MillinPro+ USER GUIDE. A Complete Web-Based Platform for Managing Medical Bills and Insurance Claims

Transcription

1 MillinPro+ A Complete Web-Based Platform for Managing Medical Bills and Insurance Claims MILLIN ASSOCIATES, LLC USER GUIDE Copyrights Reserved Millin Associates, LLC

2 Document Change History Version Date Description Author /02/2013 Version 1.0 User Documentation Draft Pulomas 2

3 About User Documentation Version 1.O Product Copyright Millin Associates, LLC The Millin Associates, LLC and its documentation are protected by copyright law and international treaties. Unauthorized reproduction or distribution of this program, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. The products described in this document are furnished under license agreement by Millin Associates, LLC. The information contained in this document is subject to change without notice. Although every effort is made to update documentation in a timely manner, Millin Associates, LLC does not assume responsibility for the accuracy of the information presented. Companies, names and/or data used in screens and sample output are fictitious unless otherwise noted. All trademarks are the property of their respective owners. Document Purpose The purpose of this document is to help you to understand Millin Associates, LLC and provides you the easy and best ways to utilize the potentials of the application to the maximum. Audience This document is written for all users and support members who work and use Millin Medical Products. 3

4 Relevant URLs Name Millin Medical Site Contact URL Millin Associates, LLC 303 Merrick Road Suite 401 Lynbrook, NY Phone: Fax:

5 Contents 1. GETTING STARTED Overview Features Logging on to MillinPro Changing Password Logging Out of MillinPro Support Understanding MillinPro+ Interface Top Right Links Navigation Bar Workspace Managing Dashboard Dashboard Options Setting Date for Viewing Statistics on Dashboard Summary Options Summary/Statistics Invoice Status AR By Payer Statistics Revenue By Location Working with Patients Patients Screen Overview Customizing the Columns to be Displayed Sorting the Records by Column Changing the No. of Records to be Displayed on a Page Navigating Between Records Searching for a Record

6 4.7 Printing Records Exporting Records Adding a New Patient Record Editing a Patient Record Viewing a Patient Statement (Invoice) Working with Appointments Appointments Scheduler Overview Creating a New Appointment Editing an Appointment Billing a Patient on Appointment Adding an Item to Issue Tracker Applying Filters Marking an Appointment as Arrived Viewing Appointment Details Viewing Patient Information Deleting an Appointment Updating Locations and Providers Managing Appointment Dates Viewing Appointments in Calendar List Searching for Appointments Managing Ready to Bill Appointments Working with Encounters Searching for an Encounter Creating a New Encounter Adding an Encounter Invoice to Issue Tracker Deleting an Encounter Invoice Reviewing Encounters Working with Batches

7 7.1 Preparing a Batch Managing Accounts Receivables Searching for an Invoice Adding an Invoice to Issue Tracker Adding Invoice Notes Crossing over Writing Off Working with Issue Tracker Searching for an Issue Editing an Issue Generating Reports Creating a Report Running a Report Adding/Removing a Report to/from Favorites Types of Reports You can Generate Appointment Reports Authorization Reports Patient Reports Encounter Reports Accounts Receivable Reports Remits Reports Issue Tracker Reports Provider Reports Statement Reports Report Sets Managing Insurance Eligibility Issues Eligibility Screen Searching for an Eligibility Issue

8 11.3 Preparing the File Uploading Response Managing Utilities File Browser FX12 Viewer Claim Status Request Claim Status Response

9 1. GETTING STARTED 1.1 Overview MillinPro+ is a complete web-based platform for managing medical bills and insurance claims. It is incredibly easy to use and packed with lots of essential features. It provides you with all the tools you need to build efficiency and productivity, and gain fast access to real-time information on claims, statuses, electronic remittances, secondary billing, patient invoices and collection. And best of all, it s APG ready. Ideally designed for physicians, clinics and hospitals, MillinPro+ supports your daily essential tasks, and helps you to get paid faster the first time. It offers a robust reporting mechanism that allows you to create and quickly view many types of reports and export them in Excel or PDF. This User Guide helps you to understand MillinPro+ and provides you the easy and best ways to work with MillinPro+. You will be able to understand the basics quickly and you will also find that its platform is very easy to use. If you still have questions, don t worry! We are always there to assist you. Contact our technical support team. 1.2 Features Appointment Scheduler Patients Record Management Visit Tracking Code EOB/ERA processing Electronic submission to over 4,000 payers Quick Bills Secure, HIPAA-compliant Available Online 24/7 Smart Dashboard with Real Time Statistics Manage Encounters Custom Settings Manage Encounters Track Claims and Issues 9

10 Accounts Receivables Generate Reports Claims Eligibility Manage Utilities Manage Users Admin Settings 1.3 Logging on to MillinPro+ You can access and log into MillinPro+ by following the steps given below. 1. Open the browser and enter in the Address bar, the client specific URL for the MillinPro+ application. Enter URL The MillinPro+ login dialog will be displayed. 2 3 Click Login 10

11 2. Enter the user name in the text entry box. 3. Enter the password in the Password text entry box. 4. Click the Login button. The MillinPro+ Dashboard will be displayed. You can start exploring the options within MillinPro Changing Password Changing password is easy. Simply follow the steps given below. 1. Click the Change Password button in the topmost right corner of the screen. Click Change Your Password The Change Your Password dialog will be displayed Click Change Password 11

