|
Transaction Types
|
Claim Status
|
|
The
following is a list of transaction types.
A - Procedure Charge
B - Product Charge
C - Inside Lab Charge
D - Outside Lab Charge
H - Billing Charge
I - Insurance Payments
J - Cash Copayments
K - Check Copayments
L - Credit Card Copayments
M - Cash Payments
N - Check Payments
O - Credit Card Payments
P - Deductible
S - Adjustments
T - Insurance Adjustments
Z - Comment |
0 Hold
1 Ready to Send
2 Sent
3 Rejected
4 Challenge
5 Alert
6 Done
7 Pending |
Appointment Status
Codes |
Appointment
Background Color |
Unconfirmed: 0
Confirmed: 1
Checked In: 2
Missed: 3
Cancelled: 4
Being Seen: 5
Checked Out: 6 |
Yellow = 65535
Blue = 16711680
Olive = 32896
Black = 0
Green = 32768
Teal = 8421376
Gray = 8421504
Red = 255
Fuchsia = 16711935
Aqua = 16776960
Lime = 65280 |
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|
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Timely Filing Indicator
(Case / EDI Tab) |
This is usually required when a claim is
submitted late. For a list of valid entries, click here. |
1 = Proof of Eligibility Unknown
or Unavailable
2 = Litigation
3 = Authorization Delays
4 = Delay in Certifying Provider
5 = Delay in Supplying Billing Forms
6 = Delay in Delivery of Custom-made Appliances
7 = Third Party Processing Delay
8 = Delay in Eligibility Determination
9 = Original Claim Rejected or Denied Due to a
Reason Unrelated to the Billing Limitation Rules
10 = Administration Delay in the Prior Approval
Process
11 = Other |
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MODIFIERS |
|
21
Prolonged Evaluation and
Management Services
22 Unusual Procedural Services
23 Unusual Anesthesia
24 Unrelated Evaluation and
Management Service
by the Same Physician During a
Postoperative Period
25 Significant, Separately Identifiable
Evaluation and Management
Service by the Same Physician on
the Same Day of the Procedure or
Other Service
26 Professional Component
32 Mandated Services
47 Anesthesia by Surgeon
50 Bilateral Procedure
51 Multiple Procedures
52 Reduced Services
53 Discontinued Procedure
54 Surgical Care Only
55 Postoperative Management Only
56 Preoperative Management Only
57 Decision for Surgery
58 Staged or Related Procedure or
Service by the Same Physician
During the Postoperative Period
59 Distinct Procedural Service
62 Two Surgeons
66 Surgical Team
76 Repeat Procedure by Same
Physician
77 Repeat Procedure by Another
Physician
78 Return to the Operating Room for a
Related Procedure During the
Postoperative Period
79 Unrelated Procedure or Service by
the Same Physician During the
Postoperative Period
80 Assistant Surgeon
81 Minimum Assistant Surgeon
82 Assistant Surgeon (when qualified
Resident surgeon not available)
90 Reference (Outside) Laboratory
91 Repeat Clinical Diagnostic
Laboratory Test
99 Multiple modifiers
|
Modifiers Approved for Hospital
Outpatient Use
Levell(CPT)
50 Bilateral Procedure
52 Reduced Services
59 Distinct Procedural Service
73 Discontinued OutPatient Procedure Prior to
Anesthesia Administration
74 Discontinued OutPatient Procedure After
Anesthesia Administration
76 Repeat Procedure by Same Physician
77 Repeat Procedure by Another Physician
91 Repeat Clinical Diagnostic Laboratory Test
Level 11 (HCPCS/National)
LT Left side (used to identify procedures
performed on the left side of the body)
RT Right side (used to identify procedures
performed on the right side of the body)
El Upper left, eyelid
E2 Lower left, eyelid
E3 Upper right, eyelid
E4 Lower right, eyelid
FA Left hand, thumb
Fl Left hand, second digit
F2 Left hand, third digit
F3 Left hand, fourth digit
F4 Left hand, fifth digit
F5 Right hand, thumb
F6 Right hand, second digit
F7 Right hand, third digit
F8 Right hand, fourth digit
F9 Right hand, fifth digit
LC Left circumflex, coronary artery (Hospitals use with
codes 9298092984, 92995, 92996)
LD Left anterior descending coronary artery
(Hospitals use with codes 9298092984, 92995, 92996)
RC Right coronary artery (Hospitals use with
codes 9298092984, 92995, 92996)
QM Ambulance service provided under
arrangement by a provider of services
(IN Ambulance service furnished directly by a provider
of services
OR Repeat laboratory test performed on the
same day
TA Left foot, great toe
Tl Left foot, second digit
T2 Left foot, third digit
T3 Left foot, fourth digit
T4 Left foot, fifth digit
T5 Right foot, great toe
T6 Right foot, second digit
T7 Right foot, third digit
T8 Right foot, fourth digit
T9 Right foot, fifth digit |
POSTING INSURANCE PAYMENTS (Click on Coins Icon)
Anthem Blue Cross / Blue Shield and Other Insurance
Companies
On EOB Amount
Approved = Payment
On EOB
Amount Covered = Allowed
Press down arrow or enter key all the way to the end to
see REMAINDER amount for line. Make sure remainder
amount, which is patient balance responsibility, is the
same as shown on the EOB
To see the remainder balance for the patient while
entering the payment, press ENTER to the end or the DOWN
ARROW key once done. It will show the remainder
balance
FINAL DRAFT
press F9
to run LETTER WIZARD
Use ALT
+ (UNDERLINED LETTER) to access option with keyboard 
HOW TO GET PATIENT BILLING INFORMATION FOR ATTORNEY CASES
ALT + R
/ S / B
ENTER KEY
F6 To search (ENTER CHART NUMBER)
TAB TAB and press DEL key to delete dates so it looks as
follows
ENTER
PATIENT APPOINTMENT LIST SHORTCUT
ALT + L
P
ENTER LAST NAME
ALT+ i
ALT + A
ALT+ A
ALT + P
PATIENT FACE SHEET SHORTCUT
ALT + R
M
DOWN ARROW TO PATIENT FACE SHEET
ENTER KEY
DOWN ARROW TO PRINT
ENTER KEY
F6 - to search
select
patient
ENTER
ENTER
PATIENT STATEMENTS
Transaction.DocumentationType =
"S" --> Statement Note
When printing statments you need to create 2 statements that
are identical. Use Statment wizard to create one to
use with STATEMENT MANAGEMENT (this reports are labeled MRSTMX.MRE
--- different from the ones that the user creates MRSTAX.MRE)
Both statements can be modified and save under UREPORTS
folder. The difference is that they may or may not
both available at the same screens at the same time in
Medisoft.
When creating statements
(STATEMENT MANAGEMENT) make sure the user selects REMAINDER
and NOT STANDARD. A column displays the type of
statement that was created for the patient. If the
type of statment is standard and the user tries to print a
Remainder statment it will say that there is not data
available to print.
Select the statement you want to
default to in Program options.
When printing a statement from
deposit screen. Make sure that the user selects
REMAINDER / CREATE / you may have to clear the STATEMENT
number so it prints. If it does not work have the user
no print from there but from a batch in STATEMENT
MANAGEMENT. Tell them that this is the only way we can
customize their statement. Otherwise they have to use
the standard statement
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