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Charge Entry Allscripts

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Presentation on theme: "Charge Entry Allscripts"— Presentation transcript:

1 Charge Entry Allscripts

2 Introduction Welcome to this training on Charge Entry within Allscripts: Module 1 You will learn about the Charge Entry process to receive, check and transmit correct information This training is approximately 3 hours long

3 Objective By the end of this course, you should be able to complete all the steps in your Charge Entry workflow using the Allscripts system.

4 Outline Your Place in the Revenue Cycle Where to Begin?
How to do Charge Entry? 01 Create a Charge Batch 02 View Other Created Batches 03 Create a Charge Voucher and Services Lines 04 Enter Charges for a Standard Office Visit

5 Outline (Cont.) What to do if there are Problems?
05 Edit, Print, Close a Charge Batch 06 Re-Open a Closed Batch 07 Run Validate Batches and Verify Claims What to do if there are Problems? How to complete Charge Entry?

6 Terms Charge Entry (Demo) – Patient identifying information
Rendering Provider - Term 2 - [definition here]

7 Your place in the revenue cycle

8 Revenue Cycle Management End-to-End

9 Where to begin?

10 Where do I get my data? PracticeMax offices receive batch loads input by provider offices in a system called BPOSS Shift Supervisors give batch cover sheets to the Data Entry team Shift Supervisors assign the rest to Charge Entry teams Points of Contact (POC) assign batch loads to Charge Entry representatives

11 Where do I get my data? (Continued)
Check your for assignments. Ask your POC if you have a question about your assignments. Note: Your Team Lead may be of help to you if you did not receive an .

12 How to do Charge Entry

13 Click to add title (Add flowchart)

14 Section 1 Create a charge batch

15 Batch Management Use Charge Batches to enter charges submitted as claims (billed as self-pay statements and organization invoices) When Open you can make changes to any field except “Batch Type,” once saved Note: Changes made to the “Charge Batch Defaults” do not affect prior voucher changes entered in the batch.

16 Batch Type At the batch type field choose “Charge.”

17 Batch # Stores the batches identification number 3 Formats
Practice Options Assignment Manual Assignment System Assignment

18 Batch Category Batch Categories allow an organization to group batches with like transactions

19 Batch Comment Batch Comments allow for a detailed explanation of the batch contents or usage

20 Proof Amount Proof Amounts are used to balance the total amount entered in the batch to total of the charge tickets when manually entering charges

21 Procedure Count Procedure Counts are used to balance the total number of Procedure codes entered in the batch to total number of Procedure Codes on the charge tickets when manually entering charges

22 Hash Total Hash Totals are used to balance the sum of all the procedures codes entered to the sum of all the procedure codes included on the charge tickets when manually entering charges

23 Correction Batch The Correction Batch option is intended to be used when re-entering Charges and Payments that were voided using a Void batch.

24 Charge Defaults Use the Charge Defaults to define the entries that will default as values for each voucher created using the batch. Often used when entering a group of charges that were not scheduled and assigned, a visit encounter number (such as hospital and nursing home rounding charges).

25 Provider Contains a listing of all Care Provider entries stored Provider Maintenance that are flagged as a Member of Organization

26 Billing Provider Contains a listing of all Care Provider entries created Provider Maintenance that are flagged as a Member of Organization

27 Department/Practice Contains list of all Departments/Practices created in the PM database and stored in Department/Practice Maintenance

28 Place of Service Contains a list of all available Places of Service created in Place of Service Maintenance

29 Location Contains a list of all Locations created in Location Maintenance

30 Referring Doctor Contains a list of all Care Providers created in Referring Doctor Maintenance and flagged as a Referral Source

31 Service Date Auto-fills both the Date From and the thru fields for each service line on the Transactions screen. Procedure Auto-fills the field Procedure for the first service line on the Transactions screen.

32 Procedure The Procedure Code auto-fills in the field Procedure for the first service line on the Transaction Screen.

33 Information Broker Format
Intended for organizations to use to import charges at patient check out.

34 Suppress Transaction Acknowledgements
Suppresses the prompt “Do you want to print a Transaction Acknowledgement?” in the associated payment batch when applying a payment in a charge batch.

35 Hold Vouchers with Coding Errors
Auto-fills the field Hold Voucher From on the Summary screen with “All Billing (Insurance & Self Pay)” when a coding error is detected.

36 Display Pending Claims Correction

37 Questions

38 View other created batches
Section 2 View other created batches

39 View Batches Created by Other Operators
Allows an Operator to view all batches created in Batch Management by other Operators. To view, click Operators and open the Select Operator(s) dialog. The list of operator names and abbreviations is based on the Security Permissions applied to each User.