12 2. Enter the old password in the Old Password text entry box. 3. Enter the password in the New Password text entry box. The password requirements are Should contain at least a character; Should contain at least a number (0-9); Should contain at least one Letter (a-z); Should contain Letters, Numbers or punctuation only [!@#$^&*()-=_] 4. Re-enter your password to confirm in the Confirm New Password text entry box. 5. Click the Change Password button at the end. Now your password is changed and you can login with new login credentials. 1.5 Logging Out of MillinPro+ 1. To log out of MillinPro+, click the Logout button in the topmost right corner of the screen. Click Logout You will be logged out and the MillinPro+ Login dialog will be displayed. 12

13 1.6 Support For any questions or technical issues, you can contact us. Here are our contact details. Millin Associates, LLC 303 Merrick Road Suite 401 Lynbrook, NY Phone: Fax: Please use the contact form in the following link to help us serve you better. 13

14 2. Understanding MillinPro+ Interface The MillinPro+ interface gives you an easy and quicker access to important modules such as Dashboard, Appointments, Patients, Encounters, Batches, Accounts Receivable, Issue Tracker, Reports, Eligibility, Utilities and Administration. For more detailed information, you must refer the respective sections. Navigation Bar Top Right Links Workspace The components of MillinPro+ interface are Top Right Links Navigation Bar o Dashboard o Appointments o Patients o Encounters o Batches o Accounts Receivable o Issue Tracker 14

15 o Reports o Eligibility o Utilities Workspace 2.1 Top Right Links The Top Right Links provide access to the core Administration module, Change Password and Logout options of the MillinPro+ application. Top Right Links Application Issues The Application Issues gives the notification about the errors or issues in the applications received. Administration - The Administration module allows you to configure and customize admin settings such as Users, Providers, Locations, Payers, External Entities, Procedures, Diagnosis, Quick Changes, Group Sessions, Auth Proc Changes, Sliding Scales, Rate Codes, Visit Reasons, File Imports and Super Admin. Change Password- The Change Password dialog allows you to change your password to access the MillinPro+ application. Logout- The Logout link allows you to logout of the MillinPro+ application. 2.2 Navigation Bar The MillinPro+ Navigation Bar has options that provide quick access to important modules such as Dashboard, Appointments, Patients, Encounters, Batches, Accounts Receivable, Issue Tracker, Reports, Eligibility and Utilities. 15

16 Dashboard The Dashboard provides summary report of scheduled appointments, eligibility issues, number of encounters for 60 days, appointments ready to be billed and issue tracker items. It also provides statistics of Accounts Receivables By Payer, Provider Scheduling, 7 Day Appointment Summary, Appointments By Category and Revenue By Location. Patients - The Patients module allows you to create and manage patient records. Appointments - The Appointments module allows you to schedule and manage both individual and group appointments of patients. Encounters - The Encounters module allows you to track and manage patients that consult providers without prior appointments. Batches - The Batches module allows you to prepare invoice batches, manage batches that are in progress, sent to payer and returned invoices. It also allows you to upload 835 HIPAA compliant documents. Accounts Receivable - The Accounts Receivable module allows you to manage patient invoices and all account receivables by payers. Issue Tracker - The Issue Tracker module allows you to add, edit, track and manage issues related to invoices and claims. Reports - The Reports module allows you to customize and generate various reports related to appointments, authorizations, patients, encounters, account receivables, remits, issue trackers, providers, statements and report sets. Eligibility - The Eligibility module allows you to manage eligibility issues, insurance order sequences, prepare files and upload responses. Utilities - The Utilities module provides you access to some of the important utilities such as File Browser, X12 Viewer, Claim Status Request, Claim Status Response and Emdeon Files. 16

17 2.3 Workspace The MillinPro+ Workspace is the area where all the core modules will show up. It is in this area, you perform all scheduling of appointments, tracking of patient records, issues, claims and related activities. Workspace with Patient Records 17

18 3. Managing Dashboard 3.1 Dashboard Options The Dashboard provides summary report and key statistics for a selected period. They are Summary - The Summary tab shows the summary report of number of scheduled appointments, eligibility issues, encounters for 60 days, appointments ready to be billed and issue tracker items. It also provides statistics of Invoice Status, AR by Payer and Revenue by Location. 3.2 Setting Date for Viewing Statistics on Dashboard You can select the starting and ending date ranges for viewing statistics on your dashboard. 1. To do so, select the starting date for viewing statistics, from the Start Date calendar as shown below. 18

19 2 3 Click Go 2. Similarly, select the ending date for viewing statistics, from the End Date calendar. 3. Click the Go button. The dashboard refreshes and displays the statistics for the selected date range. 3.3 Summary Options The Summary Tab has 4 sections. They are Summary - The Summary section shows the details such as the number of scheduled appointments, eligibility issues, appointments ready to be billed, issue tracker items, auto crossovers to review and authorizations running low. Invoice Status - The Invoice Status section shows all the status of invoices, number of invoices in those statuses and the total balance in every status. AR By Payer - The AR By Payer section shows all the account receivables by payer. Revenue By Location - The Revenue By Location section shows all the payments by location. 19

20 4 Sections of Summary Dashboard Summary/Statistics The Summary section shows the details such as the number of scheduled appointments, eligibility issues, appointments ready to be billed, issue tracker items, auto crossovers to review and authorizations running low. 20

21 3.3.2 Invoice Status The Invoice Status section shows all the status of invoices, number of invoices in those statuses and the total balance in every status. 21

22 Column Name Status Number of Invoices Balance Description Refers to the status of the invoice such as OK to Bill, Hold, In Process and Returned from Payer. Refers to the number of invoices in every status Refers to the pending amount due for payment AR By Payer Statistics The AR By Payer section shows all the account receivables by payer. It shows details by columns such as Insurance Payer ID, Charge, Payment, Adjustment and Balance. Column Name Payer Name Charge Payment Adjustment Balance Description Refers to the name of the insurance payer Refers to the amount to be paid by the payer Refers to the payment already made. Refers to any adjustments made towards the payment Refers to the pending amount due for payment Revenue By Location The Revenue By Location section shows all the details of the payment by location. It shows details by columns such as Location, Charge, Payment, Adjustment and Balance. 22

