FREQUENTLY ASKED QUESTIONS

(ACTION CODE A)     (ACTION CODE B)     (ACTION CODE C)

(ACTION CODE D)     (ACTION CODE E)     (ACTION CODE I)

(ACTION CODE T)     (ACTION CODE V)     (RESUBMITTING CLAIMS)

COMMON QUESTIONS PERTAINING TO PATIENT ADDS (ACTION A)

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Q.  WHAT WILL HAPPEN IF I DO NOT FOLLOW THE FORMAT FOR ADDING A PATIENT          NAME - LAST NAME, COMMA, SPACE AND FIRST NAME.

A.  THE PATIENT WILL NOT FALL IN ALPHABETICAL ORDER IN THE PATIENT MASTER DATA BASE MAKING IT HARDER TO LOCATE THE PATIENT FOR FUTURE INQUIRY. THE INSURANCE CLAIMS WILL BE REJECTED FOR IMPROPER NAME FORMAT. INSURANCE WILL NOT RECEIVE THE CLAIM UNTIL THE CORRECTION IS MADE AND CLAIM RESUBMITTED.

Q.  HOW WOULD I ENTER A PATIENT WITH A TITLE, IN CARE OF OR REGARDING?

A.  EXAMPLES ARE LISTED IN THE "ADD" SECTION OF YOUR TRAINING MANUAL.

Q.  DO I NEED TO ASSIGN AN ACCOUNT NUMBER TO A NEW PATIENT ACCOUNT?

A.  NO.THE SYSTEM WILL ASSIGN AN ACCOUNT NUMBER WHEN YOU PRESS ENTER AFTER INSERTING THE PATIENT NAME.

Q.  WHY DO DIFFERENT TERMINALS ASSIGN A DIFFERENT RANGE OF ACCOUNT NUMBERS?

A.  THIS IS THE WAY THE SYSTEM IS SET UP. ALL NUMBERS WILL BE USED.

Q.  WHAT ARE ADDRESS LINES 1, 2 AND 3 USED FOR?

A.  A BASIC STREET ADDRESS WOULD GO ON LINE 1 AND ANY ADDITIONAL ADDRESS INFORMATION WOULD FOLLOW ON LINE 2 AND 3. EXAMPLES ARE IN THE "ADD" SECTION OF THE TRAINING MANUAL.

Q.   WHAT IF I PUT IN A ZIP CODE THAT IS NOT IN THE SYSTEM?

A.  THE WINDOW FOR ZIP CODE INFORMATION WILL APPEAR AND YOU MAY ENTER IN THE ZIP CODE BY DOING A "CTRL E" TO EDIT. TYPE THE INDEX (ZIP CODE), CITY, STATE AND REPEAT THE ZIP.

Q.   WHAT IF A ZIP CODE HAS TWO DIFFERENT CITY NAMES FOR THE SAME ZIP?

A.   YOU MAY ASSIGN AN INDEX NUMBER FOR ONE OF THE ZIP CODES. YOU WOULD ASSIGN THE INDEX NUMBER, ENTER IN THE CITY, STATE AND ZIP CODE.

Q.   WILL THE EDIT TO THE ZIP CODE FIELD BE IMMEDIATE?

A.   YES.

Q.   WHERE DO I GET THE CODE FOR THE INSURANCE AREA?

A.   YOU CAN DO A "CTRL L" TO LOOK UP THE INSURANCE ADDRESS, P.O.BOX OR NAME ACCORDING TO THE PATIENT INSURANCE CARD. ONLY ONE OF THESE FIELDS MAY BE USED AT A TIME. IT IS RECOMMENDED THAT YOU LOOK UP BY THE BOX OR THE STREET NUMBER ONLY.

Q.   WHAT IS A PROVIDER CODE LISTING?

A.   THIS IS A LIST OF INSURANCES THAT THE PRACTICE PARTICIPATES WITH. PROVIDER NUMBERS ARE ENTERED INTO THE SYSTEM BY COMPUTER INNOVATIONS TO ENSURE ALL APPROPRIATE INFORMATION IS ATTACHED TO THE CLAIM. ALSO ENTERED IS THE UPIN NUMBER,TAX ID AND BILLER CODE FOR ELECTRONIC SUBMISSIONS.

Q.   HOW DO WE GET THIS LIST?

A.   THIS LIST CAN BE PRINTED OUT FROM THE PRINT MENU OPTION #11 AS NEEDED.

Q.   CAN I CHOOSE AN INSURANCE CODE THAT IS NOT ON MY LIST ACCORDING TO AN INSURANCE CARD ADDRESS?

A.   YES. CLAIMS WILL STILL BE SUBMITTED.

Q.   WHAT IF I HAVE MORE THAN THREE INSURANCES FOR A PARTICULAR PATIENT?

A.   THE FOURTH INSURANCE INFORMATION WILL NEED TO BE ADDED TO THE NOTE SECTION OF THE PROGRAM IN THE "CTRL N" OPTION.

Q.   DO I ADD THE MEMBERSHIP OR ID # ON THE INSURANCE CARD AS IT APPEARS?

A.   ENTER ALL ALPHA AND NUMBERIC CONSECUTIVELY WITHOUT ANY SPACES, ASTERISKS OR DASHES.

Q.  WHAT ARE THE ABBREVIATIONS USED IN THE RELATIONSHIP AREA?

A.  S=SELF, SP=SPOUSE, C=CHILD, O=OTHER

Q.  WHAT IS THE OT: 00/00/00 AND THE OT: CODE?

A.  THIS IS AN ADDITIONAL FIELD TO THE SYSTEM THAT CAN BE USED TO RECORD INFORMATION ABOUT THE PATIENT. THE OT: DATE FIELD CAN BE USED TO RECORD A PARTICULAR DATE OF A SERVICE LIKE A PHYSICAL OR A SURGERY DATE. THE OT: CODE CAN BE USED TO EXPLAIN WHAT THE DATE SPECIFIES. EX: "PE" FOR PHYSICAL OR "SD" FOR SURGERY DATE. THESE AREAS CAN BE USED TOGETHER OR SEPARATELY. IF USED SEPARATELY, THE OT: CODE MAY BE USED TO DESCRIBE A DIABETIC PATIENT, EX: DP.

Q.  WHAT IF A PATIENT HAS MORE THAN ONE REASON FOR USING THIS AREA?

A.  YOU WOULD HAVE TO CHOOSE THE MORE PERTINENT REASON.

Q.  WHAT IS THE BENEFIT FOR FILLING OUT THESE AREAS?

A.  WHEN INQUIRING ABOUT THE PATIENT, THIS PROVIDES SOME HISTORY OF THE PATIENT ON THE MAIN DEMOGRAPHIC SCREEN. ALSO, YOU CAN RUN A REPORT THAT WILL LIST ALL PATIENTS WITH THE OT: CODE AND DATE.

Q.  WHERE CAN I GET THIS REPORT?

A.  USING THE PRINT MENU OPTION #5 TO SELECT THE DATE AND CODE. SELECTION 5 WILL SET THE CRITERIA. SELECTION #6 WILL ACTUALLY PRINT THIS REPORT OUT.

Q.  WHAT DOES "AM" STAND FOR AND WHAT IS THE AREA USED FOR?

A.  "AM" STANDS FOR ACCOUNT MANAGEMENT CODE. THIS FIELD IS USED TO CATEGORIZE PATIENTS ON AN AGING REPORT THAT COMPUTER INNOVATIONS SENDS TO YOU AFTER YOUR MONTHLY BILLING.

Q.  HOW DO I CHOOSE A CODE FOR THE ACCOUNT MANAGEMENT AREA?

A.  YOU WILL DO A "CTRL L" TO LOOK UP THE CODE OPTIONS IN THIS FIELD. YOU WILL CHOOSE A CODE THAT BEST REFLECTS THE PATIENTS PRIMARY INSURANCE.

