Computers in the Medical Office

by Sanderson, Susan

• ISBN13: 9780073402130
• ISBN10: 0073402133
• Edition: 8th
• Format: Spiral Bound
• Copyright: 2012-07-27
• Publisher: McGraw-Hill Education

Summary

Computers in the Medical Office 8eis the best-selling text for training students using full-featured and current Medisoft Version 17 Patient Billing software. McGraw-Hill publishes the most titles to train students on Medisoft software. Our publishing relationship with Medisoft has been ongoing for 15 years. Computers in the Medical Office 8eoffers medical office training using current, realistic medical office cases while building transferable computerized medical billing and scheduling skills. Students who complete this course will learn the appropriate terminology and skills to use any patient billing software program with minimal additional training. As students progress through Medisoft, they learn to gather patient information, schedule appointments and enter transactions. The practical, systematic approach is based on real-world medical office activities. Go with the best. Go with the tried and true. Go with the Medisoft titles that will give you and your students the training and support you need to be successful. Go with McGraw-Hill's Computers in the Medical Office 8e.

Table of Contents

Part 1: INTRODUCTION TO COMPUTERS IN THE MEDICAL OFFICE

Chapter 1: Introduction to Health Information Technology and Medical Billing

 

1.1 THE INCREASING USE OF TECHNOLOGY IN HEALTHCARE

1.2 FUNCTIONS OF PRACTICE MANAGEMENT PROGRAMS

 

Creating and Transmitting Claims

 

Monitoring Claim Status

  

Receiving and Processing Payments

  

1.3 FUNCTIONS OF ELECTRONIC HEALTH RECORD PROGRAMS

Health Information and Data Elements

  

Results Management

  

Order Management

  

Decision Support

  

Electronic Communication and Connectivity

  

Patient Support

  

Administrative Processes

  

Reporting and Population Management

  

Advantages of Electronic Health Records

  

1.4 THE MEDICAL DOCUMENTATION AND BILLING CYCLE: PRE-ENCOUNTER

  

Step 1: Preregister Patients

  

1.5 THE MEDICAL DOCUMENTATION AND BILLING CYCLE: ENCOUNTER

 

Step 2: Establish Financial Responsibility

 

Step 3: Check In Patients

 

Step 4: Review Coding Compliance

 

Step 5: Review Billing Compliance

 

Step 6: Check Out Patients

 

1.6 THE MEDICAL DOCUMENTATION AND BILLING CYCLE: POST-ENCOUNTER

 

Step 7: Prepare and Transmit Claims

 

Step 8: Monitor Payer Adjudication

 

Step 9: Generate Patient Statements

 

Step 10: Follow Up Payments and Collections

 

1.7 THE IMPACT OF LEGISLATION: HIPAA

 

HIPAA Electronic Transaction and Code Sets Standards

 

HIPAA Privacy Requirements

 

HIPAA Security Requirements

 

State Regulation

 

1.8 THE IMPACT OF LEGISLATION: HITECH AND ACA

 

Health Information Technology for Economic and Clinical Health Act (2009)

 

Patient Protection and Affordable Care Act (2010)

 

Part 2: MEDISOFT ADVANCED TRAINING

 

Chapter 2: Introduction to Medisoft

 

2.1 THE MEDISOFT DATABASES

 

2.2 THE MEDISOFT MENUS

 

File Menu

 

Edit Menu

 

Activities Menu

 

Lists Menu

 

Reports Menu

 

Tools Menu

 

Window Menu

 

Help Menu

 

Exercise 2-1: Medisoft Menus

 

2.3 THE MEDISOFT TOOLBAR

 

Exercise 2-2: Toolbar Buttons

 

2.4 ENTERING, EDITING, SAVING, AND DELETING DATA IN MEDISOFT

 

Entering Data

 

Editing Data

 

Exercise 2-3: Editing Data

 

Saving Data

 

Deleting Data

 

2.5 CHANGING THE MEDISOFT PROGRAM DATE

 

Windows XP

 

Windows Vista and Windows 7

 

2.6 USING MEDISOFT HELP

 

Hints

 

Built-In

 

Exercise 2-4: Using Built-in Help

 

