reception Workstation screen displays. 5

6 (MM11.9) Patient Reception Workstation When the form displays, the cursor is in the Location field. Step by Step to populate the Patient Reception Workstation: Group - enter group code, if not defaulted. Location - enter location, if not defaulted. Doctor - enter either a specific doctor number or to see all of the appointments booked, <tab> or <enter> through the field to leave it blank. Dept enter the specific department or leave blank to see all. Search Date enter a specific date or <tab>/<enter> for current system date. The Field and Field Description table below further defines each available field. After entering the search criteria, the following screen is displayed. 6

7 When the screen is populated, the morning appointments are displayed on the left side and the afternoon appointments on the right side. Appointments are displayed by the Appointment Time then Reason Code. A color key, which represents the status of appointments, is displayed below the tabs: Appointments in green font are patients that are already registered. Appointments in orange font are appointments that are booked the same day. Appointments in red font are basic work-in appointments. Basic work-ins would be patients that had to be created as a work-in due to the fact that there were no open time slots. Appointments in black font are appointments previously booked prior to the current day. Appointments in purple font are same day work-in appointments. Appointments in blue font are canceled appointments and will always display at the bottom of the list. The morning cancellations will show in the left side and the afternoon cancellations will show on the right side. Users can choose the gray selector button beside the canceled appointments to view the reason for the cancellation. Appointments in pink are patients that have been flagged as checked out. If a patient is not registered the system will automatically flag them as a No Show during the nightly process. *Note: The Patient Reception Workstation screen automatically refreshes with any new information or added appointments for that specific day every thirty (30) seconds. Search Pat This button will allow you to search for a patient to see if they have an appointment booked for the specific date. Pat Bal This balance does not include any pending transactions. If pending transactions exist this field will be shaded in grey. If you would like to review the pending transactions you can double click on the balance and the form will take you to the Pending Transactions. CC If the patient has a credit card on file you will see a Y in this field. If they do not you will see an N. 7

8 Additional Patient Information To view more information regarding a specific patient, double click on the patient s name to activate the Additional Patient Information pop up window. - This button will take you to the Account Summary screen if you would like to review the patients financial information. Use the X in the upper right corner to exit the pop up window. 8

9 Patient Registration To the left of each appointment is a selector button. When the application first displays the appointments, the selector button beside the first appointment is blue. The user can click on the button beside any patient to register that patient. This action changes the selector button blue and a menu appears. The menu provides several options regarding this patient s appointment. The user can select one of the following. Note: When you see the greyed out fields this means that you are registering patients without being in a batch. Registering a patient with posting transactions is explained below. Check-In Schedule Next Visit View/Update Patient Account Print Patient Appt Report Check Out This option will not be available until after the patient has been checked in. Check In By selecting Check In, the application displays the Registration and Fee Ticket form. 9

10 Note: If your Registration and Fee Ticket screen defaults to the second radio button, Patient Check In and Encounter Form, and the practice prefers the Patient Check In Only radio button to be set to populate, there is a (med) option that can be set by contacting your client manager. The application will auto populate the following information: Group Group Name Account Number Patient Name Doctor Number Location Number ID Code This is the ID Code of the encounter form that is built in the database. A (med)option can be set to default or if there are multiple forms available, use down arrow key to select proper form to print. Registration Date Appointment Time As shown in the red box above, the user has multiple options when accessing this form. o Patient Check In Only Used if the user only wants to only register a patient. o o Check In and Encounter Form Used if the user needs to register the patient and print the encounter form. Check in, Encounter Form and Patient Information Sheet 10

11 Used if the user needs to register the patient, print the encounter form and patient information sheet. Encounter Form Example Patient Information Sheet Example: The user will select one of the radio buttons, and click on the key from the keyboard, and then the following pop-up message will display: tab or the <F8> Function The user selects OK, returning the application to the Patient Reception Workstation, also changing the patient to green font and populating the Check-In time. The options below do not check in the patient. The user will select the radio button, and click on the tab or the <F8> Function key from the keyboard, then shown below each option is the pop-up message that will display. 11

12 Encounter Form Only -select this radio option to print only the encounter form with the patient demographics populated and not register the patient. Encounter Form AND Patient Information Sheet select this radio option to print the pre- populated encounter form and patient info sheet and not register the patient. Blank Encounter Form select this radio option to print a blank encounter form only, no patient demographics will print and the patient will not be registered. Registration Labels select this radio option to print on demand labels with patient demographic information and not register the patient. 12