23 Column Name Location Charge Payment Adjustment Balance Description Refers to the name of the location Refers to the amount to be paid Refers to the payment already made Refers to any adjustments made towards the payment Refers to the pending amount due for payment 23

24 4. Working with Patients 4.1 Patients Screen Overview The Patients module allows you to create and manage patient records. In all of the core modules of MillinPro+ application, the information is represented in the form of a list. Customize Columns Search Tool Action Buttons Edit Patient Links Show # of Records Navigation Buttons View Patient Info View Appointments Add New Appointment Add an Encounter 4.2 Customizing the Columns to be Displayed You can customize the columns to be displayed for the patient records. 1. To do so, simply click the button behind the Patients heading above the list of records. 24

25 Click to Customize The Columns dialog will be displayed. Select Required Column Names Click Close 2. Select the column headers that you wish to display simply checking the box behind the required columns. 3. Click the Close button. 4. To restore the default columns, click the Revert to Default button. 25

26 The selected columns will be shown in the Patients list. 4.3 Sorting the Records by Column You can sort the records based on a specific column. 1. To do so, simply click the column header by which you wish to sort the records. The records will be sorted by column either by alphabetically or numerically in the ascending order or descending order. In the following example, the records are sorted by Account number in the increasing order. Clicking the Account column again will sort the records by Account number in the decreasing order. Observe that the button toggles between (Ascending) and (Descending). Click Account Ascending Order Then the column Full Name is selected to sort the records by name in alphabetical order. 26

27 Click Full Name Descending Order The records are now sorted by Full Name in alphabetical order. Alphabetical Order Note: By clicking the Full Name again, you can sort the records by Full Name in reverse alphabetical order. 27

28 4.4 Changing the No. of Records to be Displayed on a Page Note: This is the common operation in most of the modules. In all of the core modules of MillinPro+ application, the information is represented in the form of a list. You can choose to select the number of records to be displayed in a page. 1. To do so, select the required value from the Show drop down list above the list of the records. The available options are 10, 25, 50 and 100. In the following example, currently 50 records are displayed and the newly selected value is 10. Select # of Records Current # of Records Now only 10 records are displayed. 28

29 Changed to 10 Showing 10 Records 4.5 Navigating Between Records Note: This is the common operation in most of the modules. You can easily navigate between records using the navigation tab in the top right corner above the list of records. The available options are First, Previous, Next, Last and the specific page number. Simply click the required option to navigate to that page. 29

30 Navigation Options 4.6 Searching for a Record Note: This is the common operation in most of the modules. Searching for a record is very easy. 1. Enter the keyword to search for, in the Search text box. 2. Click the Search button. The search results will be filtered and displayed. Advanced Search Search 30

31 3. For advanced search, click the magnifying button behind the Search text entry box. The Search By dialog will be displayed Click Search Note: You can use one or more options to search for the required results. 4. Enter the first name of the patient in the First Name text entry box. 5. Enter the last name of the patient in the Last Name text entry box. 6. Enter the file number of the patient in the File Number text entry box. 7. Enter the SSN number of the patient in the SSN text entry box. 8. Click the Search button. 9. To restore the default search options, click the Reset to Default button. In the above example, the First Name of the patient as Cody is being searched. The search results will be filtered and displayed. Observe that all the patients that have their first name as Cody are listed. 31

32 By First Name 10. To clear the search results, click the Clear button. Click Clear The search results will be cleared and all the records will be displayed. 4.7 Printing Records Note: This is the common operation in most of the modules. 1. To print the records, click the Print button above the list of patients. 32

33 Click Print The Open dialog will be displayed. Click OK 2. Save the file to your computer. All the records will now be saved and displayed in PDF format. Now, you can print this file like any other file on your computer using the default printer attached to your computer. 33

34 4.8 Exporting Records Note: This is the common operation in most of the modules. 1. To export the records to excel format, click the Export button above the list of patients. Click Export 34

35 The Open dialog will be displayed. Click OK 2. Save the file to your computer. The records are now downloaded as excel file. 35

36 4.9 Adding a New Patient Record Adding a patient record is easy. Simply follow the steps given below. 1. Click the New button above the list of existing patients. 36

37 Click New The Create a Patient dialog will be displayed. Begin entering the necessary information in the required fields. Click Add a Phone The Account field takes automatic value by default. 3. Enter the file number in the File Number text entry box. 4. Select the status of the patient from the Status drop down list. The available options are Active, Inactive, Discharged and Pending. 5. Select the type of the patient from the Patient Type drop down list. 6. Enter the first name of the patient in the First Name text entry box. 37

38 7. Enter the middle name of the patient in the MI text entry box. 8. Enter the last name of the patient in the Last Name text entry box. 9. Enter the date of birth of the patient in the DOB text entry box. 10. Select the gender of the patient from the Gender drop down list. The available options are Male, Female and Unknown. 11. Enter the social security number of the patient in the SSN text entry box. 12. Enter the address of the patient in the Address 1 and Address 2 text entry boxes. 13. Enter the patient s city in the City text entry box. 14. Select the state from the State drop down list. 15. Enter the zip code in the Zip text entry box. 16. Click the Add a Phone button in the Phone Numbers section to the right. Add phone numbers of home and office. Scroll down on the Create a Patient page to access more information. 38