2.7 CREATING AND RESTORING BACKUP FILES

 

Creating a Backup File While Exiting Medisoft

 

Exercise 2-5: Backing Up

 

Restoring the Backup File

 

Exercise 2-6: Restoring a Backup File

 

2.8 MEDISOFT’S FILE MAINTENANCE UTILITIES

 

Rebuilding Indexes

 

Packing Data

 

Purging Data

 

Recalculating Patient Balances

 

2.9 USING MEDISOFT SECURITY FEATURES TO ENSURE HIPAA AND HITECH COMPLIANCE

 

User Logins and Audit Controls

 

Auto Log Off and Unapproved Codes

 

Chapter 3: Scheduling

 

3.1 THE OFFICE HOURS WINDOW

Program Options

 

Entering and Exiting Office Hours

 

3.2 ENTERING APPOINTMENTS

 

Exercise 3-1: Entering an Appointment, Leila Patterson

 

Exercise 3-2: Entering an Appointment, Elizabeth Jones

 

Exercise 3-3: Looking up a Provider and Entering an Appointment

 

3.3 BOOKING FOLLOW-UP APPOINTMENTS

 

Exercise 3-4: Booking an Appointment with a Follow-up

 

3.4 SEARCHING FOR AVAILABLE TIME SLOTS

 

Exercise 3-5: Searching for Open Time, Ramos

 

Exercise 3-6: Searching for Open Time, Klein

 

3.5 ENTERING APPOINTMENTS FOR NEW PATIENTS

 

Exercise 3-7: Entering an Appointment for a New Patient

3.6 BOOKING REPEAT APPPOINTMENTS

 

Exercise 3-8: Booking Repeat Appointments

 

3.7 RESCHEDULING AND CANCELING APPPOINTMENTS

 

Exercise 3-9: Rescheduling Appointments

 

3.8 VERIFYING INSURANCE ELIGIBILITY AND BENEFITS

 

Eligibility Verification Icons

 

Exercise 3-10: Verifying a Patient’s Eligibility

 

3.9 CHECKING PATIENTS IN AND OUT

 

Exercise 3-11: Checking In a Patient

 

3.10 CREATING AN OVERDUE BALANCE REPORT FOR PATIENTS WITH APPOINTMENTS

Exercise 3-12: Creating an Overdue Balance Report

 

3.11 CREATING A PATIENT RECALL LIST

 

Adding a Patient to the Recall List

 

Exercise 3-13: Adding a Patient to the Recall List

3.12 CREATING PROVIDER BREAKS

 

Exercise 3-14: Entering a Provider Break

 

3.13 VIEWING AND PRINTING SCHEDULES

 

Exercise 3-15: Viewing a Provider Schedule

 

Applying Your Skills 1: Enter an Appointment for a New Patient

 

Applying Your Skills 2: Search for an Open Time

 

Applying Your Skills 3: Preview a Physician’s Schedule

 

Chapter 4: Entering Patient Information

 

4.1 HOW PATIENT INFORMATION IS ORGANIZED IN MEDISOFT

 

4.2 ENTERING NEW PATIENT INFORMATION

 

Name, Address Tab

 

Exercise 4-1: Chart Numbers

 

Other Information Tab

 

Payment Plan Tab

 

Exercise 4-2: Adding a New Patient

 

Adding an Employer to the Address List

 

Exercise 4-3: Adding an Employer

 

4.3 SEARCHING FOR PATIENT INFORMATION

 

Search for and Field Option

 

Exercise 4-4: Search Using Field Box

 

Locate Buttons Option

 

Exercise 4-5 Search Using Locate Button

 

4.4 EDITING PATIENT INFORMATION

 

Exercise 4-6: Editing Patient Information

 

Applying Your Skills 4: Entering a New Patient

 

Chapter 5: Working with Cases

 

5.1 UNDERSTANDING CASES

 

When to Set Up a New Case

 

Case Examples

 

5.2 NAVIGATING CASES IN MEDISOFT

 

Case Command Buttons

 

The Case Dialog Box

 

5.3 ENTERING PATIENT AND ACCOUNT INFORMATION

 

Personal Tab

 