40 (Continued) If the currently logged on Operator is not one of the selected Operators, a warning message displays. Clicking OK allows you to view the batches but you cannot create a new batch.

41 Opening a Charge Batch Scenario: Once the Charge Batch is created, to enter charges, highlight the charge batch and a charge entry tab will appear. Key in encounter or voucher number or patient name to enter the charges. Open a new charge batch and apply the visit service charges for the Raleigh office using the appointment encounter number.

42 Open a Charge Batch Step 1:

43 Enter Batch # Step 2: Enter Batch # by selecting the choose Batch Number Format.

44 Enter Data in Fields Step 3: Enter the date, operator initials and suffix number. Click OK to continue.

45 Select Batch Category of Charges
Step 4:

46 Enter Batch Comments Step 5: Enter Batch Comments – Raleigh Office Charges

47 Select the Charge Defaults button
Step 6:

48 Charge Batch Defaults Step 7: On Charge Defaults dialog box, check Suppress Transaction Acknowledgements

49 Save Batch Step 8:

50 Questions

51 Create a charge voucher & services lines
Section 3 Create a charge voucher & services lines

52 Create a Charge Voucher
Once the Charge Batch has been opened, an organization’s charges are manually entered or electronically imported into the PM database. Options when Entering Charges: By Visit Encounter Number By Patient’s Name

53 By Visit Encounter Number
When entering Charges by Encounter# the detail from the associated appointment populates the voucher’s corresponding fields. The insurance payer, patient’s policy information, the Provider, Billing Provider, Department/Practice, Location and Referring Doctor default based on the coverage type selected when the appointment was scheduled. The Place of Services defaults based on the link to the Location entry in Place of Service Maintenance.

54 By Visit Encounter Number (Cont.)
To create a voucher by Encounter number, enter the number in the field, then Tab.

55 By Patient’s Name When entering Charges by Patient, the Payer, Policy and Responsible Party default based on the status and coverage type of the policies entered in Registration. Provider, Billing Provider and Referring Doctor fields auto-fill based on settings on the Charge Entry tab in Practice/Organization Options.

56 By Patient’s Name (Cont.)
To create a voucher by patient, either enter the patient’s number or the patient’s name.

57 Components of a Charge Transaction
Once you have retrieved the charge information, either by the Visit Encounter Number or manually entering by identifying the Patient’s name, the charge entry screen is activated.

58 Title Bar The Title Bar identifies the function name, batch number, the patient’s name and the current self-pay balance. (Current Self-Pay balance displays based on Practice Option settings).

59 Proof Amount Displays the proof amount entered on the Batch Management screen for this batch.

60 Entered Displays the total charges entered in this batch up to but not including the current voucher.

61 Payor Identifies the type of payer the voucher charges will be billed to. Available choices are Insurance, Self-Pay, Courtesy Claims or Sliding Fee.

62 Courtesy Claim Qualifies the voucher to print as a paper claim when batch paper claim is run. The balance for a voucher printed as a courtesy claim is considered a self-pay balance.

63 Sliding Fee Scale When “Sliding Fee Scale” is designated as the payor, the Policy field is renamed “Sliding Fee Scale.” Balances due for charges entered using a sliding fee scale are self-pay balances.

64 Co-Pay The patient’s co-pay responsibility associated with the policy selected for the voucher displays on the screen to the right of the field Payor.

65 Coverage Type The coverage types available are those associated with the patient policies assigned on the Policy tab in Registration. The coverage type can be changed, if necessary.

66 Policy The policies available are those associated with the patient policies assigned on the Policy tab in Registration. Available only when you select either “Insurance” or “Courtesy Claim” as the Payor.

67 Accept Assign The default state (checked or not checked) is determined by the setting for the carrier in Insurance Carrier maintenance and the setting on the patient’s Policies tab in Registration.

68 Policy Certificate Number
When a policy is selected the certificate number is displayed to the right of Accept Assign. The policy certification number pulls from the patient’s Policy tab in Registration.

69 Responsible Party The responsible party is the contact designated as the guarantor on the Account tab in Registration and will receive a statement.

70 Reset Accessible when entering the charge using the Patient’s Name or correcting charges by Voucher.

71 Provider This entry is the Care Provider that treated the patient. Appears as the Actual Provider on the AR reports. The available entries are created and stored in Provider Maintenance.

72 Billing Provider This entry is the Care Provider that appears on the claim as the Billing Provider. The system may use this entry when outputting the Group NIP, Individual NPI and Federal Tax ID numbers and address on a claim format. The available entries are created and stored in Provider Maintenance.