Q.  WHAT IF THE PATIENT DOES NOT HAVE INSURANCE, IS A WORKERS COMPENSATION CASE OR THE INSURANCE IS NOT LISTED IN THIS FIELD?

A.  YOU CAN LEAVE THIS AREA BLANK FOR PATIENTS WITHOUT ANY INSURANCE OR AN INSURANCE THAT DOES NOT HAVE A CODE AND THEY WILL FALL INTO A PRIVATE PAY AREA OF THE REPORT. YOU SHOULD DO A "CTRL L" TO LOOK UP YOUR OPTIONS AND PICK THE MOST APPROPRIATE CODE ACCORDING TO THE SITUATION.

Q.  IF I CHOOSE THE WRONG CODE, WHAT WILL HAPPEN TO THE PATIENTS CLAIMS?

A.  THIS FIELD HAS NO BEARING ON WHERE THE CLAIMS ARE SENT OR HOW THEY ARE SENT. THIS AREA IS FOR INTERNAL USE ONLY.

Q.  WHAT IS THE ICD AREA ON THE MAIN SCREEN USED FOR?

A.  THIS FIELD IS USED FOR REOCCURRING DIAGNOSIS CODES. THIS IS TO SAVE TIME ON THE DATA ENTRY FOR CLAIMS SUBMISSIONS. EX: THIS FIELD IS USEFUL ESPECIALLY FOR NURSING HOME PATIENTS WHO HAVE THE SAME DIAGNOSIS CODE. WHEN THE DIAGNOSIS CODE(S) IS IN THIS FIELD,THIS WILL AUTOMATICALLY COME UP ON THE TRANSACTION SCREEN.

Q.  WHAT IS THE ALT R FIELD USED FOR?

A.  THIS FIELD IS USED TO RECORD THE REFERRING PHYSICIAN AND/OR AUTHORIZATION NUMBER THAT WILL NEED TO BE ATTACHED TO EVERY CLAIM FOR THAT PARTICULAR PATIENT.

Q.  CAN I JUST TYPE IN REFERRING PHYSICIAN NAME AND UPIN?

A.  IT IS RECOMMENDED THAT YOU DO A "CTRL L" OPTION TO LOOK UP THE PHYSICIAN BY LAST NAME. THIS ENSURES THAT THE NAME AND UPIN ARE ATTACHED TO THE CLAIM IN THE PROPER FORMAT REQUIRED BY THE INSURANCE.

Q.  WILL THE AUTHORIZATION FOR NUMBER OF DAYS AND VISITS SUBTRACT FROM THE SYSTEM?

A.  NO. YOU WILL NEED TO MANUALLY MONITOR THIS BY FILLING OUT THE APPROPRIATE FIELD WITHIN THE "ALT R" OPTION.

Q.  IS THE "ALT R" THE ONLY PLACE I CAN VERIFY THE REFERRING PHYSICIAN AND AUTHORIZATION CODE?

A.  NO. ONCE A CLAIM HAS BEEN PROCESSED, THIS INFORMATION IS ATTACHED TO THE CLAIM AND IS PERMANENTLY RECORDED IN THE ACTION "Q" SCREEN (QUERY).

Q.  CAN I ATTACH A REFERRING PHYSICIAN AND/OR AUTHORIZATION TO JUST ONE CLAIM VERSUS TO A PATIENTS ACCOUNT?

A.  YES. REFER TO TRANSACTION QUESTIONS FOR DETAILS.

Q.  WHAT IS THE CTRL E OPTION?

A.  THIS IS TO RECORD EMPLOYMENT INFORMATION.

Q.  IS IT MANDATORY TO FILL IN EMPLOYMENT SECTION?

A.  NO. THIS SECTION IS OPTIONAL. IT CAN BE USEFUL WHEN FOLLOWING UP WITH THE INSURANCE CLAIMS.

Q.  WILL THE EMPLOYMENT INFORMATION APPEAR ON CLAIM?

A.  YES. THE EMPLOYER NAME WILL BE ATTACHED TO THE CLAIM.

Q.  WHAT DOES GUARANTOR STAND FOR?

A.  THE RELATIONSHIP TO THE EMPLOYMENT INFORMATION ENTERED. SEE THE "CTRL E" IN THE TRAINING MANUAL FOR DETAILS.

COMMON QUESTIONS PERTAINING TO THE BATCH SCREEN (ACTION B)

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Q.  WHAT IS THE BATCH SCREEN (ACTION B)?

A.  THE BATCH SCREEN IS WHERE ALL CHARGES, PAYMENTS AND ADJUSTMENTS GO THAT WILL BE PROCESSED WITH THE NIGHTLY UPDATE. THIS AREA IS ALSO USED FOR BALANCING AND CAN BE EDITED.

Q.  CAN I CORRECT OR DELETE AN INCORRECT ENTRY?

A.  YES. YOU CAN CORRECT AN ENTRY. YOU MUST HIGHLIGHT THE ENTRY TO BE CORRECTED AND USE THE "CTRL E" TO EDIT. MOVE TO THE AREA TO BE CORRECTED AND MAKE THE CHANGE. PRESS ENTER.YOU CAN DELETE AN INCORRECT ENTRY. YOU MUST HIGHLIGHT THE ENTRY AND USE THE "CTRL D" TO DELETE. PRESS ENTER. YOU WILL RECEIVE A WARNING MESSAGE TO MAKE SURE YOU ARE ON THE PROPER LINE FOR DELETION. PRESS ENTER IF YOU ARE SURE THIS IS WHAT YOU WANT TO DELETE.

Q.  WHY DOES THE WINDOW WHICH DISPLAYS THE CPT CODES AND FEES APPEAR AGAIN WHEN MAKING A CORRECTION TO A CLAIM?

A.  THE SYSTEM IS GIVING YOU THE OPTION OF CORRECTING THE CHARGED AMOUNT PER CPT CODE.

Q.  IF I CHANGE THE CHARGED AMOUNT, WILL THE COMPUTER GIVE ME A NEW BALANCE FOR THAT CLAIM.

A.  YES. AFTER THE CORRECTION IS MADE, PRESS ENTER. THIS WILL GIVE YOU A NEW BALANCE. PRESS ENTER AGAIN AND IT WILL RECORD THE CORRECTION.

Q.  WHY DOESN'T THE BATCH SCREEN LET ME SEE THE DIAGNOSIS BILLED AND ADDITIONAL INFORMATION?

A.  THE ADDITIONAL INFORMATION CAN BE DISPLAYED BY PRESSING THE RIGHT ARROW KEY.

Q.  WHY AM I HAVING PROBLEMS ESCAPING FROM THE BATCH SCREEN?

A.  IF YOU ARROW TO THE RIGHT TO DISPLAY MORE INFORMATION ABOUT THE CLAIM, YOU CANNOT ESCAPE FROM THIS SIDE. YOU NEED TO ARROW LEFT, THEN ESCAPE. COMMANDS WILL BE AT THE BOTTOM OF YOUR SCREEN.

Q.  WHY ISN'T ALL MY WORK IN THE BATCH SCREEN?

A.  YOU MUST PAGE DOWN TO SEE ADDITIONAL ENTRIES AS MANY TIMES AS NEEDED UNTIL YOU REACH THE LAST TRANSACTION.

Q.  DO THE MOST CURRENT CHARGES, PAYMENTS AND ADJUSTMENTS GO TO THE TOP OR THE BOTTOM OF THE BATCH SCREEN?

A.  NEWEST CLAIMS ARE FOUND AT THE END OR BOTTOM OF THE BATCH SCREEN.

Q.  IS THERE AN EASY WAY TO GET TO THE BOTTOM OF THE BATCH SCREEN?

A.  YES. PRESS THE END KEY. IT WILL BRING YOU TO THE DAILY TOTALS AND YOU CAN ARROW UP FROM THERE.

Q.  DO CLAIMS ALWAYS GO INTO THE BATCH IN THE ORDER AS THEY WERE ENTERED?

A.  YES.

COMMON QUESTIONS PERTAINING TO THE CHANGE SCREEN (ACTION C)

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Q.  CAN I JUST MOVE TO AN AREA THAT NEEDS TO BE CHANGED AND MAKE THE CORRECTION?

