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85 terms

e billing chapters 3/4/5/6/7

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backup data
a copy of data files made at a specific point in time that can be used to restore data to the systems
database
a collection of related bits of information
knowledge base
a collection of up to date technical information
MMDDCCYY format
a specific way in which dates must be keyed, in which MM stands for the month, DD stands for the day, CC represents the century, and YY stands for the year.
packing data
the deletion of vacant slots from the database
purging data
the process of deleting files of patients who are no longer seen by a provider in a practice.
rebuilding indexes
a process that checks and verifies data and corrects any internal problems with the data
recalculating balances
the process of updating balances to reflect the most recent changes made to the data.
restoring data
the process of retrieving data from backup storage devices
what are the 2 ways of issuing a command in medisoft
1. a command can be issued by clicking options on the menu bar 2. a command can be issued by clicking on the short cut buttons on the toolbar.
what are the 2 ways data are entered into a box
1. you enter data through the menu's or menu bar 2. enter data through buttons on the toolbar keying data into a text box.
what are the 3 hints in the help menu
1. hints 2. built ins 3. online
what menu provides access to office hours, Medisofts scheduling feature
you find the office hours under the activities menu
what is the purpose of the buttons on the tool bar
the buttons are icons, the represent the dropdown menu on the toolbar at the top
what is the format for entering data in Medisoft
the format is MMDDCCYY
describe 2 ways of exiting Medisoft
1. to exit click the file menu button and the click the close button 2. the 2nd ways is to click on the X button in the upper right corner of the screen
why it is important to back up data regularly
backdata can be used to restore data to the system in the event the data in the system is accidentally erased
why is extra caution required when purging data
once data are purged from the system it cannot be retrieved
when is a data restore performed
if you share a computer in an instructional environment, it is recommended that you perform a restore before each new session to be sure you are working with your own data
in Medisoft, what are the two places a patients balance can be recalculated?
1. the first place a balance can be recalculated is in the patient's individual file through the transactions entry dialog box by clicking the account total column. 2. the second place to recalculate the patients is through the file maintenance section on the file menu and access recalculate balance tab
how many options are in the reports menu
there are 11 options
what is the first choice on the Lists menu
the first choice is Patient/Guarntors and cases
list the options on the activities menu 1
enter transactions
list the options on the activities menu 2
claim management
list the options on the activities menu 3
statement management
list the options on the activities menu 4
enter deposits/payments
list the options on the activities menu 5
Unprocessed transactions
list the options on the activities menu 6
patient ledger, guarantor ledger,
list the options on the activities menu 7
quick balance, patient quick entry
list the options on the activities menu 8
billing charges, small balance write off
list the options on the activities menu 9
colllections list, add collection list item
list the options on the activities menu 10
launch work administrator, final draft, add new task
list the options on the activities menu 11
appointment book, eligibility verification, claims manager
what are the 4 options under File Maintenance
purging data, packing data, recalculating balances, rebuilding indexes
chart number
a unique number that identifies a patients
established patient
a patient who has been seen by a provider in the practice in the same specialty within 3 years
guarantor
an individual who is not a patient of the practice, but who is the insurance policyholder for a patient of the practice
new patient
a patient who has not received services from the same provider or a provider of the same specialty within the same practice for a period of 3 years
how do you create a chart # in Medisoft
under list menu, patient/guarantor, new patient, enter first 5 characters of the patients last name, 2 letters of the first name and the last is a 1 zero
How do you create an employer # in Medisoft
employers #s are entered there the list menu, under addresses, click new button, key E for employer, first 2 letters of Employers title followed by 2 zeros
what is the quickest way to open a patient or case
is to double click on the line associated with a patient or case
what does the copy address button saves
it sames time when entering patients with the same address, such as family members, clicking on the copy address button provides the option to copy demographic information from a patient already in the database
throughout Medisoft what function does the F8 button serves
the F8 function key serves as a shortcut for entering data in Medisoft in another part of the program without leaving the current dialog box.