13 The user selects the printer from the drop down or uses the view option and prints from the browser window that displays the requested form. New Patient Information Sheet Use this tab to print a blank Patient Information Sheet. Existing Patient Information Sheet Use this tab to print the Patient Information Sheet for the patient. Check Out The Check Out feature can be used to mark the patient as being checked out. If this option is selected the patient s appointment will be moved to the bottom of the appointments therefore, moving it out of the other patients that remain to check in. Schedule Next Visit By selecting Schedule Next Visit the application opens the Scheduler and displays the Demographics and Appointment Summary. The Demographics tab is detailed later in this module. The Appointment Summary tab shows current and future appointments at the top and will be highlighted in blue. The past appointment history is shown in black font and canceled appointments are in blue font at the bottom of the form and mark column C with a C. When a patient does not show for a booked appointment the system will show the appointment in red font at the end and mark column C with an N. To view the reason an appointment was cancelled, hover over the cancelled appointment to see the reason entered at the time the appointment was cancelled. 13

14 Any rescheduled appointments give further information as to what Doctor, date and time that the patient s appointment was rescheduled to. The user can double click on any appointment to view the details. If the user selects any past appointments, the below pop-up message will display. Select Yes, to view the specific date and that doctor s schedule. 14

15 Double click on a current or future appointment, then the Scheduler will default to the specific date and doctor s schedule of the selected appointment as shown here. The user can view the details of the appointment by hovering over the appointment time slot. 15

16 The user can copy, move, cancel, cancel and block, update, or create a work-in appointment by right clicking on the booked appointment time slot. 16

17 View/Update Patient Account In the event that the practice is utilizing an Electronic Medical Record (EMR), the user can make any changes to the patient account information before any information is transmitted to the EMR. By selecting View/Update the Patient Account, the application displays the Patient Account screen specific to the patient. Users can view/update the patient account, if needed, by selecting a Tab at the top, any of the LOVs or by clicking directly into a field. Typical Tabs utilized during this activity are defined further below. Patient Insurance When the user is in the Patient Account and selects the tab or <F8> from the keyboard, users see the Patient Insurance Record. From this form, users can view/update any information necessary. Updating a patient insurance record When the Patient Insurance Record screen launches, the primary insurance displays as '1' in the Filing Sequence field. The user can change the filing sequence view by selecting the down arrow key on the keyboard until the insurance to be updated is displayed. The user can also use the up arrow key to display a previous insurance record. When the insurance to be updated is displayed, the user updates any pertinent information regarding the effective/expiration dates, insurance company and/or the Insured Information. If the patient has new primary insurance, make sure that an effective date and expiration date is entered for the old insurance. Then down arrow until the sequence 1 is displayed, enter the new primary insurance ensuring that the effective date is after the old primary expiration date. After saving, the user will see an asterisk on the patient account screen identifying there are multiple insurance records in the sequence as shown here. The user saves the new information by selecting the Save icon or <F4> Function key on the keyboard. 17

18 Tabs that can be utilized from the Patient Insurance Record Selecting the tab users can perform real time eligibility checks if enrolled in Passport and setup completed. Selecting the tab users can run the eligibility report if enrolled in Passport and setup completed. Selecting the tab users can view or add scanned images to the patient insurance. Selecting the tab users can link scanned images to insurance sequences. Selecting the tab or <F8> from the keyboard, users can view, add, or update Precertification information. Check Eligibility To check eligibility while on the Patient s Insurance Record, select the Eligibility Checking tab. Select a primary doctor from the display pop up window as shown below. Once the eligibility check is complete you will receive either a patient eligible message or another informational message. Example of messages users might receive: o RTE - Patient Eligible; Date: o RTE - Patient not eligible; Date: o RTE - Additional Insurance found but not added; Date: User will receive the additional insurance information in the audit report they will receive the next day 18

19 o o o o RTE - PCP Name: " + pcp_name + "; Date: Users will receive this message if the PCP is different than what was selected during the eligibility check. RTE - Unable to complete eligibility request; Date: System was unable to obtain NPI RTE - System Error; Unable to provide information; Date: System was unable to generate eligibility request RTE - Update Failed; Date: If this message is received, click ok and exit back to the Patient Insurance Record and click <F2> to verify the eligibility field was not updated. If it was not updated check eligibility again. Once the user clicks OK from the eligibility pop-up, via any method, the following fields will be updated: o Eligibility Codes: EL Eligible NE Not Eligible ELP Eligible, but Medicare is Secondary NEP Not Eligible, but family planning benefits found o The date the response was received from Passport will populate to the right of the above codes. o o The Effective Date, Copay, Well Coverage, Deduct Remaining, and Co-Ins % fields will populate if insurance is Active. This information will be available if the information is passed from the insurance carrier to Clinix. Each individual insurance carrier sends different information in different formats. If the insurance is not eligible and used to be in effect, the expiration date will be populate and the eligibility field will be updated. 19

