PC - Demographics Flashcards

1
Q

Where can you find Memos and Notes?

A

In Patient Demographics.

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2
Q

Memos will pop-up upon patient search.

A

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3
Q

Hidden memo will cause a pop-up to appear each time the patient’s record is opened, but rather than full-text, an asterisk will appear to indicate memo.

A

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4
Q

Statement memo is a memo that will be included on all statements for patient.

A

.

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5
Q

You can create expiration dates for all memos.

A

.

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6
Q

You can create insurance memos as well as handling consent tracking.

A

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7
Q

Notes.

A

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8
Q

You can add permanent notes to patient tab.

A

.

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9
Q

Any note created over 24 hrs ago is locked and cannot be deleted or changed.

A

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10
Q

Within 24 hours the note can be changed, but cannot be deleted.

A

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11
Q

Registering a Patient

A

.

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12
Q

Before registering a patient, do a search to make sure there isn’t already a saved record for patient.

A

.

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13
Q

Click “New” in Scheduler to make new patient record.

A

.

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14
Q

In Quick Add, Patient’s name, responsible party, financial class, provider and zip code are required before the record can be saved.

A

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15
Q

Responsible Party is for the person responsible for making the payments on account.

A

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16
Q

Financial class determines how the patient’s insurance will be billed.

A

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17
Q

Relationship field describes the relationship of the responsible party to the patient.

A

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18
Q

Patient portal account maintenance icon is next to responsible party name.

A

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19
Q

Click invite in patient portal creation to give patient instructions.

A

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20
Q

If patient is coming for a worker’s comp claim, the Employer field must be populated.

A

.

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21
Q

If patient is responsible party, the responsible party tab does not need to be altered. If it is someone other than the patient, make sure to update tab with appropriate address and contact information.

A

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22
Q

Account Type will default in based on Financial Class that was selected on patient tab, but can be changed as needed.

A

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23
Q

3rd step of registering new patient will be updating insurance in insurance tab.

A

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24
Q

Effective date should be set prior to any visits that will be covered by insurance and the end date will indicate when coverage becomes inactive for patient (usually leave empty).

A

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25
Q

Populate group name, group #, and subscriber ID from insurance card.

A

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26
Q

Responsible party will default as the subscriber.

A

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27
Q

MSP Code is only to be entered if insurance coverage is a medicare secondary payer.

A

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28
Q

If MSP code is not selected for a secondary medicare claim, the clearinghouse will exclude the claims.

A

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29
Q

If patient has a secondary insurance coverage, save before clicking add new.

A

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30
Q

Sequence number will indicate which the coverage will be billed first on claims.

A

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31
Q

Chart Files will be where you can assign an insurance card into the billing category

A

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32
Q

Referrals

A

.

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33
Q

Attach referrals to patient visits to track insurance-authorized visits or minutes, streamline charge entry process, and track effective marketing tools.

A

.

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34
Q

Referral creation date will default to 3 days prior to appointment and the expiration date will default to 90 days later.

A

.

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35
Q

Check “Pre-Authorization Required” to remind that the carrier requries authorization prior to the patient’s visit.

A

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36
Q

Having pre-authorization will allow us to create a list of referrals needing verification with the carriers.

A

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37
Q

You can use pre-authorization report to view status of referred patients with appointments scheduled or completed and which doctors that referred patient.

A

.

38
Q

To automatically calculate used and remaining visits when scheduling an appointment leave Update Authorizations using “visits” and Calculate Authorizations at “Scheduled”.

A

.

39
Q

Enter necessary information in Reason, Status, and Facility tabs and hit save.

A

.

40
Q

Add relevant authorization information when insurance company is contacted.

A

.

41
Q

Cancelling visits are subtracted from visits used and added to the remaining field.

A

.

42
Q

Referral appointments button will view appointments attached to referral.

A

.

43
Q

Next, contact insurance carrier to confirm authorization and gather related information.

A

.

44
Q

Preauthorization and Referral numbers will be included in the electronic claim file.

A

.