39 17. In the Demographics tab, provide information about patient s marital status, language, race, employer, country and other details related to patient s PCP visits. 18. In the Insurance tab, provide the insurance details of the patient such as payer, policy number and other related information. 19. In the Authorizations tab, provide the authorization details such as authorization number, insurance policy, number of claims, provider, authorization procedure, article type and other related information. 20. In the Attributes tab, provide the details of the patient attributes. 39

40 21. In the Recurring Appointments tab, provide the details of all recurring appointments related to the patient. 22. In the Notes tab, enter comments or notes if any, related to the patient. 23. In the Additional Addresses tab, provide the details of any additional addresses of the patient. 24. In the Programs tab, provide the details of patient programs. 40

41 25. Finally click the Save button. The new patient record will be added to the list of existing records Editing a Patient Record 1. To edit a patient record, click the Account number of the patient record that you wish to edit. Click to Edit The Edit a Patient page will be displayed. 41

42 For more details on editing the patient record, refer to Adding a New Patient Record section of this manual. From the Edit a Patient page, you can also perform the following tasks. For more details, refer the respective sections. Creating a New Appointment Adding a New Encounter Viewing a Patient Statement (Invoice) 4.11 Viewing a Patient Statement (Invoice) 1. Click the Account number of the patient record for which you wish to view the statement. The patient record will be opened in the edit mode. Click Statement 2. Click the Statement button. 42

43 The invoice statement for the selected patient will be displayed. 43

44 5. Working with Appointments 5.1 Appointments Scheduler Overview The Appointments Scheduler allows you to schedule and manage both individual and group appointments of patients. 1. Navigate to Appointments tab in the main navigation bar. Click Appointments The Calendar Options dialog will be displayed for you to display the scheduler based on the location, provider type and providers Click Load 44

45 2. If you want to show the appointments based only on the scheduled providers, check the box behind the Show only scheduled providers field. Note: The selected locations will not have any effect when this field is checked. 3. To show the appointments based on locations, select the required locations by checking the respective boxes in the Locations list. 4. Select the type of the provider from the Provider Type drop down list. 5. Select the required providers by checking the respective boxes in the Providers list. 6. Click the Load button. The Appointment Scheduler displays all the appointments based on the selections made in the Calendar Options. Search Tool Secondary Navigation Calendar Settings Filters Scheduler Color Codes Arrived Patient Scheduled Appointments 45

46 5.2 Creating a New Appointment Creating a new appointment is very easy. Simply follow the steps given below. 1. Click the Create New Appointment button Or Click the time schedule on the Appointment Scheduler screen. The Create an Appointment dialog will be displayed Click Save 2. Select the Patient by clicking the Search tool in the Patient field and selecting the required patient by filtering the results. 3. The fields such as File Number, Status, Date, Time and Length are automatically filled. You can make the changes to the Status, Date, Time and Length as required. 4. Select the location by clicking the Search tool in the Location field and selecting the required location by filtering the results. 5. Select the reason for visit from the Visit Reason drop down list. 6. Select the Provider by clicking the Search tool in the Provider field and selecting the required provider by filtering the results. 46

47 7. Select the supervising person by clicking the Search tool in the Supervising field and selecting the required supervising person by filtering the results. 8. Select the referring person by clicking the Search tool in the Referring field and selecting the required referring person by filtering the results. 9. Enter the consultation fee in the Expected Amount text entry box in Copay section. 10. Select the Insurance payer by checking the required Payer in the Current Payer field. 11. Click the Save button. The appointment will be scheduled for the specified date and time for the selected patient. 5.3 Editing an Appointment 1. To edit an appointment, click that appointment on scheduler. The appointment details will be opened in edit mode. 47

48 2. Make the necessary changes and click the Save button. For more information on editing the fields, refer to Creating a New Appointment section. 5.4 Billing a Patient on Appointment 1. Open the appointment for which you wish to generate bill, in edit mode. The Edit an Appointment page will be displayed. 48

49 Click Bill Appointment 2. To bill the patient, click the Bill Appointment button. The Billing section will be appended Click Save 3. Select the rate code by clicking the Search tool in the Rate field and selecting the required rate code by filtering the results. 4. Select the date for the invoice by using the calendar in the DOS field. 5. Select the right procedure by clicking the Search tool in the OFF-HCPCS field and selecting the required procedure by filtering the results. 6. Select the diagnosis code by clicking the Search tool in the Dx1 field and selecting the required diagnosis code by filtering the results. 7. Enter the number of units in the Units field. 49

50 8. Edit the charges if necessary in the Charge field. 9. Click the Save button. The Appointment Settings dialog will be displayed Click Continue 10. Check the box in order to set the Appointment Status as Seen. 11. You can also choose to either bill the appointment or keep it in hold. To do so, select the required option to set the Invoice Status. The available options are OK to Bill and Hold. 12. Click the Continue button. The invoice will be generated for the selected appointment and related patient. 5.5 Adding an Item to Issue Tracker 1. Open the appointment for which you wish to add issue tracker, in edit mode. The Edit an Appointment page will be displayed. 50

51 Click Add To Issue Tracker 2. Click the Add to Issue Tracker button. The Add Issue Tracker dialog will be displayed Click Save 3. ID, Type and Item ID fields are automatically filled. 4. Select the Status of the issue tracker from the Status drop down list. The available options are Open, Rebilled, Written Off and Corrected. 5. Select the assignee by clicking the Search tool in the Assignee field and selecting the required assignee by filtering the results. 51