20 o o If checking eligibility on primary insurance, an eligibility report will be available by clicking on F11-Eligibility Report. The comment record fields on the Account Comments Inquiry screen will populate with: The Date field will show the date the eligibility request was submitted The Userid field will show the id of the person that requested the eligibility check The Initial and Action Code fields will show one of the following: RTS Real Time Eligibility Success RTF Real Time Eligibility Failure The free text Comment field will show RTE (Real Time Eligibility) the Response description received; Date mm/dd/yyyy. For Example: RTE Patient Not Eligible; Date: 01/01/2014. Note: If you do not want the Copay updated on the patient s account please notify your ClinixPM Client Manager, as this requires a (med)option to be set. Note: If you do not want the Effective Date updated on the patient s account, please notify your ClinixPM Client Manager, as this requires a (med)option to be set. Eligibility Report This report is available for primary insurance if enrolled in Passport and all setup options have been completed. To view the report select the Eligibility Report tab or <F11> function key from the keyboard while on the patient s insurance record screen. A sample of the report is shown below; this report may vary between payers. 20

21 Scan Insurance Cards Clinix will allow images to be scanned and stored associated with the patient record (e.g. insurance card, driver s license). The card can then be linked to the individual insurance record based on sequence. The user can build the record then scan the card or scan the card then link the image to the specific sequence. The user selects the Image tab from Patient Insurance Record. If the Patient Insurance Record has been completed, the user will want to ensure that the correct insurance record is displayed for the card being scanned. 21

22 The user s workstation must be connected to a scanner for the ability to scan insurance cards. Once the user clicks on the Image tab the Display Images screen displays. The user selects the Load Image icon as shown by the red box in the screen shot. Once the Load Image icon is selected, a pop-up message will display to select the appropriate scanner. Choose the card scanner connected to the workstation. Another screen will appear to confirm settings for the scanner. 22

23 Review settings and make changes if necessary, then select the Scan button. Review image and select Done when acceptable, the image will appear in Clinix. When the scanned image displays, the user can choose either to Re-scan, Save Image or Exit Without Saving from the options in the lower right corner of the screen. From the Display Image screen, the user can select <Ctrl Q> from the keyboard or the 'Back' icon from the Task Bar once to return to the Patient Insurance Record to scan another card or twice to return to the Patient Account screen. To scan a secondary insurance card, down arrow to populate the secondary insurance record on the Patient Insurance Record screen and then repeat the process. It is important that the image is attached to each insurance record so that if archived, the image will be attached. To scan the card prior to completing the patient insurance record the user will select the Image tab and follow the scan process above. Then after scanning create the insurance record. 23

24 Link Images to Insurance Records To link the image to the insurance record, the user will select the Link Image tab. The Link Image tab will display all insurance records and all scanned images that are related to the patient. The form will display two (2) images; additional images can be viewed by using the scroll bar. To link an image to an insurance record, enter the correct data in the following fields: Ins Seq, Effective Date, and Expiration Date. For a printable version double click on the image and select the print icon. Note: If the fields next to the image are left blank, the image will remain unlinked and will still be viewable from this screen. Users can scan and store a picture identification using this route. 24

25 Precertification Numbers Once the user has completed the Patient Insurance Record screen, they have the choice of pressing the <F8> function key or by clicking on the Precertification tab at the top of the screen. This screen will allow the user to update/add any precertification number as necessary. Step by Step to build a Precertification o Ins Company This is a required field. Enter the insurance key code of the insurance company that issued the precertification. The patient s insurance information will be displayed in the Primary, Secondary, or Tertiary Insurance fields. o Effective Date This is a required field. Enter the effective date of the precertification. o Expiration Date This is a required field. Enter the expiration date of the precertification. o Visits Authorized This is a required field. Enter the number of visits authorized on the precertification. o Certification ID This is a required field. Enter the certification number assigned by the insurance company. o Specialty If the precertification states that the patient can see any provider within a practice the user will enter the specialty code that is set in the database in this field. Note: Either the Specialty field or the Doctor field needs to be completed, not both. o Doctor If the precertification states that the patient can only see a specific provider the user will enter the provider s number in this field. Note: Either the Specialty field or the Doctor field needs to be completed, not both. o Available Visits This field will automatically populate according to the number of visits that is entered in the Visits Auth. field. This field cannot be updated by a user. o Pending Visits This field will automatically populate as the precertification is attached to either an appointment or a charge line item. Note: As the precertification is attached to either an appointment that has been booked or a charge that has been posted. The available visits will automatically decrease. o Save 25

26 Account Comments Inquiry Users have the ability to add/view comments already on the account by selecting tab or <F12> from the keyboard, the application will then display the Account Comments Inquiry form. Check-In/Form From the Patient Account the user then selects the tab, or <F9> from the keyboard. The application displays the Registration and Fee Ticket form. 26

27 Note: A (med)option may be set to default to Patient Check In Only if the practice does not want an Encounter Form to print. The application will auto populate the following information: Group Group Name Account Patient Name Doctor Number Location Number ID Code This is the ID Code of the encounter form that is built in the database. A (med)option can be set to default or if there are multiple forms available, use down arrow key to select proper form to print. Registration Date Appointment Time As shown in the red box above, the user has three options when checking in a Patient. Other options will be discussed later in this document o o Patient Check In Only Used if the user only wants to only register a patient. Check In and Encounter Form Used if the user needs to register the patient and print the Encounter form (see sample below). 27