A.  YES.

Q.  ONCE THE CHANGE IS MADE, HOW DO I MAKE THE COMPUTER ACCEPT THE CHANGE?

A.  PRESS ENTER.

Q.  IF I MADE A CHANGE THAT WAS INCORRECT OR I WANT TO SEE WHAT THE ORIGINAL INFORMATION WAS THAT I CHANGED, IS IT TOO LATE?

A.  NO, NOT IF YOU DIDN'T PRESS ENTER. JUST ESCAPE AND THE ORIGINAL INFORMATION WILL REMAIN.

Q.  IS THERE ANY EASY WAY TO MOVE AROUND THE SCREEN TO MAKE MY CORRECTIONS?

A.  YES. SEE SPECIAL FEATURES SECTION OF MANUAL.

Q.  IF I CORRECT MY PRIMARY INSURANCE, DO I NEED TO CORECT MY "AM" CODE?

A.  YES. DO A "CTRL L" TO PICK THE APPLICABLE CODE.

Q.  WILL CORRECTIONS MADE TODAY GO WITH TODAY'S CLAIMS?

A.  YES.

Q.  IF I MADE A CORRECTION TO THE INSURANCE FIELD, WILL OUTSTANDING CLAIMS STILL BE OUT TO THE PREVIOUS INSURANCE?

A.  YES.

Q.  WILL THE OLD INSURANCE INFORMATION BE RECORDED ANYWHERE?

A.  YES.

Q.  IF I MADE A CHANGE TO THE PATIENT INFORMATION, IS IT LOGGED INTO THE DATA BASE IMMEDIATELY?

A.  NO. VISUALLY ALL CHANGES ARE THERE BUT UNTIL WE PROCESS THE SYSTEM AT NIGHT, THIS INFORMATION IS NOT PERMANENT IN THE DATA BASE.

COMMON QUESTIONS PERTAINING TO DELETING A PATIENT (ACTION D)

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Q.  CAN ANY PATIENT BE DELETED?

A.  NO. ONLY PATIENTS WITHOUT CHARGES ASSOCIATED TO THEIR ACCOUNT CAN BE DELETED.

Q.  BY DELETING A PATIENT, WILL IT FREE UP THE ACCOUNT NUMBER THAT WAS BEING USED FOR THAT ACCOUNT?

A.  NO. THAT ACCOUNT NUMBER IS NOW ELIMINATED.

COMMON QUESTIONS PERTAINING TO END BATCH (ACTION E)

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Q.  WHAT IS THE PURPOSE OF ACTION E?

A.  BY PRESSING THE ACTION E, THIS ENABLES YOU TO BALANCE AT ANY TIME AFTER A SERIES OF CHARGES. THIS "ENDS YOUR BATCH". THIS CAN BE USED FOR THESE EXAMPLES: AFTER EACH CHECK IS ENTERED TO ELIMINATE BALANCING AT THE END OF THE DAY; TO SEPARATE MORNING ENTRY FROM AFTERNOON ENTRY; BALANCING BEFORE SWITCHING OF EMPLOYEES AT A PARTICULAR WORK STATION.

Q.  WHERE WILL I SEE THESE TOTALS?

A.  AFTER EACH TIME YOU PRESS E, IT CALCULATES A BATCH TOTAL THAT APPEARS IN YOUR BATCH SCREEN FOLLOWING THE SERIES OF CHARGES, PAYMENTS OR ADJUSTMENTS.

Q.  DO BATCH TOTALS GET ADDED TOGETHER?

A.  YES. A DAILY TOTAL IS ALSO CALCULATED AND DISPLAYED IN THE BATCH SCREEN.

Q.  WHAT DO I DO IF I PREMATURELY PRESS THE ACTION E AND I REALIZE THAT I DID NOT COMPLETE MY BATCH?

A.  YOU CAN GO TO THE BATCH AND DELETE THE BATCH TOTAL LINE (REFER TO BATCH B SECTION) YOU WERE WORKING WITHIN AND THEN CONTINUE YOUR ENTRY.

COMMON QUESTIONS PERTAINING TO THE INQUIRY (ACTION I)

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Q.  HOW CAN I SEARCH FOR A PATIENT?

A.  YOU CAN SEARCH FOR A PATIENT BY PATIENT ACCOUNT NUMBER, LAST NAME, SOCIAL SECURITY NUMBER, DATE OF BIRTH OR BY PRESSING "ALT P" FOR A PATIENT PHONE NUMBER.

Q.  IF I MADE A CORRECTION TO A PATIENT ACCOUNT, WILL I BE ABLE TO SEARCH BY NEW INFORMATION?

A.  YES, IF YOU ARE SEARCHING BY NAME. NO IF THE CORRECTION WAS MADE TO THE PHONE NUMBER, SOCIAL SECURITY OR DATE OF BIRTH. THESE CHANGES HAVE NOT BEEN UPDATED TO THE DATA BASE UNTIL A NIGHTLY HAS BEEN DONE.

Q.  HOW CAN I INQUIRE BY DATE OF BIRTH OR SOCIAL SECURITY IF MY CURSOR WILL NOT GO PAST PATIENT NAME/ADDRESS FIELD?

A.  YOU MUST PRESS THE F4 KEY TO GET TO THE DATE OF BIRTH FIELD OR F5 TO GET TO THE SOCIAL SECURITY NUMBER. THEN ENTER IN THE INFORMATION AND PRESS ENTER.

COMMON QUESTIONS PERTAINING TO TRANSACTIONS (ACTION T)

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Q.  WHAT IS A TRANSACTION?

A.  WE REFER TO ENTRY OF CHARGES OR BILLING FOR A DATE OF SERVICE AS A TRANSACTION.

Q.  DO TRANSACTIONS NEED TO BE ENTERED THE SAME DAY AS THE SERVICE IS PERFORMED?

A.  NO. YOU CAN BILL FOR ANY DATE PRIOR TO THE CURRENT DATE. THE SYSTEM WILL NOT LET YOU ENTER A FUTURE DATE. PLEASE NOTE THAT YOU MUST ENTER IN THE CORRECT DATE OF SERVICE. IF THE SERVICE WAS PERFORMED 2 DAYS AGO, THAT IS THE DATE THAT YOU MUST PUT INTO THE SYSTEM FOR THAT TRANSACTION.

Q.  THERE IS A DOCTOR NUMBER ON THE PATIENT'S ACCOUNT. WHY DIDN'T IT TRANSFER TO THE TRANSACTION SCREEN?

A.  THE DOCTOR NUMBER WILL NOT TRANSFER BECAUSE SOME OFFICES HAVE MULTIPLE DOCTORS. THE INITIAL DOCTOR MAY NOT SEE THE PATIENT EVERY TIME. OFFICES WITH ONE DOCTOR CAN ALSO HAVE MULTIPLE DOCTOR NUMBERS TO DISTINGUISH LOCATIONS.

Q.  WHAT IS THE CTRL AREA USED FOR?

A.  A NUMBERIC CODE CAN BE ENTERED INTO THIS FIELD TO BATCH AND STORE A GROUP OF ENTRY. THIS CODE APPEARS IN THE ACTION Q (QUERY) SCREEN FOR FUTURE REFERENCE. YOU MAY ALSO ASSIGN EACH EMPLOYEE WITH A PARTICULAR NUMBER THAT CAN BE ENTERED INTO THE CTRL AREA TO TRACK WHO DID THE ENTRY.