73 Not Incident to Billing Option
The Not Incident to billing option in Transactions > Charge Entry is available when the selected provider for the patient’s primary policy is set as Mid-Level Provider in Provider Maintenance and the associated Claim Style Maintenance has been set up for the carrier. (See next slide)

74

75 Department/Practice This entry is the Department/Practice of where the service took place. The system may use this entry to output the organization’s name, address, Group NPI, Tax ID and Taxonomy numbers on a claim format.

76 Place of Service This entry is the Place of Service where the service took place. The system may use this entry to output the organization’s name, address, Group NPI, Tax ID, and Taxonomy numbers on a claim format. The available entries are created and stored in Place of Service Maintenance.

77 Location This entry is the Location of where the service took place. The system may use this entry to output the organization’s name, address, Group NPI, Tax ID, and Taxonomy numbers on a claim format. The system may use the Billing Provider to output address information on the Professional claim format.

78 Referring Dr. This is the name of the Care Provider that has referred the patient to the organization.

79 Create Services Lines The purpose of the next several slides is to explain the various elements on the Charge Entry screen.

80 ICD-10 Effective Date The ICD-10 Effective date helps the operator determine whether to enter an ICD-9 or ICD-10 code.

81 Date From: Thru Identifies the date the service was provided to patient

82 Procedure Code Identifies the service CPT code assigned for the patient visit. Toggles between procedure code and procedure series.

83 Editable Procedure Code Description
The Procedure field on the Charge Entry tab, the Edits tab, and Specify Procedure Code accepts up to 80 characters. When Editable Description on the Procedure Code tab in Procedure Code Maintenance is selected, an additional procedure code description displays in the Procedure field: If the Editable Description text box contains a procedure code description, that description displays in the Procedure field on the Charge Entry and Edits tabs. The description also outputs on claims without the need to access Specify Procedure Code.

84 Editable Procedure Code Description
If Editable Description is selected but there is no description in the text box, Insurance Description in Procedure Code Maintenance displays in the Procedure field. If you want the value in Insurance Description to output on claims, you must open Specify Procedure Code and then click OK. If you do not open Specify Procedure Code, the procedure code description on claims is blank. See next slide

85 Note: When Editable Description is selected, you can use Specify Procedure Code on the Charge Entry tab to edit the procedure code description on the voucher, if necessary.

86 Editable Procedure Code Description
At Charge Entry, the editable description displays:

87 Modifiers Identifies the modifier(s) associated with a Procedure Code. Up to four modifiers are assigned to a single Procedure Code

88 Diagnosis Identifies a diagnosis code(s) associated with a Procedure Code. When entering diagnoses on a voucher, you cannot enter a mix of ICD-10 and ICD-9 codes on the same voucher. The first diagnosis code entered on the voucher determines the required code set for the subsequent diagnosis code, including codes entered in Claim Information.

89 Diagnosis (Cont.) If you hover over a Diagnosis in a service line row, the Long Description from Diagnosis Code Maintenance is displayed.

90 Diagnosis (Cont.) The first column displays a yellow Paper icon when an ICD-10 code entered in the service line is mapped to ICD-9 codes that are tagged for inclusion on the charge. (See next slide)

91 Diagnosis (Cont.) The second column displays a red Exclamation Point icon when the code set (ICD-10 or ICD-9) of the diagnosis code entered on a service line does not match the code set for the primary diagnosis code entered on the first service line of the voucher. The red Exclamation Point icon is only displayed for service lines entered after the first service line. Note: When an ICD-10 code is entered for a charge, both the ICD-10 and mapped ICD-9 codes are saved with the voucher.

92 Mapping Status Indicators
Indicates that the ICD-10 code is mapped to more than one row on the mapping tab in Diagnosis Code Maintenance. Indicates that the ICD-10 code does not have any mapped ICD-9 rows tagged for inclusion on the charge. Indicates that the ICD-10 code is mapped to only one row on the Mapping tab in Diagnosis Code Maintenance and that row is marked as the default.

93 Type of Svc Auto-fills when a default Type of Service is selected for the Procedure Code in file maintenance.

94 Units Determines the number of units applied to the Produce Code.

95 Fee Amt This is the fee amount the organization charges for the Procedure and it outputs on the claim, statement, or invoice.

96 Anesthesia Enabled when you enter a procedure code with a Procedure Type of “Anesthesia (Timed).” Use this dialog box to enter the start and end times Time Units is auto-filled based on Anesthesia Style Maintenance Base Units is auto-filled from Procedure Code Maintenance

97 Dental Enabled when a procedure code with a Procedure Type of "Dental." Use this dialog box to enter information pertinent to and necessary for a dental claim.