28 o Check in, Encounter Form and Patient Information Sheet Used if the user needs to register the patient, print the Encounter form and Patient Information Sheet (see samples below). The user will select one of the three radio buttons, and click on the <F8> tab or the Function key from the keyboard, and then the following pop-up message will display: The user selects OK, returning the application to the Patient Reception Workstation, also changing the patient to green font and populating the Check-In time. Collect Copay if Needed If the patient has a copay due at the time of check in and the user has chosen the path of MM11.9 to the Patient Reception Workstation, the following pop-up will display as a reminder to collect the patient s copay amount if the copay amount has been added in the patient s insurance record: If you are not in a batch you will not have the ability to post a copay at this time. If you do not post copays at the time a patient checks in there is a medoption that you can as your client manager to set so that you do not get this popup. Check in a Temporary Patient Every patient with an appointment has an account number. The application assigns a temporary account number for new patients that are booked through the scheduler. Temporary account numbers are distinguished from permanent account numbers by having the letters TP as a prefix to the numbers. Below are two examples of patient appointments with a temporary account number shown on the Patient Reception Workstation. 28

29 Checking in a patient with a temporary account number from the Patient Reception Workstation is much the same as registering a patient with a permanent account number with only a few extra steps. To the left of each appointment is a selector button, as noted by the red box above. The user clicks on this button to select the patient. When the button is selected it will turn blue and the selector menu displays the following for the patient being checked in. The user selects Check-In and the application displays the Patient Account form with the Guarantor Information overlay as shown below in the red box. 29

30 Based on the guarantor information, the user chooses the radio button beside either Change the Guarantor, Change Guarantor Demographic, or Keep This Guarantor. If the user selects the Change the Guarantor radio button as shown below, the application displays the Guarantor Setup/Maintenance form in query mode. 30

31 The user can search for an existing guarantor to attach to the patient account. Search options include the name, address, phone, SSN, birthdate, and Employer. Use the Back icon to return the information back to the patient account. The following pop up window will confirm the change. The user responds either Yes or No. Choose Yes to complete the guarantor record. The application will return the user to the Patient Account screen. 31

32 The temporary account number will be highlighted, use the delete key to remove the TP account number. Then user must update the Relation field to designate the relation of the patient to the Guarantor. Now the user can save by selecting the Save icon keyboard. from the Task Bar, or <F4> from the If the user chooses No the following pop up will display allowing the user to choose the next action. o o Do you want to do another search? -- Select to search another guarantor. Do you want to set up a new guarantor? Select to launch the guarantor screen in insert mode to build the new guarantor. 32

33 o Do you want to keep the guarantor information already on the account? Select to keep the patient information as the Guarantor. After completing the applicable action the user saves by selecting the Save icon <F4> from the keyboard. from the Task Bar, or If the user selects the Change Guarantor Demographic radio button, the application displays the Guarantor Setup/Maintenance form which includes the current patient s guarantor information. 33

34 The user updates any pertinent information and saves by selecting the Save icon <F4> from the keyboard. from the Task Bar, or If a change was made on the Guarantor Setup/Maintenance screen, when the user saves a pop-up message will appear as shown below. The user has the option to click the drop down and select the correct relation, click on OK, or click on Cancel. 34

35 If the user selects the Keep This Guarantor radio button, the application removes the Guarantor Information pop-up message. 35

36 The Patient Account form displays and the cursor is highlighted in the Account field as shown below. The user removes the TP account number by selecting Delete, Backspace, or the Space bar. The user saves by selecting the Save icon from the Task Bar, or <F4> from the keyboard and the application automatically assigns the next available account number as shown below. 36

37 The user will get a pop-up message stating Transaction complete: 1 records applied and saved, select OK. Note: If the temporary patient s account included insurance information, then the Patient Insurance Record screen will display populated with the patient s insurance information. This allows the user to verify that all of the insurance information is correct and then the user can scan insurance cards as needed. After the review is complete exit back using the Back icon or <Ctrl Q> on the keyboard to the Patient Account screen. The user can check the patient in from the Patient Account form by selecting tab or <F9> from the keyboard. This takes the user to the Registration and Fee Ticket form as shown below. The user chooses the appropriate radio button and then the tab or <F8> from the keyboard. Patient Reception Workstation Additional Tabs Tabs on the Patient Reception Workstation are detailed below. 37

38 Patient Account By selecting this tab or <F12> from the keyboard, the application displays the Patient Account form, where patient demographics can be viewed and/or updated for patients that are not on the current day s appointment schedule. Note: If after the update is complete the patient states that they would like to book an appointment, a user can select the Appt Sched tab or <F11> to access to the appointment scheduler screen. The application will retain the patient s information allowing the appointment to be booked quickly. Patient Appointment Recall recall. Select the patient then click on the tab and it will bring over the account to set a By selecting this tab or <Ctrl G> from the keyboard, the application displays the Account Recall Maintenance form and pulls over the group and account number of the patient selected. This screen can also be accessed by MM