Q.  WHAT TYPE OF SERVICES ARE BILLED FROM THE ACTION T?

A.  ANY SERVICE CAN BE BILLED FROM ACTION T. USUALLY OFFICE,HOME AND NURSING HOME VISITS. WE RECOMMEND THAT THE ACTION M BE USED FOR MULTIPLE HOSPITAL BILLING.

Q.  CAN A CPT CODE BE ENTERED BY MY OFFICE?

A.  NO. INDEX NUMBERS ARE ISSUED FOR EACH CPT CODE WITH OUR PROGRAM. THERE ARE INTERNAL CODES THAT ARE PROGRAMMED INTO THE SYSTEM FOR PAPER AND ELECTRONIC CLAIMS, SO IT IS NECESSARY TO CALL CI WITH THE INFORMATION TO BE ENTERED.

Q.  WHY DO YOU USE INDEX NUMBERS?

A.  LESS DATA ENTRY, LESS DATA ERRORS, YOU CAN GET MORE SERVICES ON ONE ENTRY.

Q.  WHO ASSIGNS THE INDEX NUMBERS?

A.  COMPUTER INNOVATIONS MUST ASSIGN THE INDEX NUMBERS.

Q.  HOW WILL I KNOW WHICH INDEX NUMBER IS ASSIGNED TO THE CPT CODE?

A.  COMPUTER INNOVATIONS WILL NOTIFY YOU OF THE INDEX NUMBER VIA FAX. YOU CAN ALSO DO A CTRL L ON THE SERVICE. THIS WILL SHOW YOU THE INDEX NUMBER TO USE.

Q.  CAN I BILL FOR A PROCEDURE THAT IS NOT LISTED ON MY SUPERBILL?

A.  YES. DO A CTRL L IN THE SERVICE AREA. IF THE CODE IS IN THE SYSTEM, YOU MAY USE IT.

Q.  WHAT IF THE CODE I NEED TO BILL IS NOT IN THE SERVICE LOOK UP?

A.  THE CPT CODE, DESCRIPTION AND PRICE HAS TO BE FAXED TO COMPUTER INNOVATIONS. AN INDEX NUMBER WILL BE ISSUED AND THIS WILL BE FAXED TO YOU. THE DATA WILL BE TRANSMITTED TO YOUR COMPUTER DURING THE EVENING CALL UP.

Q.  WHEN WILL I BE ABLE TO BILL OUT WITH THAT CODE?

A.  IF THE FAX IS RECEIVED BY 3:00 P.M. OF ANY GIVEN DAY,THE INFORMATION USUALLY GETS SENT TO YOUR SYSTEM THAT EVENING.

Q.  CAN MULTIPLE SERVICES BE ENTERED?

A.  YES. EACH SERVICE MUST BE INDICATED BY INDEX NUMBER AND SEPARATED BY COMMAS. NEVER USE SPACES IN THE SERVICE AREA. EX: 1,22,56

Q.  HOW WOULD YOU ATTACH A MODIFIER TO A SERVICE?

A.  A MODIFIER IS ATTACHED TO A SERVICE WITH A DASH (-).EX: 1-25,22,56

Q.  IS IT POSSIBLE TO MULTIPLY A PROCEDURE RATHER THAN ENTERING IT SEVERAL TIMES?

A.  YES. YOU CAN USE THE INDEX NUMBER WITH AN ASTERISK (*) AND THE NUMBER OF UNITS NEEDED. THE SYSTEM WILL KNOW IF THE CPT CODE SHOULD BE INCREASING BY UNITS OR BY NUMBERS OF DAYS.EX: 56*3 = INJECTION 3 UNITS EX: 56*3 = HOSPITAL VISIT 01/01/01, 01/02/01, 01/03/01.

Q.  WHEN WOULD I ENTER IN A PAYMENT WHEN CHARGING A SERVICE?

A.  A COPAY WOULD BE ENTERED WHEN PAID AT THE TIME OF SERVICE.WHEN A PAYMENT IS MADE FOR A NON COVERED SERVICE. PAYMENT ON A SERVICE FOR A SELF PAY PATIENT.

Q.  WHEN WOULD YOU USE THE ADJUSTMENT AREA WHEN CHARGING A SERVICE?

A.  WAIVING A COPAY.ADJUSTING A FEE FOR SERVICE AND STILL BEING ABLE TO SEE THE ORIGINAL CHARGE IN QUERY SCREEN. MOST LIKELY A SELF PAY PATIENT.

Q.  WHY IS THE ACCOUNT MANAGEMENT CODE (AM) IN A TRANSACTION SCREEN?

A.  THIS IS TO CATEGORIZE THE TYPE OF INSURANCE AND IS FOR INTERNAL PURPOSES ONLY.

Q.  IF THE ACCOUNT MANAGEMENT AREA IS BLANK, DO I NEED TO FILL THIS IN?

A.  NO.

Q.  WHAT DOES "PS" STAND FOR?

A.  PS IS FOR PAYMENT SOURCE. YOU CAN PRESS CTRL L TO LOOK UP THE APPROPRIATE CODE TO REPRESENT THE TYPE OF PAYMENT THAT WAS MADE, I.E. CASH, CHECK OR CHARGE.

Q.  WHY DOES THE PAYMENT SOURCE AREA HAVE INSURANCE COMPANY NAMES IN THERE?

A.  THIS FIELD IS ALSO USED WHEN POSTING INSURANCE CHECKS.

Q.  WHEN ENTERING A DIAGNOSIS CODE, IS THE DECIMAL ENTERED?

A.  NO. IF YOU DO ENTER IN THE DECIMAL POINT, THE CLAIM WILL BE REJECTED. INSURANCES DO NOT ACCEPT CLAIMS WITH THE DECIMAL POINT.

Q.  HOW ARE DIAGNOSIS CODES ENTERED IN THE TRANSACTION?

A.  WHEN A SINGLE DIAGNOSIS CODE IS ENTERED, IT WILL BE LINKED WITH EVERY SERVICE.

Q.  HOW ARE MULTIPLE DIAGNOSIS CODES ENTERED?

A.  MULTIPLE DIAGNOSIS CODES ARE SEPARATED BY DASHES(-).EX: 25000-496 NOTE: WHEN BILLING ELECTRONICALLY, ONLY THE FIRST DIAGNOSIS IS RECOGNIZED.

Q.  HOW CAN I LINK A DIAGNOSIS TO A PARTICULAR SERVICE?

A.   YOU WOULD USE A COMMA(,) INSTEAD OF A DASH(-).EX: 25000,496 IF THE SERVICES BILLED WERE INDEX #1,2 AND THE DIAGNOSIS CODES USED WERE 25000,496 THE SYSTEM WOULD LINK DIAGNOSIS 25000 TO SERVICE #1 AND DIAGNOSIS 496 TO SERVICE #2.

Q.  WHY DOES THE PLACE OF SERVICE ALWAYS HAVE 003 LOCKED IN?

A.  ACTION "T" IS GENERALLY USED FOR OFFICE BILLING. IF ANOTHER LOCATION OR FACILITY NEEDS TO BE BILLED, DO A CTRL L TO LOOK UP THE APPROPRIATE CODE.

Q.  WHAT IMPORTANCE DOES THE INSURANCE "INS" FIELD HAVE IN A TRANSACTION?

A.  THIS FIELD TELLS THE SYSTEM WHERE TO APPLY THE CHARGE WITHIN THE PATIENT'S ACCOUNT. IT WILL TELL THE SYSTEM TO EITHER BILL THE PATIENT, THE INSURANCE OR BOTH.