98 Drug Enabled when a procedure code with a Procedure Type of "Drug Code."

99 Unit of Measure & Unit Count Default
You can automatically fill the Unit of Measure and Unit Count values from Procedure Code Maintenance or Charge Import message to a claim without manually adding the values in the Drug Services window in Charge Entry. Unit of Measure and Unit Count are located on the Procedure Code tab in Procedure Code Maintenance. These can be set as follows in Procedure Code Maintenance:

100 Unit of Measure Unit of Measure: Select from a drop-down list containing the following options: Gram International Unit Milligram Milliliter Unit

101 Unit Count Unit Count: The default value is 0.0, and the field accepts a numeric value up to Unit of Measure and Unit Count are only enabled when Procedure Type in Procedure Code Maintenance is set to Drug Procedure.

102 Unit of Measure & Unit Count (Cont.)
The Unit of Measure and Unit Count boxes are not required, but if a value is entered in one of the boxes, the other is required in order to save the charge. When the Unit of Measure and Unit Count boxes are filled in Procedure Code Maintenance, there is no need to manually access the Drug Services window for the values to be included in claims. Note: This functionality also applies to imported charges and the designated National Drug Code, Manufacturer Code, and Lot Number values in Procedure Code Maintenance.

103 Hint: Unit of Measure & Unit Count
Unit of Measure and Unit Count values are automatically filled in the Drug Services window in Charge Entry and Edit tabs when one of the following is true: When the Unit of Measure and Unit Count values are defined on the Procedure Code tab in Procedure Code Maintenance. When Drug Procedure is included in a charge message with defined Unit of Measure and Unit Count values. When the Unit of Measure and Unit Count values are not included in a charge message, the values from Procedure Code Maintenance automatically fill the values. Note: If Unit of Measure and Unit Count values are not included in a charge message, they must be entered manually in the Drug Service window as in previous releases.

104 Purchased Service Enabled when a procedure code that has Purchased Service checked on the Procedure Code tab in Procedure Code Maintenance. Allows you to enter Laboratory Identifier, Laboratory CLIA#, and Purchased Service Price at the service level.

105 View H&P Allows operator to access the Professional HER History and Physical chart notes for this encounter

106 New Line Add a new service line to the charge voucher. Allows for multiple Procedure Codes to be added to the service voucher.

107 Summary Once all the Procedure lines are added to the service voucher choose the Summary button.

108 Summary (Cont.) The Summary screen allows for various pieces of additional information to be attached to a voucher. Invokes the system checks set in Practice Options, Registration, Scheduling and PM Maintenance tables.

109 Local Use Text Free text field that allows a maximum of 50 characters to be entered. Alternate Local Use Text: Free text field that allows a maximum of 50 characters to be entered.

110 Statement Message Message outputs on patient statements.

111 Claim Message Message that prints on the bottom of a standard CMS-1500 NPI paper claim form below Box 31. Once attached to a voucher the message always prints when that voucher is billed out unless the message is removed from the voucher using the Edits tab.

112 Hold Voucher From Allows the operator to select an option to holder the voucher from such as; all insurance billing, electronic claim billing, self-pay statements, or all billing.

113 Hold Voucher Reason Enabled when the field Hold Voucher From is populated. Allows the operator to select the reason for holding a voucher.

114 Referrals Allows for a referral to be attached to the service voucher and for the insurance authorization to output on the claim.

115 Claim Info Allows for additional Claim Information to be attached to voucher

116 CMN/DIF Info Field enabled when Procedure Code mark as CMN/DIF Info and primary carrier is Medicare

117 Ailment Info Allows for additional information required for payment to be attached to the voucher.

118 Add’l Claim Dx Additional Claim Diagnosis allows the entry of additional diagnosis codes to the voucher.

119 Attachment Info Identifies a Report Type associated with the treatment and the method the payer will receive report.

120 Amb Info Allows for Ambulance Billing information to be attached to voucher and output on claim. Enabled when an Ambulance specific procedure code is attached to voucher.

121 NY Workers’ Comp Only enabled when the Carrier on the charge has a Source of Payment in ICM of "NYWORKERS'COMPENSATION."

122 Self-Pay Allows for a collected self-pay co-pay or patient responsibility payment to be attached to the service voucher.

123 Next Encounter/Patient/Voucher
Enabled after a voucher is saved. Clears all the voucher information and ready the screen for new voucher.

124 Same Patient Enabled after a voucher is saved. Used to enter another voucher using the same Patient Information.

125 Save Saves the voucher information If Display Pending Claims Correction is checked in Charge Batch Defaults, the Pending Claim Corrections dialog screen opens.