39 Step by Step to set a Patient Appointment Recall The group number and account number will populate based on the selected patient. Use <tab> or <enter> past the group and account number, then the patient s last name, first name and DOB will populate, <tab> or <enter> to the doctor number field. Enter the doctor number, <tab> or <enter>. Enter the date to recall (MMDDYY). Enter the recall reason, choose a reason code. Enter the recall frequency, see help message, if applicable. Enter the recall letter id, enter the number if known or use the tab, then select <F2> to view letters available. From Recall Letters Maintenance use Back or <Ctrl Q> from the keyboard to return to the Account Recall Maintenance screen to enter the Id number of the letter necessary. When all information is complete, the user saves by selecting the Save icon from the Task Bar, or <F4> from the keyboard. To return to the Patient Reception Workstation, the user can select <Ctrl Q> from the keyboard or the 'Back' icon from the Task Bar. 39

40 To remove a patient from receiving a Recall Letter Access the Account Recall maintenance screen from MM11.5 or from the Patient Reception Workstation Patient Appointment Recall tab. Query the patient, then use the Delete Record icon or <Ctrl E> from the keyboard. Check Eligibility To enable Real Time Eligibility capability a (med) option must be set as well as participation in Passport. Please contact your client manager to ensure proper set up for this feature. Select the patient using the blue selector button then click on Check Eligibility or <F11> from the keyboard. When the eligibility begins to process, a box like the one below will appear if the patient has more than one (1) insurance on file. Double click on the correct insurance sequence to continue the eligibility check. If the patient only has one (1) insurance on file the eligibility will continue to process without a pop-up. Once the eligibility check is complete you will receive either a patient eligible message or another informational message, like the ones below. If the eligibility check is not successful or if there is missing information, the user will be taken to the Patient Insurance Record once the OK button is selected. If the patient is eligible the user will be taken back to the Patient Reception Workstation. 40

41 Appointment Scheduling By selecting this tab or <F8> from the keyboard, the application displays the Appointment Booking form where users can book appointments for patients who call in and they are not on the current day s appointment schedule. Generate Doctor s Schedule By selecting this tab or <F6> from the keyboard, the application will display the Generate Appointment Schedule form. This form can also be accessed by MM11.11 without the need of going through Patient Reception Workstation. 41

42 Group - Users can <tab> or <enter> to populate the group number and name. Start Date - The system will auto populate the current system date, as the start date, or the user can enter another date. End Date - If the End Date field is left blank, the system will default the same date as the Start Date. Enter the Location number (if applicable). For the question For all Doctors in the Group?, if a schedule is needed for all doctors on a specific day, the user will need to change the defaulted N to a Y and hit <tab> or <enter>. If this field is left to the defaulted N, when the user hits <tab> or <enter>, the cursor will default to the Doctor field and the user can enter the doctor number or doctors numbers for which they would like to print the schedule. The user will then select the tab or <F8> from the keyboard. The following pop-up displays: The user selects the appropriate radio button beside the report to run. If multiple printers are available the user can select the down arrow beside the printer field to select the appropriate printer or the user can leave it on View and the application will produce a PDF which can be printed. 42

43 Chart Pull List (6114) Route Slip/Out-Guides (9062) 43

44 Doctor s Appt List (13981) Patient Info (8631) 44

45 Daily Schedule (6113). This report will print both booked appointments and open time slots. Daily Schedule - Abbreviated (21562). This report will print both booked appointments and open time slots. 45

46 REGISTERING PATIENTS WHEN POSTING TRANSACTION Purpose: Used to check patients in for appointments and post payments and or charges. Post Copay/Charges: MM9.3 for users who need to post copays and/or charges, which requires the user to open a batch. Create or Query a Batch To post a charge or payment a batch must be opened or created. At the Master Menu, the user selects 9 Transaction Entry with the mouse or by entering 9 in the Enter Selection field to access the Transaction Entry Menu. 46

47 After selecting 9 Transaction Entry the Transaction Entry Menu displays. (MM9) The user selects 3 Batch Control: Patient Reception and Open Item Payment/Adjustment Entry with a mouse click or by entering 3 in the Enter Selection field and the Batch Control screen displays. 47

48 (MM9.3) Create a New Batch When creating a batch the only fields that are mandatory in this screen are Group Code, Batch Number and Deposit Date. However, other fields may be required operationally by the practice. The user can choose to enter a unique batch number or allow the system to the Save icon from after all applicable fields are completed and the batch is saved. The user selects Step by Step to create a new batch. The Task Bar or the <F4> Function key on the keyboard automatically assigns a sequential number. In the Group field, <tab> or <enter> through the field if the database code is set to default, or manually enter the group code. The user can use the mouse to skip to the Deposit Date field if entry in the following field is not necessary. Batch Number, <tab> or <enter> through the field to use a system. Generated number (populated upon save), or manually enter a number. Comment, optional free text field. Deposit Date, insert the current date. Lock Box ID, optional to enter the lockbox identification. Default DOS, optional to enter a date of service to default to each transaction line posted in the batch. Bank Batch ID, optional to enter the bank batch identification. Control Totals, <tab> or <enter> through the fields, a zero will populate in the Variance column. 48