52 6. Select the description for the issue tracker from the Description drop down list. 7. The related message will be automatically updated. You can also edit the same. 8. Click the Save button. The new issue tracker will be added. 5.6 Applying Filters The filters help you to display only required results by eliminating unwanted results To view all scheduled appointments, check the Scheduled option. 2. To view the appointments in which patients have arrived, check the Arrived option. 3. To view all appointments that are seen, check the Seen option. 4. To view all cancelled appointments, check the Cancelled option. 52

53 5. To view all billed appointments, check the Billed option. 6. To view all rescheduled appointments, check the Rescheduled option. 7. To view all appointments where patients did not show up, check the No Show option. 8. To view all out of house appointments, check the Out of House option. 9. To view all issue trackers with appointments, check the Issue Tracker option. 10. To view all appointments, check the Hide No Appointments option. As you apply the filter, the results will be filtered automatically and displayed. 5.7 Marking an Appointment as Arrived 1. Right click on the appointment that you wish to mark as arrived. Click Arrived 53

54 2. Select the Arrived option in the popup menu. The appointment will be now set as Arrived. Note that the color code of the appointment is also changed. 5.8 Viewing Appointment Details 1. To view appointment details, right click on the required appointment. Then select the View Details option in the popup menu. Click View Details The Appointment Details will be displayed in View mode. 54

55 5.9 Viewing Patient Information 1. To view patient information, right click on the required appointment. Then select the View Patient Info option in the popup menu. Click View Patient Info The Patient Info will be displayed in View mode. 55

56 5.10 Deleting an Appointment 1. Open the appointment that you wish to delete, in edit mode. The Edit an Appointment page will be displayed. Click Delete 2. Click the Delete button. The message box asking you to confirm the deletion of the appointment will be displayed. 56

57 Click Ok 3. Click the OK button. The selected appointment will be removed Updating Locations and Providers You can update the locations and providers to view specific appointments related to those locations and providers. 1. To do so, click the Update Locations and Providers button ( ) in the top right navigation buttons. Click Update Locations The Calendar Options dialog will be displayed. 57

58 Click Load 2. If you want to show the appointments based only on the scheduled providers, check the box behind the Show only scheduled providers field. Note: The selected locations will not have any effect when this field is checked. 3. To show the appointments based on locations, select the required locations by checking the respective boxes in the Locations list. 4. Select the type of the provider from the Provider Type drop down list. 5. Select the required providers by checking the respective boxes in the Providers list. 6. Click the Load button. The Appointment Scheduler displays all the appointments based on the selections made in the Calendar Options. 58

59 5.12 Managing Appointment Dates You can view appointments in various modes using the top right navigation buttons To view appointments of the previous date. 2. To select or change appointment date. 3. To view appointments of next date. 4. To view appointments for today. 5. To view appointments for 1 day. 6. To view appointments for 3 days. 7. To view appointments for 5 days. 8. To view appointments for 7 days Viewing Appointments in Calendar List 1. To view appointments in calendar list format, click the Calendar List tab within the Appointments module. All the appointments for the selected date will be displayed in the list form. Click Calendar List 59

60 5.14 Searching for Appointments Searching for appointments is very easy. 1. Click the Appointment Search tab in the secondary navigation within the Appointments tab. Click Appointment Search The Appointment Search page will be displayed. 60

61 Click Search Note: You can use one or more search criteria for searching for the required appointment. 2. Enter the patient name in the Patient text entry box or select the patient by clicking the Search tool in the Patient field and selecting the required patient by filtering the results. 3. Enter the location name in the Location text entry box or select the location by clicking the Search tool in the Location field and selecting the required location by filtering the results. 4. Enter the provider name in the Provider text entry box or select the provider by clicking the Search tool in the Provider field and selecting the required provider by filtering the results. 5. Select the starting and ending appointment dates from the calendars in the Appointment Date field. 6. Select the status of the appointment from the Status drop down list. The available options include Scheduled, Arrived, Seen, Cancelled, Billed, Rescheduled, No Show, Out of House and Issue Tracker. 7. Click the Search button. The search results will be displayed based on the selected search criteria. 61

62 5.15 Managing Ready to Bill Appointments You can view only the appointments that are ready for billing. 1. To do so, click the Ready to Bill tab in the secondary navigation bar within the Appointments module. Click Ready to Bill All the appointments that are ready for billing will be displayed. You can click the Appt Id (Appointment Id) to generate the bill. For more information, refer to Billing a Patient on Appointment section. 62

63 6. Working with Encounters The Encounters module allows you to track and manage patients that consult providers without prior appointments. 1. Navigate to Encounters tab in the main navigation bar. Click Encounters The Encounters page will be displayed. You can manage the invoices of all the patients who visit providers without appointments. 63

64 6.1 Searching for an Encounter Searching for encounters is very easy. 1. On the Encounters page, provide search criteria to search for required encounter Click Search Note: You can use one or more search criteria for searching for the required encounter. 2. Enter the patient name in the Patient text entry box or select the patient by clicking the Search tool in the Patient field and selecting the required patient by filtering the results. 3. Enter the location name in the Location text entry box or select the location by clicking the Search tool in the Location field and selecting the required location by filtering the results. 4. Enter the provider name in the Provider text entry box or select the provider by clicking the Search tool in the Provider field and selecting the required provider by filtering the results. 5. Enter the payer name in the Payer text entry box or select the provider by clicking the Search tool in the Payer field and selecting the required payer by filtering the results. 6. Select the starting and ending encounter number ranges in the Encounters # field. 7. Select the starting and ending date of service ranges from the calendars in the DOS field. 8. Select the status of the invoice from the Status drop down list. The available options include Hold, OK to Bill, Batched and Rejected by Payer. 64