126 Cancel You can cancel the entry of a voucher any time before you execute the Save command.

127 Voucher Additional Information
The Voucher Additional Information icon is available on the Charge Entry tool bar once the voucher has been saved. The fields and values are defined in the Practice/Organization Set Up folder on the Voucher Additional Info tab.

128 Enter charges for a standard office visit
Section 4 Enter charges for a standard office visit

129 Charge Management Scenario: When the patient has seen the doctor and is ready to check out, the check-out person will highlight their Charge Batch in the Transactions folder; this will activate the Charge Entry Tab. Key in the encounter number to auto fill the provider and practice information from the patient’s appointment and add the procedure codes.

130 Scheduling Step 1: Go to the Scheduling module, Appointment Scheduling folder, and then the Patient Scheduling tab.

131 Select a Patient Step 2: Select a patient with the primary insurance carrier cover type of Medical.

132 Schedule Patient Step 3: Schedule patient appointment for today.

133 Get Encounter Number Step 4: Select the Appointment Activity tab, double-click the scheduled appointment, and retrieve the Encounter Number from the Appointment Detail screen.

134 Batch Management Step 5: Go to the Financial Processing module, Transactions folder and then to the Batch Management tab.

135 New Charge Batch Step 6: Open a new Charge Batch

136 Enter Encounter Number
Step 7: Select the Charge Entry tab and enter the appointment’s Encounter Number.

137 Insurance Information
Step 8: Review the Insurance Information that was assigned to this patient’s visit charges when the appointment was scheduled.

138 Encounter Detail Info Step 9: Review the Encounter Detail Information

139 ICD-10 Effective Date Step 10: Point out the ICD-10 Effective Date field (above transaction date fields)

140 Procedure Code Step 11: Procedure Code: 99215

141 Diagnosis Step 12: Diagnosis Field select the Binoculars for single code only

142 Diagnosis Code Lookup Step 13: There are 4 sections of the Diagnosis Code lookup dialog box Code Set section Code Description section Diagnosis Code History section Mapped Codes section

143 Diagnosis Code Lookup (Cont.)
Step 14: Set search by: Descriptions Set Code Set: Both Search For: Strep or %Strep Select Search Button

144 Diagnosis Code Lookup (Cont.)
Step 15: Displayed are both ICD-9 and ICD-10 codes for Strep

145 Select Tag Step 16: Check mark the tag column for the code to attach to Procedure code Tag A40.9 Streptococcal sepsis, unspecified

146 Mapped Codes Step 17: Associated ICD-9 codes in the Mapped Codes section: If practice wants to add a new ICD-9 select the binoculars ICD-9 look up dialog box appears Search all codes for 038 and select then 038.1 The new ICD-9 will be marked as tagged This ICD-9 will out on claim for non ICD-10 carriers

147 Select OK Select the OK button

148 Diagnosis Code Maintenance
Step 19: The single diagnosis code description displays in the Diagnosis field. To the left of an ICD-10 code will be a color circle

149 Diagnosis Code Maintenance (Cont.)
Step 20: To add more than one diagnosis code to a single Procedure Code, select the Dialog icon.

150 Specify Diagnosis Code(s)
Step 21: The Specify Diagnosis box displays: Green circle with check mark = ICD-10 code is mapped to 1 row Yellow circle with question mark = ICD-10 code is mapped to >1 row on Mapping tab in diagnosis Code Maintenance Purple circle with an X = ICD-10 code does not have any mapped ICD-9 rows tagged for inclusion on the charge

151 Pecking Order Step 22: When multiple ICD-10 codes are entered in Diagnosis, the mapping status indicator is displayed based on this hierarchy: Purple circle with an X, Yellow circle with a question mark, and (3) Green circle with a check mark.

152 Diagnosis Codes Section
Step 23: Hover mouse over ICD-10 Diagnosis Codes section to display the description of each code

153 Mapped Codes Step 24: Hover mouse over icon to display the ICD-9 mapped to ICD-10 codes

154 New Line Step 25: Choose New Line Button

155 Procedure Code for CPT Step 26: Choose Procedure Code for Injection CPT J3420 Vitamin B12 Injection

156 Drug button Step 27: Choose the Drug button

157 Drug Services Step 28: Enter the Drug Services Information and click OK o NDC: N4 o Unit of Measure: Milligram o Unit Count: 250

158 Select Modifier Step 29: Select Modifier Use code AA – Physician Personally Performed

159 Select Summary Step 30: Select the Summary button

160 Alpha II Claimstaker Step 31: After selecting the Summary button, the Alpha II Claimstaker automatically checked the voucher and returned the edit comments specific to ICD-10 codes.