Q.  HOW DO I KNOW WHICH CODE TO USE?

A.  YOU CAN DO A CTRL L TO LOOK UP THE CODES AVAILABLE.

Q.  IF I WANT TO BILL JUST THE INSURANCE, WHICH CODE DO I USE?

A.  LETTER "A" FOR ACCEPT ASSIGNMENT. THIS CODE JUST BILLS THE INSURANCE AND PUTS THE CLAIM INTO VOUCHER (ACTION V).

Q.  WHAT IS THE VOUCHER?

A.  THIS IS AN AREA OF THE PATIENTS ACCOUNT WHERE THE CHARGE IS HELD IN SUSPENSION UNTIL PAYMENT IS RECEIVED FROM THE INSURANCE. THE PATIENT WILL NOT BE BILLED FOR THIS SERVICE.PAYMENT FROM INSURANCE IS POSTED IN ACTION "V".

Q.  IF THE PATIENT IS A SELF PAY, WHICH CODE DO I USE?

A.  THIS FIELD IS LEFT BLANK IN ORDER TO BILL THE PATIENT. THE CHARGE WILL GO UNDER THE CURRENT AREA OF THE PATIENT'S ACCOUNT.

Q.  WILL THE PATIENT BE BILLED IMMEDIATELY?

A.  NO. THE PATIENT WILL BE BILLED AT THE TIME YOU HAVE CHOSEN TO END YOUR BILLING CYCLE.

Q.  WHAT CODE WOULD I USE IF WE ARE NON PARTICIPATING?

A.  YOU WOULD USE AN "S". THIS WOULD SEND A CLAIM TO THE INSURANCE AND WILL BILL THE PATIENT AS WELL. IF YOU USE AN "S", THE INSURANCE CODE LISTED ON THE PATIENT'S ACCOUNT CANNOT BE ON THE PROVIDER CODE LISTING. OTHERWISE, THE SYSTEM WILL OVERRIDE YOUR "S" WITH AN "A" BECAUSE THE SYSTEM IS PROGRAMMED AS PARTICIPATING.

Q.  HOW CAN I PRODUCE A RECEIPT IF THE PATIENT WANTS TO BILL THEIR INSURANCE?

A.  AFTER THE TRANSACTION IS COMPLETE, PRESS CTRL O. THIS WILL GIVE YOU A HCFA ON DEMAND. YOU MUST ANSWER THE QUESTIONS APPROPRIATELY. BY ANSWERING THE QUESTIONS, IT WILL PUT THE CHARGE EITHER TO INSURANCE OR TO PATIENT.

Q.  WHAT DOES RCL STAND FOR?

A.  THIS IS A FIELD TO ENTER A RECALL CODE AND DATE. THE RECALL CARD IS A REMINDER TO THE PATIENT OF AN APPOINTMENT THAT SHOULD BE MADE OR ANY PROCEDURE THAT NEEDS TO BE PERFORMED BY THE OFFICE.

Q.  WHAT ARE THE CODES USED FOR?

A.  A LETTER WOULD BE ENTERED INTO THE FIRST PORTION OF THE RECALL TO REPRESENT A SPECIFIC MESSAGE TO APPEAR ON THE RECALL CARD. THERE CAN BE SEVERAL DIFFERENT TYPES OF REMINDERS SET UP IN THE SYSTEM.

Q.  WHERE WOULD WE GET THESE CODES?

A.  THE CODES AND MESSAGES WOULD BE DISIGNED BY YOU AND ENTERED INTO THE SYSTEM FOR YOUR USE BY COMPUTER INNOVATIONS.

Q.  WHAT IF WE DO NOT USE A CODE?

A.  A GENERIC MESSAGE WILL PRINT ON THE POSTCARD. THIS WOULD ALSO INCLUDE THE NAME OF THE PRACTICE AND A PHONE NUMBER TO CONTACT THE OFFICE.

Q.  HOW WOULD A DATE BE ENTERED?

A.  THE SYSTEM IS SET UP TO RECOGNIZE MONTHS. IF YOU WOULD LIKE THE PATIENT TO RETURN IN ONE YEAR, YOU WOULD ENTER 12. TWO YEARS WOULD BE 24, ETC.

Q.  HOW WILL I KNOW WHO I SENT RECALLS TO FOR THE MONTH?

A.  A LIST IS PRODUCED AND FORWARDED TO THE OFFICE EACH MONTH.THIS INCLUDES THE NAME, PATIENT NUMBER, TELEPHONE NUMBER, THE RECALL TYPE, DATE THE RECALL WAS ENTERED, THE LAST CHARGE DATE AND THE DATE THE PATIENT SHOULD BE SEEN BY.

Q.  WILL THE RECALL SHOW ANYWHERE?

A.  THE RECALL IS DISPLAYED ON THE PATIENT'S MAIN DEMOGRAPHIC SCREEN AS WELL AS THE APPOINTMENT SCHEDULER.

Q.  WILL THE PATIENT RECEIVE THE RECALL ON THE EXACT RECALL DATE?

A.  THE RECALL IS SENT OUT APPROXIMATELY 45 DAYS PRIOR TO THE RECALL DATE TO GIVE THE PATIENT TIME TO RESPOND.

Q.  CAN THE 45 DAY PRIOR NOTIFICATION BE CHANGED?

A.  YES. YOU WOULD NEED TO CONTACT COMPUTER INNOVATIONS AND COMMUNICATE THESE CHANGES.

Q.  WHAT IS THE COMMENT SECTION USED FOR IN A TRANSACTION?

A.  TO ADD ADDITIONAL INFORMATION TO A CLAIM. FOR ADDITIONAL INFORMATION ABOUT THE COMMENT SECTION, SEE THE TRANSACTION SECTION OF THE MANUAL (COMMENT HELP PAGE)

Q.  WHEN I PRESS CTRL F TO DISPLAY MODIFIERS, WHY WON'T THE LIST APPEAR?

A.  YOU NEED TO BE HIGHLIGHTED IN THE SERVICE AREA. THEN THE LIST OF MODIFIERS WILL APPEAR.

Q.  IS IT POSSIBLE TO LOCK IN THE DATE?

A.  YES. THE DATE, DOCTOR NUMBER AND CTRL SECTION CAN BE PROGRAMMED. ENTER IN INFORMATION AND PRESS CTRL P. THE COMMAND IS LOCATED ON THE BOTTOM OF THE TRANSACTION SCREEN.

Q.  CAN I MOVE DIRECTLY TO THE SERVICE AREA?

A.  YES. YOU CAN CHOOSE TO SKIP THE DATE, DOCTOR NUMBER AND CTRL AREA BY PRESSING CTRL D FOR THE DATE, CTRL R FOR THE DOCTOR, CTRL S FOR THE CTRL AREA.

Q.  WHAT IF I STARTED ENTERING A CHARGE AND I REALIZED THAT THE PATIENT HAS A NEW INSURANCE?

A.  PRESS ALT I TO EDIT INSURANCE INFORMATION. YOU MAY DO A CTRLL UNDER INS TO SEARCH FOR THE NEW INSURANCE CODE.

Q.  WILL THIS CHANGE BE EFFECTIVE FOR THE CHARGE CURRENTLY BEING ENTERED?

A.  YES. THE CHANGE IS EFFECTIVE IMMEDIATELY.

Q.  DO I NEED TO ESCAPE DURING A TRANSACTION IF I'M UNSURE OF WHICH INSURANCE THE THREE ALPHA OR NUMERIC CODE REPRESENTS?

A.  NO. PRESS ALT I TO ACCESS INSURANCE AREA. THEN PRESS CTRL S TO DISPLAY THE NAME AND ADDRESS OF THE INSURANCE.

COMMON QUESTIONS PERTAINING TO VOUCHER (ACTION V)

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Q.  WHY ARE CLAIMS IN VOUCHER?