65 9. Select the originating source of the invoice from the Originating Source drop down list. The available options include Select All, Original, Rebill and Crossover. 10. Enter the user name in the Added By text entry box or select the user by clicking the Search tool in the Added By field and selecting the required user by filtering the results. 11. Click the Search button. The search results will be displayed based on the selected search criteria. 6.2 Creating a New Encounter 1. On the Encounters page, click the Create New button on the top right corner above the Search section. Click Create New The Charge Entry page will be displayed. 65

66 2. Enter the patient name in the Patient text entry box or select the patient by clicking the Search tool in the Patient field and selecting the required patient by filtering the results. 3. The File Number, Provider and Supervising fields are automatically updated. 4. Enter the location name in the Location text entry box or select the location by clicking the Search tool in the Location field and selecting the required location by filtering the results. 5. Enter the amount expected from the patient in the Expected Amount text entry box. 6. Select the Current Payer for the patient in the Insurance section. 7. Select the billing status from the drop down list. The available options are Hold, OK to Bill and Non Billable. 8. In the Billing section, enter the rate in the Rate text entry box or select the rate by clicking the Search tool in the Rate field and selecting the required rate by filtering the results. 9. Specify whether the encounter was offsite or not by checking or un-checking the field in the Offsite checkbox. 10. Select the reason for encounter billing from the 90 Day Reason drop down list. 66

67 11. Select the date of service from the DOS calendar. 12. Click the Add Procedure button to add the procedure related to the patient encounter. 13. Enter the diagnosis in the Dx1 text entry box or select the diagnosis by clicking the Search tool in the Dx1 field and selecting the required diagnosis by filtering the results. 14. Similarly enter or select other diagnosis if any, in the Dx2 and Dx3 fields. 15. Enter the number of units in the Units text entry box. 16. Enter the related charge in the Charge text entry box. 17. Click the Save button. The new encounter will be saved. 6.3 Adding an Encounter Invoice to Issue Tracker 1. On the Encounters page, search for the required invoice and click the invoice that you wish to add to an issue tracker. Click Encounters 67

68 The View Invoice page will be displayed. Click Add To Issue Tracker 2. Click the Add to Issue Tracker button. The Add Issue Tracker dialog will be displayed Click Save 3. ID, Type and Item ID fields are automatically filled. 4. Select the Status of the issue tracker from the Status drop down list. The available options are Open, Rebilled, Written Off and Corrected. 5. Select the assignee by clicking the Search tool in the Assignee field and selecting the required assignee by filtering the results. 68

69 6. Select the description for the issue tracker from the Description drop down list. 7. The related message will be automatically updated. You can also edit the same. 8. Click the Save button. The new issue tracker will be added. 6.4 Deleting an Encounter Invoice 1. On the Encounters page, search for the required invoice and click the invoice that you wish to delete. The View Invoice page will be displayed. 69

70 Click Delete 2. Click the Delete button. The confirmation message box asking you to confirm the deletion of the invoice will be displayed. Click Ok 3. Click the OK button. The selected encounter invoice will be removed. 6.5 Reviewing Encounters 1. Click the Encounter Review tab in the secondary navigation within the Encounters tab. 70

71 Click Encounter Review Search for the encounters using the search criteria in the search fields. The list of all encounters based on search criteria will be displayed. 2. Click the Invoice Id to review the invoice and encounter details. 71

72 7. Working with Batches 7.1 Preparing a Batch 1. Click the Prepare Batch tab in the secondary navigation within the Batches tab. The list of all invoices along with the processing methods and patient details will be displayed. 2. Click the Generate Batches button. The Columns dialog will be displayed. 72

73 3. Select the columns that you wish to include in the batch. 4. Click the Close button. The new batch will be prepared and listed in the In Progress tab. All the batches are sent to the payer will be listed in the Sent to Payer tab. 73

74 All the batch files that are accepted will be listed in the File Accepted tab. All the batch files that are rejected and returned will be listed in the Returned tab. 74

75 8. Managing Accounts Receivables The Accounts Receivable module allows you to manage patient invoices and all account receivables by payers. 1. Navigate to Encounters tab in the main navigation bar. The Accounts Receivable page will be displayed. From here, you can manage all your invoices. 8.1 Searching for an Invoice Searching for invoices is very easy. 1. On the Account Receivable page, provide search criteria to search for required invoice. 75

76 1 Click Search Note: You can use one or more search criteria for searching for the required invoice. 2. Enter the patient name in the Patient text entry box or select the patient by clicking the Search tool in the Patient field and selecting the required patient by filtering the results. 3. Enter the location name in the Location text entry box or select the location by clicking the Search tool in the Location field and selecting the required location by filtering the results. 4. Select the starting and ending dates of service ranges from the calendars in the DOS field. 5. Select the starting and ending invoice date ranges from the calendars in the Invoice Date field. 6. Select the status of the invoice from the Status drop down list. The available options include Sent to Payer, Returned from Payer and Accepted by Payer. 7. Select the originating source of the invoice from the Originating Source drop down list. The available options include Select All, Original, Rebill and Crossover. 8. Enter the payer name in the Payer text entry box or select the payer by clicking the Search tool in the Payer field and selecting the required patient by filtering the results. 9. Select the status of the payment for invoice from the Payment/Denial drop down list. The available options include Sent to Payer, Has Payments and Has Denials. 10. Enter the remit code of the invoice in the Remit Code text entry box. 11. To hide all invoices that have null balance, check the box in the field, Hide 0 Bal. 76