49 Select the Save icon from the Task Bar or the <F4> Function key. Upon save, a batch number will be assigned. Querying for an Existing Batch If a user already has a batch open and would like to find the original batch, instead of opening a new one, please follow the steps below. Step by step to query an existing batch: Master Menu, select 9 Transaction Entry Menu Select 3 Batch Control: Patient Reception and Open Item Payment/Adjustment Entry the screen will be in 'Insert' mode which means the user will need to start a query. Start the query/search by selecting the 'Enter Query' icon from the Task Bar or by using the <F1> Function key on the keyboard. Enter any of the following information in order to search for an existing batch: o Batch number o Deposit Date o User ID Select the 'Execute Query' icon from the Task Bar or the <F2> Function key on your keyboard. (MM9.3) 49

50 From the Batch Control screen, the user selects the keyboard. tab or <F8> Function key from the (MM9.3, F8) The Charges/Payments/Adjs Entry form displays. The user selects the tab as shown by the red box above or <Ctrl A> from the keyboard to access the Patient Reception Workstation. The Patient Reception Workstation displays as shown below. 50

51 (MM9.3, F8, Ctrl A) Once a batch is created or an existing batch is found please follow the step by step on checking in a patient as shown above. The rest of this module will go into details on posting transactions via the Patient Reception Workstation. If you do NOT need to post any transactions you will only have access to the options in the red boxes (this via MM11.9) when checking in patients. 51

52 HOWEVER; if you DO need to post transactions at either the time the patient is checking in or checking out you will need to access the Patient Reception Workstation via MM9.3, F8, Crl A and will see the options in the red boxes. If posting Co-pays at the time the patient checks in If the patient s copay is attached to their insurance, on their account, you will receive this popup at the time the patient is checked in. NOTE: If you do not post copays at the time the patient checks in and you do not need this popup, please contact your Client Manager and asked them to turn this popup off. 52

53 Click on Yes you will then get a popup that contains your specific Co-pay payment codes. It is important to utilize your co-pay codes as this will allow the copay to attach itself to the charge if the charge is for the same doctor and same DOS at the time the charge is entered. Select the method of payment by either double clicking on it, or clicking on the Save, or using the F4 button. At this time the Charges/Payments/Adjs Entry form will automatically populate all of the patients information and will also populate the Attending doctor, as the doctor the appointment was booked with, the Ty field will automatically enter a P for payment and the Unit Amt will be completed with the amount of the patient s copayment. If the copayment amount is different you will have the ability to override the amount. 53

54 Save At the time that the payment is saved you will get a popup allowing you to print a receipt. You can make multiple copies. If you would like to print a receipt select OK, if not select Cancel. 54

55 If you printed a receipt you will receive the below popup, click on OK This will return you to the Patient Reception Workstation and you will see the word Paid in the Copay column. Step by Step if only the Copayment is posted at the time the patient checks out Click on the button to the left of the patient s appointment and select Post Copay from the popup Repeat the step by step directions as shown above in posting a copay at check in. 55

56 If a charge and a true copay are posted at the time the patient checks out Click on the button to the left of the patient s appointment and select Post Transactions This will bring you to the Quick Multiple Posting Screen to post any charge(s) and true copay The Acct, Name, Group, Batch and D.O.S. will default. NOTE: The D.O.S. will only default if you have entered the Default DOS on the Batch Control Screen. If the DOS. needs to be changed you can override the defaulted DOS. Tab or Enter to the Dx1 field. Enter all diagnosis codes needed After diagnosis codes are entered Tab or Enter and the cursor will move to the APhy field. This is for the attending doctor, this will default according to the doctor the appointment was booked with. RPhy is for referring physician if needed From the RPhy field <Enter>. This will take the cursor to the Loc field. This is the location field. When posting from the Patient Reception Workstation the Location will default from the appointment. When you <Enter> or <Tab> from the Loc field the cursor will advance to the Admit field. If none of the fields in this block need to be completed click on the Change Blocks tab and the cursor will advance to the block where transactions will be entered. The T column will default to a C, for charge. The D.O.S. will populate if it was defaulted on the Batch Control Screen. If not, enter the DOS <Enter> Enter the code for the charge <Enter> or <Tab>. This will populate some hidden fields for an Accession Number and NDC Code. If these fields are not needed <Enter> or <Tab> past these fields until the Description field populates according to the procedure code that was entered. MD fields These 4 fields are for any modifiers that need to be attached to the procedure code. Enter any modifiers needed. If none are needed <Enter> or <Tab> through the fields. <Enter> or <Tab> to the UnitAmt field. This is the dollar amount for the procedure. If you have attached your fees to each code the unit amount will populate. If needed the amount can be overridden. If the unit amount did not populate enter the amount <Enter> or <Tab> Perf is the Performing Physician. This will automatically default from the Attending Physician. If the patient saw an NP or PA and the patient s insurance does not recognize them enter the performing physician in this field and make sure that the APhy has the supervising physician entered. Qn is for quantity, if the quantity needs to be multiplied enter that amount in this field. IT field is for Insurance Type. This will automatically populate according to the patient s insurance or self pay if patient does not have insurance. PS is the Place of Service. This will default if the POS has been attached to the procedure code. If it does not populate enter the appropriate POS. 56