45
Q

Add note to include who at the insurance carrier authorized visits and charge amount.

A

.

46
Q

Authorize Warning with Remaining visits/minutes setting is not related to the Continue to display expired referral plans system default.

A

.

47
Q

When scheduling final visit add in comment for provider to evaluate patient’s progress.

A

.

48
Q

If patient needs additional care, I call the carrier to request additional authorization.

A

.

49
Q

If you don’t want to decrement the visit from authorized visits, click “No” on Update Referral.

A

.

50
Q

Visits using Minutes will calculate authorizations at “Posted”.

A

.

51
Q

Inbound referrals based on minutes function in the same way as referrals based on visits.

A

.

52
Q

Each unit based on minutes will be 15 minutes (i.e. 60 minutes = 4 units).

A

.

53
Q

To create a referral letter, use the outbound referral tab.

A

.

54
Q

Inactivated referring provider displays in pre-existing and expired referrals, but does not display as an option for new referrals.

A

.

55
Q

Patient Demographics Configuration

A

.

56
Q

Master Files - Message Types allow you to categorize what type of message is to be sent out.

A

.

57
Q

Message Distribution Lists are located in “Utilities”.

A

.

58
Q

Creating Patient Document and Form Templates.

A

.

59
Q

This section will allow you to create templates for letters you generate regularly.

A

.

60
Q

Go to Master Files and form templates to create new types of letter templates.

A

.

61
Q

In Appointments Scheduler, click “Edit” and select the forms tab in patient demographics and click “Welcome Letter” and also check to make sure information is correct.

A

.

62
Q

Clicking “Batch” will save the letter in a batch print queue.

A

.

63
Q

Names added by merge fields to templates will automatically be in uppercase, to edit, right click the merge field and click “Title case” in Format.

A

.

64
Q

After creating template, perform a patient mail merge to generate letters for multiple patients who fit criteria.

A

.

65
Q

Mail merge is located in Utilities.

A

.

66
Q

Chart Files

A

.

67
Q

Attach files received through Document Scanning and AdvancedFax modules.

A

.

68
Q

%C

A

Chart Number

69
Q

%N

A

Patient’s Name

70
Q

%D

A

Current Date

71
Q

PM integrates with Microsoft Word so documents and templates can be easily created and modified.

A

.

72
Q

“I” is indicative of an image and “D” is indicative of a word document, etc.

A

.

73
Q

Locked files can only be edited and saved.

A

.

74
Q

Clicking Rollback will undo the unlocked revision.

A

.

75
Q

Posting Charges

A

.

76
Q
  • Online Charge Slips
  • Transaction Entry
  • Quick Charge Entry
A

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77
Q

Quick Charge Entry

A
  • Quickly enter charges and modify billing details
  • Fastest method for billers to post charges
  • Click Arrow up w/ money sign to access this page
  • Column displays appointments for the day
  • Convenient for billers with appointments view and billing fields
78
Q

Transaction Entry

A
  • Click Dollar sign on notepad to access this screen or use “Demographics” drop-down
  • Click “Charge” or “Alt+C” to access charge entry screen
  • Click “Ok” to process charge or “Ok & Stay” to post additional charges
  • Post a corresponding payment by clicking “Ok & Pay”
  • Most comprehensive method
79
Q

Online Charge Slips

A
  • Quick point & click method ideal for providers
  • Easily view carriers diagnoses code set to help determine which codes to post
  • Recall can be created if patient needs to be seen for a FUV
  • Beneficial for clinical staff to quickly post charges
80
Q

Charge Review

A
  • Important part of closing your day as claims must be approved prior to a claim being generated
  • Charges are approved from charge review tab of claim center (Claim center icon is magnifying glass on folded paper)
  • “Reset Visit” will remove all charges from a visit
  • “Void” will completely remove charges and voice visit
81
Q