161 Referrals Step 32: Select the Referrals button

162 Incoming Referrals Step 33: From the Incoming Referrals screen the Operator can choose from a list of existing referrals or they have the ability to add a new referral

163 Existing Referral Step 34: For an existing Referral, highlight the referral information displayed in the grid.

164 Attach to Voucher Step 35: To ensure the Referral information outputs on the claim, select the Attach to this Voucher field.

165 Select OK Step 36: Select the OK button Note: A green flag will appear next to the Referral button

166 Claim Info Step 37: Select the Claim Info button

167 Claim Info (Cont.) Step 38: When the Claim Information screen appears, complete the select to allow information to output on the claim. Note: Field Names that have a red check in the Req? Column are required and must have an entry in the Field Value column to save.

168 Select OK Step 39: Select the OK button Note: A green flag will appear next to the Claim Info button

169 Select Ailment Info Step 40: Select the Ailment Info button

170 Select Add New Step 41: Select the Add New icon

171 Ailment Type Step 42: At the Ailment Type field choose from a list of Ailments. The items in this are created and maintained in Ailment Type Maintenance.

172 Ailment Comment Step 43: At the Ailment Comment field list the reason for the Aliment information.

173 Field Name & Value Step 44: Once the Ailment Type entry is selected, then the grid below is populated with the associated fields. The Operator will complete the necessary field by providing a response in the Field Value column. If a field has a red check in Req Column then Operator must complete field prior to saving aliment record.

174 Attach to Voucher Step 45: To ensure the Aliment information outputs on the claim, select the Attach to this Voucher field.

175 Save Ailment Info Step 46: Select the Save button to save the Ailment information. Note: A green circle will display to the left of the Ailment Info button.

176 Add’l Claim Dx Step 47: Select the Add’l Claim Dx button to display all diagnosis codes attached to voucher

177 Add’l Claim Dx (Cont.) Step 48: The Add’l Claim Dx screen displays a view only screen of the diagnosis codes attached to the voucher and the order the diagnosis codes will output on a claim.

178 Select Code Set Step 49: The Add’l Claim Dx screen displays both the ICD-10 and linked ICD-9 codes. To view the ICD-9 code, set select the down arrow then select ICD-9 at the Code Set field.

179 Add’l Claim Dx Step 50: The Add’l Claim Dx screen displays a view only screen of the diagnosis codes attached to the voucher and the order the diagnosis codes will output on a claim. By default the first four diagnosis codes always output in the order shown on the claim. Diagnosis codes in positions 5 – 12 can be unchecked so they will not output on the claim.

180 Attachment Info Step 51: Select the Attachment Info button.

181 Claim Attachments Step 52: Select the Add New icon to create a new Claim Attachment. Outputs on claims to provide carrier with instructions to request and receive documents

182 Attachment Report Type
Step 53: At the Attachment Report Type choose from the predefined options

183 Attachment Transmission
Step 54: At the Attachment Transmission Type choose from the predefined options.

184 Self-Pay Step 55: Select Self-Pay button

185 Apply Self-Pay Payments
Step 56: While on the Self Pay Payments dialog screen the Operator can enter the payment, attach an existing payment or mark Uncollectable.

186 Select OK Step 57: Select the OK button

187 Save Step 58: Select the Save Button to save the voucher information

188 Voucher Step 59: Result is the Encounter has now become a Voucher. The Encounter # will drop from the Encounter Tracking report.

189 Edit, print and close a charge batch
Section 5 Edit, print and close a charge batch

190 Print & Close a Charge Batch
Scenario: When your work is completed and balanced it is now time to close the batch. When charges are entered and payments posted in the self-pay dialog screen an associated batch will be created automatically to hold the payments associated with the charge batch. Batches must be closed before they can be updated. Complete the steps that follow to print and close the charge batch.