57 DDDD columns. These columns are used for you to rank the diagnosis code(s) that need to be applied to the specific charge. When the cursor is in each field as you <Enter> or <Tab> through the fields the numbers will populate according to how the diagnosis code(s) that were entered on the charge. You can rank the diagnosis codes accordingly by changing the number that defaults to correspond with the Dx number in the diagnosis codes. If additional charges are needed you can down arrow and the cursor will advance to the next line. Repeat the process. Save If a true copay needs to be posted please see next section. Posting true copays at the time charges are being posted After the charge(s) have been posted, the user can down arrow to the next line item to post the patient s copay. Change the T column from a C to a P for payment. The D.O.S. will default to the same as the charge(s), <enter> Enter the method of the co-payment in the Procedure field. A user will need to select from the specific co-payment pay codes that are set up in the database, <enter>. The user will see a hidden field for a Check Number. If the payment was something other than a check, the user will <enter> past the check number field. Note: If the patient is paying by credit card, the type of credit card could be entered in this field, if needed. The cursor will default to the UnitAmt field; the user will enter the amount of the copayment. At this point the user can Save. To return to the Patient Reception Workstation, the user can select <Ctrl Q> from the keyboard or the 'Back' icon from the Task Bar. 57

58 Post transactions on accounts not on current day s schedule Step by step to post a charge or payment to a patient that is not on the current day s schedule Access the Charges/Payments/Adjs Entry Screen by exiting back one screen from the Patient Reception Workstation Enter the patient s account number if you know it. If you do not know the account number refer to the next bullet. Query the patient s account by using the account number LOV button to search. This will take you to the Patient Account screen, query for the patient s account. Once it is located exit back and the account number will pull over. Tab or Enter to the diagnosis fields Dx1-Dx12 - There can be up to twelve (12) diagnosis codes entered. Note: Do not enter the decimal point; the system will insert the decimal point. Enter the Attending Doctor number, if on patient s account it will default. Enter the location where the patient was seen. In the TY field enter the type of transaction C for charge or P for payment. Enter the procedure according to the type of transaction that is being posted. MD1 MD4 These 4 fields are utilized to enter any modifiers that will be applicable to the charge being posted. Unit-Amount This is the dollar amount of the transaction that is being posted. Note: If the CPT fees spreadsheet was completed and loaded into a database the dollar amount for the CPT code will automatically populate. It can be overridden if necessary. Also, for a copayment that is being posted, if the copay amount has been attached to the patient s insurance record, the amount will automatically populate in the Unit-Amount field. Perf This field is where the Performing Doctor will need to be entered, if different from the Attending Doctor. Note: This field will automatically populate the doctor number that is entered in the APhy, attending physician, field. It can be overridden if the patient was seen by a NP or PA. If the NP 58

59 or PA cannot bill to the patient s insurance under his or hers own numbers then the Supervising physician s number will need to be in the APhy field and the NP or PA s doctor number will need to be entered in the Perf field. However; if the patient s insurance company allows a NP or PA to bill under their own numbers, then the NP or PA s doctor numbers can be entered in both the APhy and Perf fields. Quantity This field will default based on quantity associated with procedure code. This can be changed if you need to multiply the units enter a 2,3,4, etc. If the quantity is increased the dollar amount will also multiple. IT This field represents the Insurance Type. This will automatically populate according to the patient s primary insurance. Use the Reception tab or <Ctrl A> to return to the Patient Reception Workstation. NOTE: It is very important that payments or adjustments are posted to each charge line item when a payment has been received. Otherwise the payment or adjustment will appear on the Unallocated report and will have to be allocated at a later time. Step by step to post a patient payment on a past balance Exit back to the Batch Control Screen then select Auto Distribution tab or <F11> from the keyboard. 59

60 Enter the patient s account number <tab> or <enter>. This will populate the following fields: o Patient s name. o Balance The patient s balance. o Insurance Balance The balance out to insurance. o FC -Financial Class. o Ex Code - Exception code if one is attached to the patient s account o Msg Code Message code if one is attached to the patient s account o Cnt The number of times the Msg Code is to print on a patient s statement, if set. o Hold Stm Hold Statement if one is set on the patient s account. The below screen will populate. Enter the amount of the payment in the Payment Amount field. Enter the payment code for the method of payment in the Pay Code field. If the entire payment should be automatically distributed to the oldest charges first, either <tab> or <enter> or Click on the Select ALL DOS button. By activating the Select ALL DOS button, the system will apply a check mark to all of the open charge line items that have a balance that can be paid with the dollar amount of the payment. 60

