1. Entering Charge Transactions and Patient Payments6
Entering Charge Transactions and Patient Payments

2. Learning Outcomes
6-2
6.1 Identify the three types of transactions recorded in Medisoft. 6.2 Recall how to select a patient and case in Transaction Entry. 6.3 Indicate how to enter charge transactions in Medisoft. 6.4 Identify how to enter payments made at the time of an office visit. 6.5 Recall how to print a Walkout Receipt. 6.6 Indicate how to process a refund for a patient. 6.7 Identify how to post a Nonsufficient Funds (NSF) check.

3. Key Terms 6-3 adjustments charges MultiLink codes NSF checks payments
Teaching Notes:
Have students define all key terms as an assignment. Then, in class, ask each student to define one key term aloud.
Optional assignment: Have students do an Internet search of one key term and write a short paragraph describing what they learned about that term from looking at a few websites.

4. 6.1 Understanding Charges, Payments, and Adjustments
6-4
Three types of transactions are recorded in Medisoft: charges, payments, and adjustments
Charges are the amounts a provider bills for the services performed
Payments are monies received from patients and insurance carriers
Adjustments are changes to patients’ accounts
Learning Outcome: 6.1 Describe the three types of transactions recorded in Medisoft.
Page: 174
Teaching Notes:
The document needed to enter charge transactions in Medisoft is a patient’s encounter form. These are provided in the back of the text in the source documents.

5. 6.1 Understanding Charges, Payments, and Adjustments (Continued)
6-5
Transaction Entry dialog box with three sections highlighted
Learning Outcome: 6.1 Describe the three types of transactions recorded in Medisoft.
Page: 174
Teaching Notes:
The Medisoft transaction entry dialog box is divided into 3 sections, 2 that represent the 3 types of transactions.
The top is information about the patient, the insurance coverage, and the patient’s account.
The middle section is where charge transactions are entered.
The bottom third is where payments and adjustments are entered and applied.

6. 6.2 Selecting a Patient and Case
6-6
Selecting a patient chart
Key first several letters of patient’s last name
If correct choice is not highlighted, use arrow keys to move up and down through charts
When the desired patient is highlighted, press Tab to select and close the drop-down list
Learning Outcome: 6.2 Discuss how to select a patient and case in Transaction Entry.
Pages:
Teaching Notes:
This is the top part of the dialog box. In a real office there would be hundreds of patients listed so knowing how to do a search is important.
Key the first several letters of a patient’s last name. The first chart number in the list that matches those letters is highlighted.

7. 6.2 Selecting a Patient and Case (Continued)
6-7
Selecting the case that relates to the current charges or payments
Must locate the patient’s chart first
Select the desired choice from the case numbers and descriptions for the patient
Only one case can be opened at a time
Learning Outcome: 6.2 Discuss how to select a patient and case in Transaction Entry.
Pages:
Teaching Notes:
It is important to select the correct case. In real life patients will have many cases. Remember cases are the reason that a patient comes to the physician. Some are chronic, some acute. If you do not select the correct case then it can affect reimbursement from insurance companies. Transactions and procedures will be posted to the wrong complaint. This will cause claims to be denied.

8. 6.3 Entering Charge Transactions
6-8
Entering charges after selecting a case
Click the New button to open a new line for entering charges
Learning Outcome: 6.3 Demonstrate how to enter charge transactions in Medisoft.
Pages:
Teaching Notes:
This is the middle of the dialog box. When the new button is clicked, the program automatically enters the current date (the date that the Medisoft Program Date is also set in the Date box. Very important when completing exercises throughout the text that you pay attention to the date the exercise tells you to use in Medisoft and that you change it before beginning. All dates in the exercises are in the future and the program must be changed for accurate pulling reports later in the text.
New button

9. 6.3 Entering Charge Transactions (Continued)
6-9
When the New button is clicked, the program automatically enters the current Medisoft Program Date
A procedure code is then selected from a drop-down list of CPT codes in the database
Learning Outcome: 6.3 Demonstrate how to enter charge transactions in Medisoft.
Pages:
Teaching Notes:
It is more efficient to locate a code by entering the full code number or the first several digits than to scroll through the entire list of codes.
Only one procedure code can be selected for each transaction. If multiple procedures were performed for a patient, each must be entered as a separate transaction.
If the code is not in the database it can be added by pressing the F8 key or clicking Procedure/Payment/Adjustment Codes on the Lists menu.
CPT codes

10. 6.3 Entering Charge Transactions (Continued)
6-10
After the code is selected and the Tab key is pressed, the program automatically enters the charge amount for that procedure
Charges section
after a procedure
code is selected
Learning Outcome: 6.3 Demonstrate how to enter charge transactions in Medisoft.
Pages:
Teaching Notes:
This amount is determined by the practice fee schedule and is input into the database with the code.