191 Batch Management Step 1: Go to the Financial Processing module, Transactions folder and then to the Batch Management tab

192 Batch Management (Cont.)
Step 2: Choose an Open Charge and an associated Payment Batch.

193 Batch Management (Cont.)
Step 3: Choose the Print and Close button

194 Batch Print & Close Step 4: Choose the Report Preferences, select close batches field and choose Close

195 Preview the Report Step 5: Preview the Report (view on the screen)

196 Review Info Review the Information contained on the report.

197 Edit Charge Voucher Click the Edits Tab to view the Main Screen

198 Transactions Folder Step 1: Go to the Financial Processing module, Transactions folder and then to the Edits tab

199 Voucher Step 2: At the Voucher field enter the voucher’s number and select the tab key (or click the key icon)

200 View Only Fields Step 3: Those fields that display as view only cannot be changed for the Edits tab.

201 Location Step 4: The Location field is accessible and can be changed on the voucher.

202 Place of Service Step 5: The Place of Service field is accessible and can be changed on the voucher.

203 Accept Assign Step 6: The Accept Assign field is accessible and can be changed on the voucher.

204 Student Billing? Step 7: The Student Billing field is accessible and can be changed on the voucher.

205 Resp Party Step 8: The Responsible Party field is accessible and can be changed on the voucher.

206 Referring Doctor Step 9: The Referring Doctor field is accessible and can be changed on the voucher.

207 Service Lines Step 10: The grid displays the service lines of the voucher. Click on a service line to display the detail in the field below. Hover the mouse over the Diagnosis Code to display the description. Hover the mouse over Diagnosis Linking icon to display the ICD-9 to ICD-10 linking.

208 Voucher Service Dates Step 11: Voucher service dates; From and Thru

209 Procedure Step 12: The Procedure field is disabled.

210 Modifiers Step 13: At the Modifiers field, enter the modifier abbreviation code. Select the Binoculars icon to search for a single modifier. Select the Dialog icon to choose up to four modifiers per service line.

211 Diagnosis Binoculars Step 14: The PM Operator can modified the diagnosis codes attached to the voucher by selection the Binoculars icon to the right of the Diagnosis field

212 Entering Text Step 15: The PM Operator can enter and edit text in the Local Use Text field. Free text field that allows for a maximum of 50 characters to be entered.

213 Hold Voucher From Step 16: Defaults to the most recently saved selection. Selecting a hold option prevents the voucher for qualifying for billing.

214 Held Voucher Reason Step 17: Enabled when the field Hold from Billing is populated.

215 Patient’s Statement Step 18: From the drop-down list select a message that prints on the Patient's statement.

216 Claim Msg Step 19: From the drop-down list select a message that prints on the bottom of a standard CMS-1500 claim form below Box 31.

217 Rebill? Step 20: Allows the voucher to qualify for the next Insurance Billing run. Enabled when the voucher has a bill date and checking this option strips the voucher of its current bill date.

218 Add’l Claim Dx Step 21: Add’l Claim Dx allows the entry of additional diagnosis codes to the voucher.

219 Referrals Step 22: Click the Referrals button (Alt+r) to Attach or Link a Referral to a Voucher

220 Claim Info Step 23: Access the Claim Information fields

221 Ailment Info Step 24: Allows for additional information required for payment to be attached to the voucher.

222 CMN/DIF Step 25: Field enabled when Procedure Code mark as CMN/DIF Info and primary carrier is Medicare

223 Attach Info Step 26: Identifies a Report Type associated with the treatment and the method the payer will receive report.

224 Ambulance Billing Info
Step 27: Allows for Ambulance Billing information to be attached to voucher and output on claim. Enabled when an Ambulance specific procedure code is attached to voucher.

225 NY Workers’ Compensation
Step 28: Only enabled when the Carrier on the charge has a Source of Payment in ICM of “NY WORKERS’ COMPENSATION.”

226 Co-Pay Step 29: Allows the co-pay amount due for the service visit to be changed.

227 Void Re-Enter Step 30: Allows for the voucher to be reopened and changes to be made such as change the carrier or billing provider. The process will assign a new billing date

228 Payments Step 31: Enabled when payments have been applied to a Voucher. Allows you to edit the Payment Date and Reference fields related to each payment transaction applied to the voucher.

229 View H&P Step 32: Opens the View H&P Summary screen from the Allscripts Professional EHR.

230 View History Step 33: Stores the history of changes made to the voucher's editable fields on the Edits tab. These changes can be made from the Edits tab, Charge Entry once the voucher was saved or during the Void and Re-Enter process.

231 Save Step 34: Select Save to keep the changes. Select Cancel to not keep the changes.

232 Section 6 Re-Open a closed batch

233 Re-Open a Closed Batch Scenario: A closed batch can always be re-opened to allow the operator to edit the existing vouchers and add new vouchers.

234 Batch Management Step 1: Go to the Financial Processing module, Transactions folder and then to the Batch Management tab

235 Closed Status Batch Step 2: Highlight the Closed status batch

236 Reopen Batch Step 3: Select the Reopen Batch icon

237 Confirm Step 4: Select “Yes” when Transactions box displays.

238 Open Status Step 5: Batch is now in an Open Status

239 Run validate batches & verify claims
Section 6 Run validate batches & verify claims

240 Run Validate Batches Validate Batches allows for claim and carrier specific checks to be perform on vouchers prior to updating batches in order to verify that all system hardcoded and Claim Style Maintenance Validations are met. Those vouchers that do not pass the validation edits can be corrected using the Validate work list. Only vouchers in Open or Closed Charge Batches qualify for Validate Batches.