Patient Billing

A
  • ePayments will send an e-mail or text to responsible parties
  • To edit ePayments go to Master Files-Templates-Automated Messaging & Reminders
  • For a responsible party to only receive online reminders, click “Online Only”
  • Messaging preferences is located in top-right of responsible party and looks like a person on a notebook
  • Payments made through ePayments module are indicated in the Patient History Tab and on related reports with the payment code #PTPORTAL
  • Patient Billing Wizard is located in Billing - Patient Billing - Patient Billing Wizard
82
Q

Using and Managing Batches

A
  • To create a new batch, click Billing - Batch Entry - Begin New Batch
  • Batch Trial Balance report lists transaction activity for the batch
  • Billers will click Transaction Entry - Payment - Begin New Batch
  • eRemittance Review icon is magnifying glass with lightning through it on paper
  • To add additional payments throughout the day, open your batch information and click “Reconnect”
  • At the end of the day, balance all payments by clicking Trial Balance and verifying and close the batch
  • You can re-open batches if you have not closed for the day
  • Each person starts a batch in the morning and balances it before closing for the day
  • End of Day Wizard looks like a clock at 5 o’clock
83
Q

Online Charge Slip

A
  • Master File - Templates - Charge Slip Templates
  • Icon looks like a 3x3 chex mix piece
  • ???
84
Q

Macros and Modifiers

A
  • Modifiers simple two-character codes that signal a change on how a procedure should be included on a claim (must be accurate)
  • Master Files - Transaction Codes - Modifiers
  • Master Files - Transaction Codes - Macros
  • Macros can be 10 digits and contain alphanumeric characters
  • Code boxes below allow you to attach up to 6 procedures in a macro
  • Nesting is a macro in a macro
  • Up to 6 macro codes can be used in a macro
85
Q

Debit Adjustments

A
  • Quickly add a balance such as interest, no-show fees and return check fees
  • Master Files - Transaction Codes - Debit Adjustment
  • Fee-Type Adjustments will create a new visit # for charges enter
  • Associated with Payments will not create a new visit # and be associated with the visit
  • Use for All Adjustments Associated with Payments; no-show fee, bad check fee, interest, post payments retrieved by 3rd parties
  • If you enter the adjustment after you’ve entered line items, you’ll have to re-enter them
86
Q

Denial Tracking

A
  • Tracking claims denied or underpaid
  • Use claim submission analysis report to see a high-level summary of percentage of clean claims versus the three main reasons for denied claims
  • Modules - A/R Control Center - Denial Tracking
  • Before calling carrier, click Action History, this will show any updates on claim, after; record actions in action tab and select Next Action and Follow Up
  • To remove a denial from Denial Tracking, click Actions-Resolved, no follow up is required
87
Q

Collections - Working Insurance and Patient Balances

A
  • Track outstanding insurance and patient balances
  • To customize click - Utilities - System Defaults - A/R Control Center, then choose settings for Default Collections Filter
  • Action Codes are used as quick reference to track steps taken to collect an outstanding account
  • Master Files - A/R Control Center - Collections Worklists customized list of accounts with overdue balances
  • Maximum forced days set number of days you will allow an account to be forced to another worklist
  • Worklist at the top of grid is usually the highest priority
  • To access Control Center module click; Modules - A/R Control Center - Collections (icon looks like a stamp wiht the word “DUE” under it)
  • Forcing a worklist keeps it from further evaluation until maximum date set in Master Files has been met
  • Once an action is submitted on collection item, it will be moved to the Recalculate Worklists bucket and then the correct worklist
  • Clearing the Remove Forced Worklist check box will keep this collection item in the forced worklist
88
Q

Color Key for charges in Collections

A
  • Black: Current
  • Blue: Payment Plan
  • Magenta: Past 90 days
  • Dark Red: Past 120 Days
  • Green: Payment
  • Red: Write-off
89
Q

Action Types

A
  • A: Account notes made from Collections by Account
  • D: Denial notes made from Denial Tracking
  • V: Visit notes made from Collections by Visit
90
Q

To record Action in Collections

A
  • Select a line
  • Click actions search bar icon
  • Set action and type explanation in note
  • Select corresponding action and modify next action and follow up dates as needed