Chronic Care Billing Module

Written: 09/13/02
Author: Diane Kermode
MediFile version: 3
Enhancement:
Bug Fix: n/a

Description:

The Chronic Care Billing module facilitates practitioners who see the same patient in a long term care facility on a regular basis. These patients will often have the same problems visit after visit, so the fee codes are the same for every one. Chronic Care billing is a quick way to bill the physician’s list of long-term care patients at each of the facilities that the physician will visit.

Each Chronic Care record saves billing information such as calls, encounters, fee codes and prices, which were used the last time the claim was billed. MediFile© does not redo any price calculations unless the information in the fields has been changed and the data has been updated.

Note: This billing area does not verify the billing for correctness. Verification must be done by the person doing the billing.

Objectives:

To create and modify Chronic Care patient records
To bill using the Chronic Care Billing feature
To update the pricing for a claim before billing
To print the Chronic Care list

Note: When a Chronic Care billing is billed, the billing record can be found in the Billing File.

Creating new Chronic Care Billing records

Chronic Care Billing records can be created using three methods:
Method 1. From the menu, select: Billings > Chronic Care
Method 2. From the menu, select: Billings > Other Billings
Method 3. From the menu, select: File > Administration Corner Page 1
Note: Method 1 or Method 2 are the preferred choices for creating new Chronic Care Billing records.

Method 1.
1. From the Menu, select: Billing > Chronic Care
The Chronic Care billing screen will appear.

The Chronic Care billing screen will use the default area account defined in the user preferences. If this area account does not have any chronic care patients, an alert will appear notifying you of this.

2. Select the doctor’s area account from the area account popup or type in the area account code beside the pop-up and press the tab key to execute the search for that area account.
3. Select the facility where the patients are located. This is done with the next field popup, which contains all the facilities where patients are located for this doctor.

Once the facility is selected, you will be prompted for the service date.

4. Enter the Service Date (MM/DD/YYYY) and click "Ok." You can click the Cancel button to return to the previous screen. The service date will automatically be added to the record.
The list of Chronic Care records that have been previously saved will now appear.

5. To add a new line to the list of patients, click the New button. A new blank line will be added to the Chronic Care list.
6. Double-click on the new line to enter the patient and billing information.
An alert, “Can’t find Fee Code” will be displayed in the input region. This is a reminder to enter the Fee Codes. Start typing the information and tab though the fields in the Chronic Care Screen to enter the new patient information. If you do not want to add any information other than the name, you are not required to fill in these fields of information.
7. The Service Start and End Dates will default to the current date. To change the Service Start and End Date, tab to the Start Service Date text field. Enter the Service Start Date and End Date in the format of MM/DD/YYYY
8. To find a patient to add to the list, click the Search icon in the patient area. This allows a search for the patient in the database or allows the creation of a new patient master.
9. Enter the number of calls. If there is only a single call during the day, the number of calls should be set to 1. If there is more than one call for this patient during the day then the call number can be set to 2 or more.
10. Check the Bill checkbox to mark this record to be billed to the patient or agency.
11. The Comment box is used for the doctor’s or other internal comments. Enter comments as needed.
12. Click the Update button to save this information to the list. This patient is now added to the Chronic Care list.

When a Doctor does not have any Chronic Care records for a certain facility, the following the steps are required to add new records for that doctor at the specific facility.

1. An Alert will appear. Click the OK button.

2. Select the Facility number by clicking on the down arrow next to the Facility number label. Select the facility from the popup.