11. 6.3 Entering Charge Transactions (Continued)
6-11
Other information entered includes:
▪ Date
▪ Procedure
▪ Units
▪ Amount
▪ Diag 1-4
▪ 1-4
▪ Provider
▪ POS
▪ TOS
▪ Allowed
▪ M1
▪ Copay
Learning Outcome: 6.3 Demonstrate how to enter charge transactions in Medisoft.
Pages:
Teaching Notes:
Units indicates the quantity of the procedure. Usually one.
Amount lists the charge amount for a procedure.
The Diag 1, 2, 3, and 4 boxes correspond to the information in the Diagnosis tab of the Case folder If a patient has several different diagnoses, the diagnosis that is most relevant to the procedure is used.
The 1, 2, 3, and 4 boxes to the right of the Diag 1, 2, 3, and 4 boxes indicate which diagnoses should be used for this charge.
TOS stands for “type of service.” Medical offices may set up a list of codes to indicate the type of service performed.
The POS, or place of service box, indicates where services were performed.
Allowed is the amount allowed by the payer for this procedure.
The M1 box is for a CPT code modifier.
Copay A check mark in this box indicates that the code entered in the Procedure column requires a copayment.

12. 6.3 Entering Charge Transactions (Continued)
6-12
MultiLink codes are groups of procedure code entries that relate to a single activity, and save time when entering multiple CPT codes
MultiLink button
Learning Outcome: 6.3 Demonstrate how to enter charge transactions in Medisoft.
Pages:
Teaching Notes:
There are 5 buttons in the Charges area: New, Delete, MultiLink, Note, and Details.
When procedure codes are entered as a MultiLink, it is impossible to forget to enter a procedure, since all the codes that are in the MultiLink group are entered automatically.
Delete delete a charge transaction.
Note button is used to enter additional information about a particular procedure.
The Details button displays a dialog box that is used to enter drug/prescription information for a charge.
MultiLink code
drop-down list

13. 6.3 Entering Charge Transactions (Continued)
6-13
Transactions are color-coded, making it easy to determine the status of a charge or payment
No payment (gray)
Partially paid charge (aqua)
Overpaid (yellow)
Transactions are saved by clicking the Save Transactions button, or the Update All button
Learning Outcome: 6.3 Demonstrate how to enter charge transactions in Medisoft.
Pages:
Teaching Notes:
Charges that have been paid in full are not colored and appear white. You can see the list of color codes by right clicking in the white below the list of transactions.
The other buttons located in this row, Quick Receipt and Print Receipt, are used to print a walkout receipt for a patient.

14. 6.3 Entering Charge Transactions (Continued)
6-14
Transactions already entered can be edited by clicking in the field that contains the error and entering new data
Data must be saved after making edits
Learning Outcome: 6.3 Demonstrate how to enter charge transactions in Medisoft.
Pages:
Teaching Notes:
Depending on the type of edit, the program may display several message boxes. You need to pay attention to the messages and follow the instructions.

15. 6.4 Entering Payments Made at the Time of an Office Visit
6-15
Payments in Medisoft are entered in two ways
Patient payments made at the office are entered in the Transaction Entry dialog box
Payments received electronically or by mail, such as insurance payments and mailed patient payments, are entered in the Deposit List dialog box
Learning Outcome: 6.4 Demonstrate how to enter payments made at the time of an office visit.
Pages:
Teaching Notes:
Patient payments made at the time of an office visit are entered in the Transaction Entry dialog box.
Payments that are received electronically or by mail, such as insurance payments and mailed patient payments, are entered in the Deposit List dialog box.