241 Validate Batches Validation errors will prevent a claim from being created and submitted to the carrier. Click on the Validate Batches tab to view the Main Screen.

242 Verify Batches Verify Batches uses a product called Alpha II ClaimStaker Enterprise version to check the Diagnosis codes and Modifiers that are attached to the voucher’s Procedure Codes prior to updating batches. These checks are specific to an organizations state, zip code and insurance carriers. Changes to the Alpha II checks are completed on the Alpha II ClaimStaker web site.

243 Verify Batches (Cont.) Those vouchers that do not pass the verify edits can be corrected using the Validate work list. Verify errors will not prevent a claim from being created and submitted to the carrier. Only vouchers in Open or Closed Charge Batches qualify or Verify Batches.

244 Run Validate Batches for Claim Errors
Scenario: Complete the following steps to identify claim validation errors and correct the errors. Step 1: Go to the Financial Processing module, Transactions folder and then to the Validate Batches tab.

245 Batch Status Step 2: At the Batch Status section check the options for Open Batches and Closed Batches.

246 Batch Status (Cont.) Step 3: At the Batch Status section select the Query button to display results in grid below.

247 Available Batches Step 4: The available charge batches will display in the Available Batches grid.

248 Available Batches (Cont.)
Step 5: Highlight a single batch from the grid.

249 Validate Claims Step 6: Accept default value of Validate Claims checked. Uncheck the option for Verify Claims. Fields located left corner below grid.

250 Run Step 7: Select Run button

251 Validating Vouchers Message
The Validating Vouchers message displays and indicates the validation function is evaluating the selected charge batch.

252 Voucher Grid Step 8: Vouchers with claim validations will display in the Voucher grid. Note: The message above the grid identifies the number of failed vouchers in the charge batch.

253 Voucher Corrections Step 9: Double-click on a voucher line or right-click on the voucher line and click Corrections.

254 Validation Errors Step 10: The Pending Claims Correction dialog identifies the specific validation and verification errors for the voucher. View any previous Voucher and Claim Notes that are attached to the voucher.

255 Execute Step 11: Highlight the appropriate function and select the Execute button to open to correct the specific errors.

256 Re-Validate Step 12: After errors are corrected, select the Re-Validate button to check the voucher against the carrier specific validation checks.

257 Pending Claim Corrections
Step 13: Once validation errors are corrected, choose OK to close the Pending Claim Corrections dialog box and select the next failed voucher included in the charge batch.

258 Select OK Step 14: Select OK

259 Next Voucher Step 15: Highlight next voucher and open the Pending Claim Corrections dialog box.

260 Run Verify Claims

261 Run Verify Claims (Cont.)
The Verify Claims functionality available in Allscripts Practice Management™ requires the use of the third party software Alpha II ClaimStaker. The purpose of this topic is to provide you with an understanding of the Verify Claims functionality as it is used in Allscripts Practice Management. Alpha II ClaimStaker is a separate application that is installed to work with Allscripts Practice Management. For assistance with specific installation and setup of the third party ClaimStaker software contact Allscripts Support.

262 Run Verify Claims (Cont.)
Scenario: Complete the following steps to identify coding errors and correct the errors. Step 1: Go to the Financial Processing module, Transactions folder and then to the Validate Batches tab.

263 Batch Status Step 2: At the Batch Status section check the options for Open Batches and Closed Batches.

264 Query Step 3: At the Batch Status section select the Query button to display results in grid below.

265 Available Batches Grid
Step 4: The available charge batches will display in the Available Batches grid.

266 Claims Passed Step 5: Choose the option to Include Claims Passed.

267 Run Step 6: Choose Run

268 Charge entry tool bar

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275 What to do if there are problems

276 Problems Ask your Supervisor

277 How to complete charge entry

278 conclusion Thanks for your participation in this course:
You are now prepared to enter your first Charge Entry in Allscripts Please ask your Supervisor if you have any further questions… Other Resources: Policy Document WikiMax

279 credits Flowcharts: Alberto Ablen Cloyd Villarubia
Program Director: Michael Johnson Project Manager: Chad Parker Subject Matter Expert: Valerie Petersen Flowcharts: Alberto Ablen Cloyd Villarubia Version 1 (updated ) ©2017 PracticeMax, Inc.


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