3. To add a new line to the list of patients, click on the New button. A new blank line will be added to the Chronic Care record.
4. Double-click on the new line to enter the patient and billing information.
An alert “Can’t find Fee Code” will be displayed in the input region. This is a reminder to enter the Fee Codes. Commence typing the information and tab though the fields in the Chronic Care Screen to enter the new patient information. If you do not want to add any information other than the name, you are not required to fill in these fields of information.
5. The Service Start and End Dates will default to the current date. To change the Service Start and End Date, Tab to the Start Service Date text field. Enter the Service Start Date and End Date in the format of MM/DD/YYYY.
6. To find a patient to add to the list, click the Search icon in the patient area. This allows a search for the patient in the database or allows the creation of a new patient master.
7. Enter the number of calls. If there is only a single call during the day, the number of calls should be set to 1. If there is more than one call for this patient during the day, the call number can be set to 2 or more.
8. Check the Bill checkbox to mark this record to be billed to the patient or agency.
9. The Comment box is used for the doctor’s or other internal users' comments. Enter comments as needed
10. Click the Update button to save this information to the list. This patient is now added to the Chronic Care list.

Method 2. Create a new Chronic Care Billings record from Other Billing
From the menu, select: Billing > Other Billings
The Other Billings screen will appear.

1. Create a Chronic Care billing record by typing and tabbing through the fields in the screen.
2. Click the Bill button to add the record to the patient billing history.
3. Double-click on the billing in the history listing area to select the entry.
4. Click the Chronic button to add this patient and their billing information to the Chronic Care file.

Method 3. Creating a new Chronic Care Billing record from the Administration Corner on Page 1

1. From the Menu, select: File > Administration (also Cmd-1(Ctrl-1))
Select Chronic Care from the Billing Files drop-down menu

You will be shown the Chronic Care file
2. From the Menu select: File > New (also Cmd-n(Ctrl-n)
A new record screen will appear.

3. To find a patient to add to the list, click the search icon in the patient area. This allows for a search for a current patient in the database or allows the user to create a new patient master.
4. Add the billing information for this patient by typing and tabbing through the fields.
5. Enter the number of calls. If there is only a single call during the day, the number of calls should be set to 1. If there is more than one call for this patient during the day, the call number can be set to 2 or more.
6. Enter the Hospital Admit Date and Last Date Billed Date in the format of MM/DD/YYYY.
7. The Comment box is used for the doctor’s or other internal users' comments. Enter comments as needed.
8. Click the Accept icon to save information.
Note: This billing area does not verify the billing for correctness. Verificaton must be done by the person doing the billings.

Deleting a patient from the Chronic Care list
There are two methods to delete a patient from the Chronic Care List
Method 1. From the menu, select: Billing > Chronic Care
Method 2. From the Administration Corner, Page 1

Method 1:
From the Menu select: Billing > Chronic Care
1. Select the doctor and facility to bring up all the patients on the list.
2. Double-click on the line item and patient that you want to delete.
3. Click the delete button. You will be given an alert to verify the deletion of that patient from the Chronic Care list. Click "Delete" again to proceed, or click "No" to cancel the deletion.

Method 2:
1. Select File > Administration (Cmd-1 (Ctrl-1))
2. From the Administration Corner, Page 1 select: Chronic Care from the Billing Files popup menu.
You will be shown the Chronic Care file.
3. Find the record by using find button and doing a search, as follows.
3a. Click on the Find button; you are shown a search screen
3b. To select search criteria, click on the appropriate radio button and enter search information in the Search For text field.
3c. Click on the Search icon to execute the search.

Any records that meet the search criteria will appear.
4. Highlight the record, then click the Select button. You can delete more than 1 record at a time.
Shift-Click highlights a group of records
Cmd-Click (Ctrl-Click) highlights non-contiguous records.

5. From the File menu, select Delete Selection.
6. An alert will be shown to verify the deletion of the selected records. Click Delete to proceed, or click Cancel to cancel the deletion.
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The record(s) is now deleted from the Chronic Care file.
Note: The previously billed billing file records for this patient still exists and have not been affected by the deletion of the record from the Chronic Care file. The patient master file is left untouched.

Modifying doctor’s list for a covering doctor

From the menu, select: Billing > Chronic Care
1. Select the original doctor and facility to bring up all the patients on the Doctor’s list for that facility.
Note: If the doctor in question is away and another doctor is covering his patients, it is still necessary to bring up the list under the original doctor’s name.
2. Hold the Option (Alt) key down and select the new doctor from the area account pop up. This will change the doctor but not the patients on the list, nor the facility.