A.  THE CLAIMS IN VOUCHER ARE PENDING INSURANCE PAYMENT.THE PATIENT WILL NOT BE BILLED FOR THESE CLAIMS AS LONG AS THEY REMAIN IN THIS FIELD.

Q.  ONLY INSURANCE PAYMENTS GET POSTED INTO THE VOUCHER?

A.  YES. UNLESS A PAYMENT WAS SENT TO A PATIENT BY AN INSURANCE AND PATIENT IS THEN REIMBURSING THE DOCTOR. THIS HAPPENS USUALLY WITH SECONDARY PAYMENTS.

Q.  HOW DO YOU POST A PAYMENT TO A VOUCHER?

A.  HIGHLIGHT THE CLAIM TO BE POSTED AGAINST AND PRESS ENTER.ALWAYS VERIFY THE DATE, DOLLAR AMOUNT AND CPT CODE YOU ARE POSTING AGAINST.

Q.  HOW DO YOU FIGURE OUT THE ALLOWED?

A.  THE INSURANCE PAYMENT + COPAY/COINS + DEDUCTIBLE + RISK/WITHHELD (IF YOU TRACK THOSE FIGURES) = ALLOWED.

Q.  WHAT IF THE EOB ONLY HAS A DEDUCTIBLE LISTED?

A.  ALLOWED = ALL OF THE ABOVE OR ANY COMBINATION OF THE ABOVE FORMULA.

Q.  HOW WILL THE SYSTEM KNOW WHAT TO ADJUST ACCORDING TO THE EOB?

A.  THE SYSTEM RECOGNIZES THE ORIGINAL CHARGE YOU ARE HIGHLIGHTED ON. IT WILL ADJUST THE DIFFERENCE BETWEEN THE ORIGINAL CHARGE AND THE AMOUNT THAT IS ENTERED INTO THE ALLOWED COLUMN.

Q.  WHY DO YOU NEED TO PUT ALL THOSE FIGURES IN THE ALLOWED FIELD?

A.  THE SYSTEM WILL NOT ADJUST ANY FIGURE ENTERED INTO THE ALLOWED COLUMN.

Q.  HOW WILL THE SYSTEM BILL THE SECONDARY OR THIRD INSURANCE?

A.  THE DIFFERENCE BETWEEN THE ALLOWED AMOUNT AND THE PAYMENT WILL BE BILLED TO THE SECOND OR THIRD INSURANCE ACCORDING TO THE CODE ENTERED INTO THE "INS" FIELD.

Q.  WHAT CODES DO YOU USE IN THE "INS" FIELD?

A.  USE #2 OR LETTER "H" TO SEND BALANCE TO SECONDARY INSURANCE.USE #3 OR LETTER "J" TO SEND TO THE THIRD INSURANCE. USE LETTER "Y" WHEN THE PRIMARY INSURANCE HAS AUTOMATICALLY ROLLED THE BALANCE OVER TO THE SECONDARY.

Q.  WHAT IS THE DIFFERENCE BETWEEN #2 AND LETTER "H" OR #3 AND LETTER "J"?

A.  THE #2 WILL SEND THE BALANCE TO THE SECONDARY INSURANCE AND THE HCFA FORM WILL GENERATE THE NEXT DAY. THE LETTER "H" WILL SEND THE BALANCE TO THE SECONDARY INSURANCE AND YOU CAN GENERATE A HCFA ON DEMAND THAT SAME DAY. THE #3 WILL SEND THE BALANCE TO THE THIRD INSURANCE AND THE HCFA WILL GENERATE THE NEXT DAY. THE LETTER "J" WILL SEND THE BALANCE TO THE THIRD INSURANCE AND YOU CAN GENERATE A HCFA ON DEMAND THAT SAME DAY.

Q.  HOW DO YOU GENERATE THE HCFA AFTER USING THE "H" OR "J"?

A.  ACTION CODE "X".

Q.  HOW WILL THE SYSTEM BILL THE PATIENT FOR A COPAY, DEDUCTIBLE OR NON-COVERED SERVICE?

A.  THE DIFFERENCE BETWEEN THE ALLOWED COLUMN AND THE PAYMENT COLUMN WILL BE BILLED TO THE PATIENT BY LEAVING THE "INS" FIELD BLANK.

Q.  WHEN BILLING THE PATIENT, CAN I PUT A NOTE TO THE PATIENT?

A.  YES, BY TYPING SN: (SPACE) IN THE COMMENT SECTION OF THE VOUCHER. THIS NOTE WILL APPEAR IN THE BODY OF THE PATIENT'S STATEMENT UNDER THE DATE OF SERVICE.

Q.  WILL THE NOTE BE RECORDED ANYWHERE?

A.  YES. THE NOTE WILL BE ENTERED AS PERMANENT INFORMATION IN THE QUERY SCREEN (ACTION Q).

Q.  WHY DO YOU INCLUDE THE PAYMENT AND THE RISK IN THE ALLOWED?

A.  THE SYSTEM SUBTRACTS THE PAYMENT ENTERED UNDER THE PAYMENT FIELD AND THE RISK AMOUNT ENTERED IN THE RISK FIELD FROM THE ALLOWED, LEAVING ONLY A DIFFERENCE OF THE COPAY OR DEDUCTIBLE. THE REMAINING BALANCE IS THE AMOUNT NEEDED TO BILL THE PATIENT OR THE SECONDARY INSURANCE.

Q.  THE SYSTEM WILL NOT ALLOW MY CURSOR TO ENTER INTO THE RISK FIELD. WHY?

A.YOU MUST OPEN UP THAT FIELD BY PRESSING "ALT R" AND HITTING THE "ENTER" KEY. THIS WILL OPEN THE RISK FIELD.

Q.  DO I NEED TO OPEN THE RISK FIELD PRIOR TO EACH CLAIM?

A.  NO. ONCE OPENED, IT WILL REMAIN OPEN UNTIL YOU EXIT THE PROGRAM WITH THE ACTION "R".

Q.  DO I NEED TO RECORD THE DATE OF SERVICE, PROCEDURE CODE OR ANY INFORMATION ABOUT THE CLAIM DURING POSTING?

A.  NO. THE SYSTEM AUTOMATICALLY PUTS THE PAYMENT UNDER THE HIGHLIGHTED DATE OF SERVICE AND WILL RECORD THE CPT YOU ARE POSTING AGAINST AS WELL AS THE INSURANCE CODE THAT PAID.

Q.  WHERE WILL THE PAYMENTS BE DISPLAYED FOR FUTURE REFERENCE?

A.  IN THE ACTION Q (QUERY). THIS IS A PERMANENT RECORD OF ANY ACTIVITY REGARDING THE PATIENT'S ACCOUNT.

Q.  WILL THE COMPUTER RECORD THE DATE THE PAYMENT WAS POSTED?

A.  YES. IT WILL AUTOMATICALLY STAMP THE DATE POSTED.

Q.  CAN I CHANGE THE POSTING DATE?

A.  YES. PRESS "CTRL D" PRIOR TO POSTING YOUR PAYMENT. THE DATE ENTERED WILL REMAIN LOCKED INTO THE SYSTEM UNTIL IT IS CHANGED AGAIN.

Q.  HOW CAN I BILL A PATIENT FOR A NON-COVERED SERVICE?

A.  HIGHLIGHT THE SERVICE AND PUT THE AMOUNT DESIRED TO BILL THE PATIENT INTO THE ALLOWED SECTION. LEAVE THE PAYMENT BLANK AND PUT AN SN: NOTE TO PATIENT. PRESS THE "ENTER" KEY. A WARNING MESSAGE WILL APPEAR LETTING YOU KNOW THAT YOU MAY HAVE FORGOTTEN TO ENTER THE PAYMENT. PRESS THE "ESC" KEY AND THEN ENTER AGAIN.