16. 6.4 Entering Payments Made at the Time of an Office Visit (Continued)
6-16
Entering patient payments
Patient payments are entered in the Payments, Adjustments, and Comments section of the Transaction Entry dialog box
Click the New button, verify/enter the date, and press the Tab key to begin
Learning Outcome: 6.4 Demonstrate how to enter payments made at the time of an office visit.
Pages:
Teaching Notes:
First select a patient’s chart number and case number in the Transaction Entry dialog box.
Program automatically enters the current date (the date that the Medisoft program date is set to) in the Date box

17. 6.4 Entering Payments Made at the Time of an Office Visit (Continued)
6-17
Entering patient payments
The code for a payment is selected from a drop-down list already in Medisoft
Learning Outcome: 6.4 Demonstrate how to enter payments made at the time of an office visit.
Pages:
Teaching Notes:
Press the tab key throughout this process so those fields that can will populate themselves.
If a payment code is not listed, it can be added to the database by pressing the F8 key or by clicking Procedure/Payment/Adjustment Codes on the Lists menu.
Drop-down list

18. 6.4 Entering Payments Made at the Time of an Office Visit (Continued)
6-18
Entering patient payments
The Who Paid field displays a drop-down list of guarantors and carriers that are assigned in the patient case folder
Select the person who is paying for the charges
Learning Outcome: 6.4 Demonstrate how to enter payments made at the time of an office visit.
Pages:

19. 6.4 Entering Payments Made at the Time of an Office Visit (Continued)
6-19
Entering patient payments
Other information entered includes:
▪ Date ▪ Description ▪ Provider
▪ Amount ▪ Check Number ▪ Unapplied
Learning Outcome: 6.4 Demonstrate how to enter payments made at the time of an office visit.
Pages:
Teaching Notes:
The Description field can be used to enter other information about the payment, if desired.
Amount field contains the amount of payment received.
Provider column lists the code number of the provider.
Check Number field is used to record the number of the check used for payment.
Unapplied box is the dollar amount that has not yet been applied to a charge transaction.

20. 6.4 Entering Payments Made at the Time of an Office Visit (Continued)
6-20
Applying charges to payments
After payments are entered, they must be applied to the appropriate charge
Once a charge is selected, choose Apply To Co-pay or Apply to Oldest based on the type of payment received
Learning Outcome: 6.4 Demonstrate how to enter payments made at the time of an office visit.
Pages:
Teaching Notes:
Payments are color-coded to indicate payment status
1. Partially applied payment (blue)
2. Unapplied payment (red)
3. Overapplied payment (pink)
Payments that have been fully applied are not colored and appear white.
After applying all payments, make sure the unapplied amount in the top right window should be zero.
Payments can be applied manually by clicking in the box in the This Payment column on the line that contains the charge.
Payments can be applied to more than one charge.
When all the information on a payment has been entered and checked for accuracy, it must be saved.

21. 6.5 Printing Walkout Receipts
6-21
A walkout receipt includes information on the procedures, diagnosis, charges, and payments for a visit
Given to patient after a payment is made before the patient leaves the office
Walkout receipts are created via the Print Receipt button
Learning Outcome: 6.5 Demonstrate how to print a Walkout Receipt.
Pages:
Teaching Notes:
Also known as a walkout statement.
The Quick Receipt option remembers the user’s preferred report format and eliminates several steps in the creation of a receipt.
Print Receipt button

22. 6.5 Printing Walkout Receipts (Continued)
6-22
When the Print Receipt button is clicked, the Open Report window appears with the first report highlighted Walkout Receipt (All Transactions)
Click the OK button
Choose an option from the Print Report Where? dialog box and click the Start button
Select the date for the receipt from the Data Selection Question dialog box and click the OK button to print the walkout receipt
Learning Outcome: 6.5 Demonstrate how to print a Walkout Receipt.
Pages:

23. 6.6 Processing a Patient Refund
6-23
Adjustments to patient accounts are entered in the same manner as payments are recorded, in the lower third of the Transaction Entry dialog box
The New button begins the process of entering an adjustment
Overpayments are color-coded yellow
Learning Outcome: 6.6 Demonstrate how to process a refund for a patient.
Pages:
Teaching Notes:
This indicates the patient is due a refund for that procedure, and an adjustment needs to be made
PTREFUND (patient refund) is the code for refund

24. 6.7 Processing a Nonsufficient Funds (NSF) Check
6-24
An NSF check is one not honored by a bank because the account it was written on does not have sufficient funds to cover the check
When a practice receives a NSF notice from a bank, an adjustment is made in the patient’s account
Patient then owes the amount of the returned check, and often an additional fee
Learning Outcome: 6.7 Demonstrate how to post a Nonsufficient Funds (NSF) check.
Pages:
Teaching Notes:
Commonly called “bounced” and “returned” checks. A bank may also not honor a check if the account has been closed.
The fee for a returned check is governed by state laws.