Aternate Method: Type in the Area Account prefix (next to the doctor’s name), hold the Option (Alt) key down and Tab out of the Area Account text field.
3. To print a list for the covering doctor with his name on that list, click the Print icon.
4. Click the Update button to save the changes.
5. Click the Bill button on the top of the screen, every line item in the list that has an "X" beside it will be billed this time.
Note: The patients will all be billed under the covering doctor selected; however, the list of Chronic Care Records still belongs to the original doctor.

Entering a Referring Doctor for Chronic Care Billing

1. From the Menu, select Billing > Chronic Care
2. Select the doctor and facility to bring up all the patients on the list.
3. Double-click on the line item and patient that you want to modify.
4. Type in the referring doctor’s surname in the referring doctor field, then press Tab. This will execute a search for the doctor by that surname. If more than one doctor is found, the address book selection dialog will appear. Highlight the correct doctor from the address book and click the Select button.

Use the Doctor button to see the address book record, as per usual, when checking the pracid.
5. Click the Update button to save this information.

Delete a referring doctor from Chronic Care Billing

1. From the menu, select Billing > Chronic Care
2. Select the doctor and facility to bring up all the patients on the list.
3. Double-click on the line item and patient you wish to modify.
4. Highlight the name in the Referring Doctor field then delete it using the delete key. The name is removed but the doctor’s Key Number still exists (to the left of the Bill checkbox).

5. To delete the referring doctor’s Key Number, hold the Option (Alt) key down and Tab out of the field. This will then delete the name and the Key Number.
6. Click the Update button to save the changes.

Updating pricing for a Chronic Care claim before billing

1. From the menu, select Billing > Chronic Care
2. Select the doctor and facility to bring up all the patients on the list.
3. Double-click on the line item and patient you wish to modify.

4. Retype the Fee code and the number of calls (if this information has changed).

Note: The billing amount is saved with the Chronic Care record and is not updated unless you reselect and reenter the fee code and/or the number of calls. Incorrect fee prices could be billed if you do not reselect the fee code or change the calls to the correct number. This is especially true for the 03.03D fee code, for when the patients are seen more than once within the span of 7 days, which means that the patients are no longer in the initial pricing level. The price must be recalculated by retyping in the fee code and calls.
5. Click the Update button to save this new pricing.

To Bill the Chronic Care List

1. From the Menu, select Billing > Chronic Care
2. Select the doctor and facility to bring up all the patients on the list.
3. Double-click on the line item and patient you want to modify or bill. Change any information in the field by typing and tabbing through the fields.

4. Check the Bill checkbox to mark this record as "to be billed" to the patient or agency. Repeat for each of the billings you want to have billed this session.
5. Click the Update button to save the changes.
6. Click the Bill button on the top of the screen; every line item in the list that has an "X" beside it will be billed this time.
7. Click the Bill button on the top of the screen. An Alert will be shown indicating if there were any errors or omissions on the billing file. Click the Exit icon to return to the previous screen and correct any errors.

8. Click the Print icon to print the Alert then click the Exit icon to return to the previous screen.
Once the items in the list are billed, the "X" will be removed from the line.

Add another billing item for the same patient on the Chronic Care list

1. From the menu, select Billing > Chronic Care
2. Select the doctor and facility. This brings up all the patients on the Chronic Care list.
3. Double-click on the line item and the patient you want to duplicate.
4. Click the Duplicate button to add another line with same patient and billing information as is contained in the original line. This new line, with the same patient, will be added to the bottom of the list.

5. Double-click on the new line to modify any duplicated information in it. This is required when the doctor bills more than one fee code for the patient for that visit date.
6. Click the Update button to save the changes.
The original line is left intact and the new line reflects the changes.
Note: When the list of patients is printed, these duplicate lines are not shown on the printout.

Printing the Chronic Care List
1. From the Menu, select Billing > Chronic Care
2. Select the doctor and facility to bring up all the patients on the list.

3. Click the Print button to print the Chronic Care list.