77 12. Click the Search button. The search results will be displayed based on the selected search criteria. 8.2 Adding an Invoice to Issue Tracker 1. On the Accounts Receivable page, search for the required invoice and click the invoice that you wish to add to an issue tracker. The View Invoice page will be displayed. Click Add To Issue Tracker 77

78 2. Click the Add to Issue Tracker button. The Add Issue Tracker dialog will be displayed Click Save 3. ID, Type and Item ID fields are automatically filled. 4. Select the Status of the issue tracker from the Status drop down list. The available options are Open, Rebilled, Written Off and Corrected. 5. Select the assignee by clicking the Search tool in the Assignee field and selecting the required assignee by filtering the results. 6. Select the description for the issue tracker from the Description drop down list. 7. The related message will be automatically updated. You can also edit the same. 8. Click the Save button. The new issue tracker will be added. 8.3 Adding Invoice Notes 1. On the Account Receivable page, click the invoice for which you wish to add a note. The View Invoice page will be displayed. 78

79 2. Click the button above the invoice details. The Invoice Notes dialog will be displayed. Click Add A Note 3. Click the Add a Note button. The Add Notes dialog will be displayed. 79

80 4 5 Click Save 4. Select the type of the message from the Type drop down list. The available options include Issue Tracker, Message, Warning and Hold Reason. 5. Enter the message in the Message text entry box. 6. Click the Save button. The message will be added to the invoice. 8.4 Crossing over You can adjust an invoice by crossing it over to zero balance. 1. To do so, click the required invoice on the Account Receivable page. The View Invoice page will be displayed. 80

81 2. Click the Crossover button. The invoice amount will be adjusted. 3. In order to restore back the invoice to OK to Bill status, click the invoice link above the Invoice Details. The invoice will now be changed to OK to Bill. 81

82 8.5 Writing Off 1. To write off an invoice, click the required invoice on the Account Receivable page. The View Invoice page will be displayed. 2. Click the Writeoff button. The message box asking you to confirm the writing off of the invoice will be displayed. 3. Click the OK button to confirm. The payment will be written off and the balance will be adjusted to zero. 82

83 9. Working with Issue Tracker The Issue Tracker module allows you to add, edit, track and manage issues related to invoices and claims. 1. Navigate to Issue Tracker tab in the main navigation bar. Click Issue Tracker The Issue Tracker page will be displayed. You can manage the invoices of all the patients who visit providers without appointments. 9.1 Searching for an Issue Searching for an issue is very easy. 1. On the Issue Tracker page, provide search criteria to search for required issue. 83

84 Click Search Note: You can use one or more search criteria for searching for the required issue. 2. Enter the patient name in the Patient text entry box or select the patient by clicking the Search tool in the Patient field and selecting the required patient by filtering the results. 3. Select the status of the issue tracker from the Status drop down list. The available options include Open, Rebilled, Written Off and Corrected. 4. Enter the user name in the Created By text entry box or select the user by clicking the Search tool in the Created By field and selecting the required user by filtering the results. 5. Select the lookup status of the issue, from the Lookup Status drop down list. The available options include Open and Closed. 6. Select the category of the issue, from the Category drop down list. 7. Select the type of the issue, from the Type drop down list. The available options include Appointment and Invoice. 8. Click the Search button. The search results will be displayed based on the selected search criteria. 84

85 9.2 Editing an Issue 1. On the Issue Tracker page, click the issue that you wish to edit. The View Issue Tracker dialog will be displayed ID, Type and Item ID fields are automatically filled. 85

86 3. Select the status of the issue from the Status drop down list. The available options are Open, Rebilled, Written Off and Corrected. 4. Select the assignee by clicking the Search tool in the Assignee field and selecting the required assignee by filtering the results. 5. By and Created On fields are automatically filled. 6. Select the status of the invoice from the Invoice Status drop down list. The available options include Hold and OK to Bill. 7. Select the category of the issue tracker from the Issue Tracker Category drop down list. 8. Edit the description for the issue in the Description text entry box. 9. Enter the notes in the Add a Note multi text entry box. 10. Click the Save button. The selected issue will be edited. 86

87 10. Generating Reports The Reports module allows you to customize and generate various reports related to appointments, authorizations, patients, encounters, account receivables, remits, issue trackers, providers, statements and report sets. 1. Navigate to Reports tab in the main navigation bar. Click Reports The Reports page will be displayed. From here, you can create and run reports Creating a Report You can create various reports related to appointments, authorizations, patients, encounters, account receivables, remits, issue trackers, providers, statements and report sets. All reports are created in the same way. 87

88 In the following example, an appointment report is created. 1. On the Reports page, click the Add ( ) button to the right of the report that you wish to generate, in the secondary navigation tabs. The Create Report page will be displayed Click Save 2. Enter the name of the report in the Report Name text entry box. 3. The Report Source field is automatically selected. 4. To disable editing the report, you can lock it by checking the box in the Lock field. 5. Enter the description for the report in the Description text entry box. 6. Double click the field names to add the required fields to the report in the Fields column. 88

89 7. You can select the Sub Total for the specific field. It will be either Count or Sum. 8. You can rearrange the fields by moving the field up or down. To do so, use the button to move up and button to move down the list. 9. To remove a field, simply click the Delete ( ) button. 10. You can also group the fields based on a specific field. You can group up to 3 levels. To group fields based on a specific field, select the required field from the Group 1 drop down list. Similarly, you can select up to 3 groups. 11. Click the Save button. The report will be now saved. You can run the report and view or print the results Running a Report 1. On the Reports page, click the report that you wish to generate. The report will be ready for generating. 89