Q.  WHAT DO I DO IF I WANT TO WRITE OFF/ADJUST A SERVICE?

A.  HIGHLIGHT DESIRED DATE AND SERVICE. LEAVE THE ALLOWED AND PAYMENT BLANK. PUT A NOTE IN THE COMMENT SECTION REGARDING THE ADJUSTMENT FOR FUTURE REFERENCE AND PRESS THE "ENTER" KEY. A WARNING MESSAGE WILL APPEAR LETTING YOU KNOW THAT IF YOU PRESS ENTER, THE CLAIM WILL BE ADJUSTED.

Q.  WHAT IS THE P/S FIELD USED FOR?

A.  TO RECORD WHICH INSURANCE COMPANY IS MAKING THE PAYMENT.PRESS "CTRL L" TO LOOK UP THE AVAILABLE CODES. IF THE CODE IS NOT AVAILABLE FOR A PARTICULAR INSURANCE, USE THE LETTER "I" FOR COMMERCIAL INSURANCE.

Q.WHAT PURPOSE DOES THE P/S FIELD HAVE WHEN THE SYSTEM ALREADY HAS A 3 DIGIT ALPHA OR NUMERIC CODE?

A.  THE P/S FIELD IS FOR REPORTING PAYMENTS AT THE END OF YOUR BILLING CYCLE. THIS LETS YOU SEE PAYMENTS MADE BY INSURANCES AND ADJUSTMENTS MADE FOR THE CLOSING OF THE MONTH.

Q.CAN I CORRECT AN ERROR IN POSTING?

A.  YES. GO TO ACTION B (BATCH). REFER TO BATCH SECTION OF THESE QUESTIONS.

Q.DO I HAVE TO POST LINE BY LINE?

A.  NO, ALTHOUGH WE DO RECOMMEND THIS TYPE OF POSTING.

Q.WHY IS IT RECOMMENDED TO POST EACH LINE ITEM?

A.  ALL APPROPRIATE INFORMATION OF THE CLAIM IS THEN RECORDED. ALSO, FOR FOLLOW UP AND FOR SECONDARY, IT IS MUCH CLEARER TO SEE WHAT BALANCE IS OWED ON EACH PROCEDURE.

Q.HOW DO I BULK POST?

A.  ENTER THE VOUCHER AND PRESS "F1" KEY. ENTER IN THE PAYMENT, ANSWER "Y" OR "N" IN ADJ IF YOU WANT THE COMPUTER TO ADJUST THE DIFFERENCE BETWEEN THE ORIGINAL CHARGE AND THE PAYMENT.ENTER IN THE PATIENT RESP, ANY RISK AND THE P/S. THERE IS ALSO ROOM FOR A COMMENT.

Q.EVEN IF I ROUTINELY POST LINE BY LINE, WOULD THERE EVER BE A REASON WHEN I WOULD BULK PAY?

A.  YES. IF AN EXPLANATION OF BENEFITS BULK PAYS ON SEVERAL SERVICES AND DOESN'T BREAK THEM DOWN BY PERCENTAGE OR DOESN'T INDICATE THE AMOUNT PAID ON EACH PROCEDURE SEPARATELY.

Q.WHEN WILL THE PATIENT RECEIVE THE BILL ACCORDING TO HOW VOUCHERS WERE POSTED?

A.  AT THE END OF YOUR BILLING CYCLE.

Q.IF THE CLAIM IS OLD AND FINALLY PAID BY INSURANCE AND WE ARE NOW BILLING THE PATIENT FOR THE BALANCE, WILL THE BALANCE AGE IMMEDIATELY?

A.  NO. THE BALANCE WILL GO TO THE PATIENT'S CURRENT STATUS.

Q.WHAT IF I GO TO POST AN INSURANCE CHECK INTO THE VOUCHER AND THERE ARE NO OPEN VOUCHERS OR DATES OF SERVICE ARE NOT IN VOUCHER?

A.  POST PAYMENT UNDER "ACTION P" (PERSONAL PAYMENTS) OR IN AN INSURANCE OVERPAYMENT/MISC ACCOUNT IF PAYMENT IS DUPLICATED.

Q.HOW WILL I KNOW IF THE PAYMENT IS DUPLICATED?

A.  CHECK UNDER ACTION Q (QUERY).

Q.DOES IT MATTER WHEN POSTING INSURANCE PAYMENTS IF THE PATIENT HAS PAID THEIR COPAY OR NOT?

A.  NO. ALWAYS INCLUDE THE COPAY IN THE ALLOWED AMOUNT REGARDLESS. IF THE PATIENT HAS PAID THE COPAY, THE ACCOUNT WILL HAVE A CREDIT THAT THE COPAY WILL BALANCE TO. OTHERWISE, THE PATIENT WILL BE BILLED.

Q.WHAT IF THE PATIENT PAID AN INCORRECT COPAY AT THE TIME OF THE SERVICE AND NOW THE EOB STATES A DIFFERENT AMOUNT?

A.  IF THE PATIENT OVERPAID, THE PATIENT WILL THEN HAVE A CREDIT FOR THE DIFFERENCE. IF THE PATIENT UNDERPAID, THE SYSTEM WILL BILL THE PATIENT FOR THE BALANCE OF THE COPAY.

Q.CAN I POST A SECONDARY PAYMENT BEFORE THE PRIMARY?

A.  NO.

Q.IF THE PRIMARY APPLIED A CHARGE TO THE DEDUCTIBLE AND SECONDARY PAID AND I RECEIVED BOTH EOB'S THE SAME DAY, DO I NEED TO WAIT UNTIL THE NEXT DAY TO POST SECONDARY AFTER THE GOODBYE IS DONE?

A.  NO. YOU CAN POST TO THE PRIMARY, ROLL THE BALANCE OVER TO THE SECONDARY BY USING #2 IN THE "INS" AREA AND THEN POST TO THE SECONDARY.

Q.WHEN POSTING, IF THERE IS A DENIAL ON A CLAIM AND IT NEEDS TO BE CORRECTED AND RESUBMITTED, WHAT DO I DO?

A.  SEE THE RESUBMITTING SECTION OF THIS.

COMMON QUESTIONS PERTAINING TO RESUBMITTING CLAIMS

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Q.WHICH ACTION CODE DO I RESUBMIT THROUGH?

A.  YOU CAN RESUBMIT THROUGH THE ACTION V AND THE ACTION Q.

Q.WHEN WOULD I RESUBMIT THROUGH THE ACTION V?

A.  ANY TIME YOU MAKE A CORRECTION UNDER THE ACTION "C" TO THE PATIENTS DEMOGRAPHIC SCREEN.

Q.AFTER THE CHANGE IS MADE, WHAT DO I DO NEXT?

A.  ACTION "V" BRINGS UP THE PATIENT AGAIN. PRESS THE "CTRL R" FOR QUICK RESUBMIT. ANSWER WITH A "Y" TO RESUBMIT ALL CLAIMS OR AN "N" FOR A PARTICULAR DATE OR DATE RANGE. ONLY FILL IN QUESTION TO CHANGE INSURANCE CODE IN VOUCHER ITEMS TO: IF YOU HAVE CHOSEN A NEW INSURANCE CODE. ENTER THAT CODE. OTHERWISE, PRESS THE "ENTER" KEY. THE SYSTEM WILL TELL YOU HOW MANY CLAIMS WILL BE RESUBMITTED. PRESS THE "ENTER" KEY.THE CURRENT DATE WILL BE ENTERED INTO THE FILE DATE. THE CLAIM OR CLAIMS WILL EITHER BE RESUBMITTED ELECTRONICALLY OR ON PAPER ACCORDING TO THE INSURANCE.