61 Note: If it is determined that these are not the charge line items that the payment needs to be applied to the user can click on the Deselect ALL DOS button and the check marks will be removed. Once the Select ALL DOS button has been activated and the check marks are applied to the charge line items, and it is determined that these are the charge line items that need to have the payment(s) applied against, the user will either <enter> or Click on the Chgs Selected button, the cursor will default to the Check # field. If the method of payment was a check, enter the check number in this field. Note: This field could also be utilized to enter an authorization number from a credit card it that was the method of payment. Enter the Check Date, this is a required field. Please see screen shot below. 61

62 Save Step by Step if the patient payment needs to be applied to specific charge line item(s) and not auto distributed. Enter the patient s account in the Account field <tab> or <enter>. This will populate: o The patient s name, o Balance This is the patient balance, o Insurance Balance This is the balance that is out to insurance, o FC - Financial class, o Ex Code - Exception code if one is attached to the account, o Msg Code Message Code if one is attached to the account, o The count of how many statement cycles the message code should appear on the patients statement, if entered, o If a value is marked in the hold statement field on the patients account, it will display in the Cnt field. Enter the amount of the payment in the Payment Amount field <enter>. Enter the payment code for the method of payment in the Pay Code field <enter>. Using the mouse, click on each charge line item that the payment needs to be applied against. Note: When a payment is more than the Item Balance of the line item that is being selected, the Unapplied Amount, will display how much money remains to be applied to the remainder of the charge line item(s). Once all of the money has been applied, 62

63 the Unapplied Amount will be zero (0). Once the check marks are applied to the charge line item(s) <enter> or Click on the Chgs Selected button, the cursor will default to the Check # field. Complete the Check # field if applicable. Enter the Check Date. This is a required field. Save View/Update Copays/Charges To review transactions that have been entered for the patient s account, select View/Update copays/charges from the selector menu. The Charges/Payments/Adj Entry form will display. The user can review and update fields as necessary. Reconciling, Printing and Releasing a batch Batch Status o H= Hold A batch must be on a hold status before any transactions can be posted in it. The batch will automatically default to a H when a batch is opened. o E= Release for Editing In order to print the batch edit report, the user will change the batch status to and E and Save. Please see below for steps to printing a batch edit report. o R= Release for Posting Once a batch has been balanced and the Control Totals have been changed, the user will change the batch status to a R. Note: Clinix will only look for batches that have the R status on them to process in the nightly post. If the batch status is either an H or E that batch will still be available, to the user, until it is released. 63

64 Step by Step on how to print a batch Change the Batch Status to an E and Save. Click on the Batch Edit or use the <Shift F8> function key. The printer Parameters pop up will appear. o Printer The user can either click on the down arrow and choose a network printer, or choose to leave it on VIEW. o Updated By This field will automatically default to the person that is working in the batch. o Report Type The option of PDF will automatically default. However; if the user prefers to have the batch edit report print in the CSV format, the CSV radio button can be selected. Once the parameters have been selected, the user will click on OK. This will create the batch edit report. This report can be used to balance the batch or can be utilized as a hard copy of the transactions that are posted within the batch. 64

65 The batch edit report will print in the order that the transactions were posted within the batch. If payments and/or adjustments were posted in the batch, there will be a separate page with the totals for payments and adjustments. The Payment Summary will be a helpful tool in balancing the user s cash drawer at the end of the day. 65

66 Step by Step on how to balance and release a batch Actual Amounts The dollar amount will automatically continue to calculate as Charges, Payments and Adjustments are being posted in a batch. This is the dollar amount that the user will balance to. Variance The dollar amount in the Variance fields will automatically populate and will be just the opposite of the dollar amount in the Actual Amounts fields. Control Totals - These fields are for the user to balance the batch in order to release it for the nightly process. Once the batch has been balanced, the user will enter the amount that is showing in the Actual Amounts fields in each of the Control Totals fields. As the Control Totals are manually being entered, the Variance totals will change to 0, zero. The Variance fields must all be 0, zero before a batch can be released for the nightly process. Batch Status Once all the Variance fields are 0, zero, the user will change the Batch Status field to an R and Save. Clinix will check all batches at the time the nightly post, process, is run. Any batch that is set to status of R will be processed. The charges will be sent through our internal upfront scrubber and all charges that make it through our scrubbing process will be filed to the insurance companies. For the charges, if any, that do not make it through the upfront scrubbing process they will be stored in MM5.5 for the users to correct the next day. The user will receive a report each night when charges are rejected to MM5.5. If a batch is on either the status of H or E, Clinix will not process those batches and they will remain in the database until the user is ready to release them. 66