90 Click Run Report 2. To filter reports, provide the required search criteria and click the Run Report button. The report will be generated. You can print or export the report Adding/Removing a Report to/from Favorites 1. To add a report to Favorites section, click the Add to Favorites ( ) button in the row of the report you wish to add. Click Add To Favorites The selected report is now added to Favorites section. 2. Click the Favorites tab. 90

91 3. Click the Remove from Favorites ( ) button in the row of the report you wish to remove from Favorites section. The selected report will be removed from Favorites Types of Reports You can Generate There are many types of reports that you can customize and generate. They are reports related to appointments, authorizations, patients, encounters, account receivables, remits, issue trackers, providers, statements and report sets Appointment Reports You can customize and generate various types of appointment reports such as daily / weekly / monthly / yearly appointment reports with required fields and grouped by specific fields. 91

92 Authorization Reports You can customize and generate various authorization reports with custom selected fields and grouped by specific fields Patient Reports You can customize and generate various patient reports with custom selected fields and grouped by specific fields. 92

93 Encounter Reports You can customize and generate various encounter reports with custom selected fields and grouped by specific fields. 93

94 Accounts Receivable Reports You can customize and generate various invoice reports with custom selected fields and grouped by specific fields Remits Reports You can customize and generate various remits reports with custom selected fields and grouped by specific fields Issue Tracker Reports You can customize and generate various issue tracker reports with custom selected fields and grouped by specific fields. 94

95 Provider Reports You can customize and generate various provider reports with custom selected fields and grouped by specific fields. 95

96 Statement Reports You can customize and generate various statement reports with custom selected fields and grouped by specific fields Report Sets You can customize and generate various report sets with custom selected report fields and grouped by specific fields. 96

97 97

98 11. Managing Insurance Eligibility Issues 11.1 Eligibility Screen The Eligibility screen provides information on eligibility issues and insurance order sequence. You can also prepare file related to eligibility and upload response for the same Searching for an Eligibility Issue Searching for an eligibility issue is very easy. 1. Navigate to Eligibility tab in the main navigation bar. The Eligibility page will be displayed. Click Click Eligibility 2. Click on the Eligibility Issues sub tab. The Eligibility Issues page will be displayed. 98

99 Click Note: You can use one or more search criteria for searching for the eligibility issue. 3. In the Patient field, enter the name of the patient in the text entry box or click the Search ( ) button to search for the patients names. The Search window will be displayed A 99

100 A. In the Patients field, enter a part of or complete name in the text entry box. The results with the search keyword will be displayed. You may copy the name and paste it in the text entry box in the Patient field in the Eligibility Issues window. 4. Select the starting and ending date of service ranges from the calendars in the DOS field. 5. Enter the batch ID in Batch ID text entry box. 6. Select the result code for the eligibility issue from the Result Code drop down list. 7. Specify whether there should be an exception filter or not by checking/un-checking the box in the Exception Filter? field. 8. Specify whether or not only latest search results to be displayed by checking/un-checking the box in the Only Latest? field. 9. Click the Search button. The search results will be filtered and displayed Preparing the File Preparing the file is very easy. 1. Navigate to Eligibility tab in the main navigation bar. The Eligibility page will be displayed. Click Prepare 2. Click the Prepare File tab. 100

101 The Eligibility Search page will be displayed. Click Search 3. In the Search section, select the starting and ending date of the eligibility from the calendars in the Date field. 4. Select the search criterion for the eligibility from the drop down list. The available options are Appointment, Encounters and Patient Created. 5. Select the eligibility status from the Eligibility Status drop down list. 6. Click the Search button. The search results will be filtered and displayed

102 7. Click the Get X12 button to download the X12 format file. A system message box asking for you to open or save the file will be displayed. Click 8. Click the OK button Uploading Response Uploading response is very easy. 1. Navigate to Eligibility tab in the main navigation bar. The Eligibility page will be displayed. Click Upload 2. Click the Upload Response tab. 102

103 The Eligibility Response page will be displayed. 3 Click Preview 3. In the File section, click the Browse button to upload the related file from your computer. 4. Click the Preview Results button. The selected file will be displayed. 103

104 12. Managing Utilities 12.1 File Browser Browsing for a file is very easy. 1. Navigate to Utilities tab in the main navigation bar. The Utilities page will be displayed. Click File Browser 2. Click the File Browser tab. The File Browser page will be displayed. 3 Click Search 3. Enter the keyword to search for, in the Search text box. 4. Click the Search button. The search results will be filtered and displayed. 104

105 12.2 FX12 Viewer Viewing a file in X12 format is very easy. 1. Navigate to Utilities tab in the main navigation bar. The Utilities page will be displayed. Click X12 Viewer 2. Click the X12 Viewer tab. The File Browser page will be displayed Click the Browse button to select a file from your computer to view in the X12 format. 4. Click the View button. A new link View Raw File option will be displayed next to the View button. 105

106 5. Click the View Raw File option Claim Status Request Requesting for the claim status is very easy. 1. Navigate to Utilities tab in the main navigation bar. The Utilities page will be displayed. Click Claim Status 2. Click the Claim Status Request tab. The Claim Status Request page will be displayed In the Batch IDs (comma separated) field, enter the batch ID in the text entry box. 4. Click the Generate button. 5. To filter and view all medicare claim status, click the All Medicare option. 6. To filter and view all medicaid claim status, click the All Medicaid option. 106

107 You can also export the claim status by clicking the Export button Claim Status Response Responding for a claim status is very easy. 1. Navigate to Utilities tab in the main navigation bar. The Utilities page will be displayed. Click Claim Status 2. Click the Claim Status Response tab. The Claim Status Response page will be displayed Click the Browse button to select the related file from your computer. 4. Click the View button to view the response. 107