right clicking
allows searching easier on a column heading in a window that contains several columns. you can select the located button, or can select alt+ L. This opens a locate window that defaults the fields selection to the column you selected
case
a case is a grouping of transactions for visits to a physicians office, organized around a condition. when a patient comes for treatment a case is created
example of case
all treatments and procedures for a patient's bronchial asthma would be stored in a case called "Bronchial Asthma"
when do you set up a new case
a new case should be set up each time a patient comes to see the physician for a NEW CONDITION or when there is a change in the provider or insurance carrier
why set up a new case when the ins. carrier changes
you set up an new case for the insurance carrier because it makes it easier to submit insurance claims to the appropriate carrier.
would you set up more than one case per office visit
yes, you would if the customer was diagnosed with 2 or more unrelated conditions.
when are cases closed
when the patient is no longer being treated for the condition, or when the insurance policy in the case is no longer in effect, or when the patient leaves the practice
where are cases created
in the list dialogue box under the patients/guarantors selection then select the Case radio button
what options can you create once the case radio button is selected
you can delete, edit, new, copy case print grid, quick entry, and close
in the Edit section of Case radio button
it contains 11 different tabs that can be edited. the condtion, misc, medicid and tricare, comment, EDI, Personal, ACcount, Diagnosis, Policy 1, Policy 2, Policy 3 (all info to change the insurance carriers)
what is the only thing you cannot change in the edit section of the radio button
you cannot change the case number
the delete case button
will delete the case from the system if their are not open transactions that have not been fully paid by the insurance carrier or the the policyholder.
the delete case button 1
should be used with caution because the information cannot be retrieved and will be lost forever. the case should only be deleted when the patients records will never be needed again.
what is the normal policy in retaining case information
the normal retention period is 5 years for cases
copy case button
copies all the information from an existing case into a new case. it is especially useful for existing patients that present with a new condtion
the print grid
is used to select or deselect columns of information for printing purposes
quick entry
allows the office to customize the way patient data is entered
close button
closes the patient list dialog box
chart
is a folder that contains all records pertaining to a patient
record of treatment and progress
contains the physicians notes about a patients condition and diagnosis.
encounter form
is a list of services performed and the charges for those services
referring provider
a physician who recommends that a patient see a specific other physcian
account tab
on the case area includes info on a patients assigned provider, referring provider, and referral source, as well as other information that may be used is some medical practices but not others
account tab=attorney box
is used for accident cases. if a patient has an attorney, the name of the attorney should be selected from the drop down list, if not there enter under list menu, under addresses
account tab-case billing code
is a one or 2 character box used by some practices to classify and sort patients by insurance carriers, diagnosis, billing cycle, or other kinds of information
account tab-price code
the price code determines which set of fees is used when entering transactions for this case.
where are price code fees entered
they price code fees are entered under the list menu, drop down to the Procedure, payment, adjustment
primary insurance carrier
the first carrier to who claims are submitted
policy 1 tab
is where information about a patient's primary insurance carrier and coverage is recorded
insurance 1 section
lists the code number and name of insurance carrier, use f8 to add new insurance companies from this screen
policy holder 1
is the guarantor on policy, if not a patient of this practice, you must establish a chart # for the guarantor
capitated plan
an insurance plan in which payments are made to a physician by a managed care company for a patient who selects the physician as his or her primary care provider, regardless of whether the patient visits the physician
UB-04
is the treatment authorization field in the policy 1 section that record the treatment authorization Used for hospital claims
insurance coverage percents by service classification
the % of fees that an ins. carrier covers is entered in the Ins. Coverage Percents by Service Classification box. some ins. plans pay different percentages of charges based on the type of service provided. example 80 for medical, 100% lab, 50 % for outpaitent mental health
crossover claim box
located in Policy 2 section of the case section is only used when a patient has medicare as the primary carrier and Medicaid as the secondary carrier
the Condition Tab
contains or stores data about a patients illness, accident, disability and hospitalization. this information is used by ins carriers to process claims
charges
amounts a provider bills for the services performed
payments
monies received from patients and insurance carrierswha
adjustments
changes to patients accounts that alter the amounts charged or paid
what are the 3 transactions performed in Medisoft
payments, adjustments, charges are the 3 transactionsqw
what are examples of adjustments in Medisoft
return check fees, insurance writeoffs, medicare adjustments, and changes in treatment
what are the 2 locations payments are entere
in the activities menu, in the enter transaction drop down menu (use if payment received at time of office vist) or in the deposits, payments menu (use when receive payments from ins. carriers by mail or electronically . also for mailed payment from patients)