Q.WHAT IF ONLY A PORTION OF THE CLAIMS IN VOUCHER NEED TO BE RESUBMITTED WITH A NEW INSURANCE ACCORDING TO THE EFFECTIVE DATE?

A.  ONLY CHOOSE THE DATES OF THE CLAIMS THAT YOU WISH TO SEND WITH THE NEW INSURANCE CODE. THE REMAINDER OF THE CLAIMS WILL REMAIN WITH THE OLD INSURANCE.

Q.HOW CAN I RESUBMIT A CLAIM WITH A CORRECTION?

A.  ANY CORRECTIONS TO A CLAIM NEED TO BE RESUBMITTED THROUGH THE ACTION "Q".

Q.HOW WILL I MAKE THE CORRECTION?

A.  HIGHLIGHT THE DATE OF THE CLAIM THAT YOU WISH TO CORRECT. PRESS THE "ENTER" KEY. THE CLAIM WILL APPEAR IN THE ORIGINAL STATE YOU INITIALLY ENTERED IT IN. YOU MAY NOW MOVE THROUGH THE CLAIM AND MAKE ANY CORRECTION NECESSARY.

Q.WILL MY CORRECTIONS SHOW ANYWHERE?

A.  NO. THE VOUCHER WILL REMAIN THE SAME AS THE ORIGINAL CHARGE WAS SUBMITTED. THE "Q" SCREEN WILL ALSO REMAIN THE SAME AS ORIGINALLY SUBMITTED. THERE WILL BE A RESUBMIT DATE ENTERED IN THE "Q" UNDER THE DATE RESUBMITTED AFTER THE GOODBYE IS RUN.

Q.HOW WILL I NOTE MY CORRECTION?

A.  YOU MAY DO A "CTRL N" AND ADD A NOTE TO THE NOTE SECTION.

Q.IS THERE SOME WAY THAT I CAN CHANGE THE VOUCHER SO MY CORRECTIONS WILL SHOW THERE?

A.  YES. YOU CAN GO TO THE ACTION "V", HIGHLIGHT THE CLAIM YOU ARE CORRECTING AND RESUBMITTING, DO A "CTRL X" TO DELETE THE VOUCHER. FROM THE ACTION "Q", PRESS ENTER ON THE CLAIM TO BE CORRECTED AND RESUBMITTED, PRESS THE "ENTER" KEY AND MAKE YOUR CORRECTION. IN THE INSURANCE AREA, REPLACE THE "R" WITH THE LETTER "C".

Q.BY DOING A "CTRL X", WHAT HAPPENS TO THE CLAIM IN VOUCHER?

A.  THE CLAIM IS REMOVED AND IS SENT TO THE PATIENT BALANCE IF YOU DO NOT PUT THE CLAIM BACK IN VOUCHER.

Q.WHAT WILL THE LETTER "C" IN THE INSURANCE AREA OF THE CLAIM IN ACTION "Q" DO?

A.  THIS CODE TAKES THE CLAIM FROM PATIENT BALANCE AND PUTS THE CLAIM BACK IN VOUCHER TO THE INSURANCE. BY DOING THESE TWO STEPS, YOUR CLAIM WILL NOW SHOW IN VOUCHER WITH THE CORRECTION.

Q.IS THERE ANY OTHER SITUATION WHEN I WOULD USE THE LETTER "C" IN THE INSURANCE AREA FROM THE "Q" SCREEN?

A.  YES. WHEN THE PATIENT RECEIVES A BILL FOR A DATE OF SERVICE AND HE HAS INSURANCE. AS MENTIONED ABOVE, THE LETTER "C" TAKES THE BALANCE AWAY FROM THE PATIENT AND PUTS IT OUT TO INSURANCE IN SUSPENSION.

Q.WHICH INSURANCE DOES THE LETTER "C" SEND THE CLAIM TO?

A.  PRIMARY INSURANCE.

Q.WHAT IF A PATIENT GETS A BILL AND THE BALANCE SHOULD HAVE BEEN SENT TO THE SECONDARY?

A.  RESUBMIT THROUGH THE "Q" SCREEN. HIGHLIGHT THE DATE, PRESS THE "ENTER" KEY, CHANGE THE CHARGE AMOUNT TO THE BALANCE THE PATIENT IS BEING BILLED/BALANCE OWED BY SECONDARY, MOVE TO THE "INS" AREA AND PUT LETTER "D".

Q.WHAT IF THE PATIENT GETS A BILL FOR THE BALANCE PENDING THE THIRD INSURANCE?

A.  USE THE SAME PROCEDURE AS THE SECONDARY RESUBMIT. CHANGE THE CHARGE AMOUNT PENDING AND PUT A LETTER "E" IN THE INSURANCE AREA.

Q.WHY WOULD THE PATIENT GET A BILL FOR THE BALANCE OF A CLAIM WHEN THEY HAVE SECOND AND THIRD INSURANCE?

A.  WHEN POSTING, THE CODE USED TO SUBMIT THE BALANCE TO THE SECOND AND THIRD INSURANCE WAS FORGOTTEN. (SEE SECTION ON VOUCHER POSTING).

Q.HOW WOULD I ADD A REFERRING PHYSICIAN OR AUTHORIZATION TO A CLAIM WHEN RESUBMITTING?

A.  GO TO ACTION "Q", HIGHLIGHT THE LINE AND PRESS THE "ENTER" KEY. MOVE TO THE COMMENT SECTION TYPE RP:(SPACE) PRESS "F1" THEN DO "CTRL L" TWO TIMES. TYPE IN THE DOCTOR LAST NAME AND PRESS THE "ENTER" KEY. HIGHLIGHT THE CORRECT DOCTOR AND PRESS THE "ENTER" KEY TWICE. THE SECOND TIME LOCKS IN THE DOCTOR NAME. ENTER A THIRD TIME AND THE CLAIM WILL BE RESUBMITTED. FOR AUTHORIZATION, TYPE IN PN:(SPACE) PRESS "F1" AND TYPE IN THE AUTHORIZATION.

Q.HOW DO I PRINT A HCFA ON DEMAND?

A.  GO TO ACTION "Q", HIGHLIGHT THE DATE TO PRINT, PRESS ENTER. MOVE TO THE "INS" FIELD AND PUT AN "F" TO PRINT TO PRIMARY, "H" TO PRINT TO SECONDARY, "J" TO PRINT TO THIRD.

Q.DO RESUBMITTED CLAIMS AFFECT THE BALANCE OF THE PATIENT ACCOUNT?

A.  NO. THE ONLY TIME A RESUBMITTED CLAIM WILL AFFECT THE BALANCE OF THE ACCOUNT IS IF YOU RESUBMIT THROUGH THE "Q" SCREEN AND USE AN INS CODE OF "C", "D", "E" AND THE CLAIM IS ALREADY IN VOUCHER. REMEMBER, THESE CODES TAKE THE BALANCE AWAY FROM THE PATIENT. IF THE PATIENT HAS A ZERO BALANCE AND YOU TRY TO TAKE DOLLARS AWAY, YOU WILL CREATE A CREDIT IN THE CURRENT AREA OF THE PATIENT'S ACCOUNT.

Q.WHAT DO I DO IF THIS HAPPENS?

A.  YOU WOULD HAVE TO GO TO THE VOUCHER ACTION "V" AND DO A "CTRL X" ON ONE OF THE DUPLICATE CHARGES. THIS WILL SEND THE CLAIM TO PATIENT AND BALANCE OUT THE ACCOUNT.

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Copyright © 2002-2004 Computer Innovations, Inc. All rights reserved.
Revised: August 06, 2010 .