Exercise 5-1: Entering Data in the Personal Tab

 

Account Tab

 

Exercise 5-2: Entering Data in the Account Tab

 

5.4 ENTERING INSURANCE INFORMATION

 

Policy 1 Tab

 

Exercise 5-3: Entering Data in the Policy 1 Tab

 

Policy 2 Tab

 

Policy 3 Tab

 

Medicaid and Tricare Tab

 

5.5 ENTERING HEALTH INFORMATION

 

Diagnosis Tab

 

Exercise 5-4: Entering Data in the Diagnosis Tab

 

Condition Tab

 

Exercise 5-5: Entering Data in the Condition Tab

 

5.6 ENTERING OTHER INFORMATION

 

Miscellaneous Tab

 

Comment Tab

 

Exercise 5-6: Entering Data in the Comment Tab

 

EDI Tab

 

5.7 EDITING CASE INFORMATION

 

Exercise 5-7: Editing a Case

 

Exercise 5-8: Copying a Case

 

Applying Your Skills 5: Creating a Case for a New Patient

 

Chapter 6: Entering Charge Transactions and Patient Payments

 

6.1 UNDERSTANDING CHARGES, PAYMENTS, AND ADJUSTMENTS

 

6.2 SELECTING A PATIENT AND CASE

 

Chart

 

Case

 

Additional Information

 

6.3 ENTERING CHARGE TRANSACTIONS

 

Buttons in the Charges Area of the Transaction Entry

Dialog Box

 

Color Coding in Transaction Entry

 

Saving Charges

 

Editing Transactions

 

Exercise 6-1: Entering a Charge for Hiro Tanaka

 

Exercise 6-2: Entering a Charge for Elizabeth Jones

 

6.4 ENTERING PAYMENTS MADE AT THE TIME OF AN OFFICE VISIT

 

Applying Payments to Charges

 

Saving Payment Information

 

Exercise 6-3: Entering a Copayment

 

Exercise 6-4: Entering Charges and Copayment

 

6.5 PRINTING WALKOUT RECEIPTS

 

Exercise 6-5: Creating a Walkout Receipt

 

6.6 PROCESSING A PATIENT REFUND

 

Exercise 6-6: Processing a Refund

 

6.7 PROCESSING A NONSUFFICIENT FUNDS (NSF) CHECK

 

Exercise 6-7: Processing an NSF Check

 

Applying Your Skills 6: Add a Diagnosis and Enter

Procedure Charges

 

Chapter 7: Creating Claims

 

7.1 THE BASICS OF MEDICAL INSURANCE

 

Types of Health Plans

 

7.2 THE ROLE OF CLAIMS IN THE BILLING CYCLE

 

Medical Necessity

 

Clean Claims

 

CMS-1500 and X12 837 Health Care Claim

 

Exercise 7-1: Exploring the CMS-1500 in Medisoft Help

 

7.3 CLAIM MANAGEMENT IN MEDISOFT

 

7.4 CREATING CLAIMS

 

Exercise 7-2: Creating Claims

 

7.5 LOCATING CLAIMS

 

Exercise 7-3: Using the List Only Feature

 

7.6 EDITING CLAIMS

 

Carrier 1 Tab

 

Carrier 2 and Carrier 3 Tabs

 

Transactions Tab

 

Comment Tab

 

EDI Note Tab

 

Exercise 7-4: Reviewing a Claim

 

7.7 CHANGING THE STATUS OF A CLAIM

 

Exercise 7-5: Changing Claim Status

 

7.8 ELECTRONIC CLAIMS WORKFLOW

 

Exercise 7-6: Perform an Electronic Claim Edit Check

 

7.9 SENDING ELECTRONIC CLAIM ATTACHMENTS

 

Applying Your Skills 7:Reviewing Claims

 

Chapter 8: Posting Payments and Creating Patient Statements

 

8.1 THIRD-PARTY REIMBURSEMENT OVERVIEW

 

Indemnity Plan Example

 

Managed Care Example

 

Medicare Participating Example

 

8.2 REMITTANCE ADVICE (RA) PROCESSING

 

Claim Adjustments and Denials

 

Processing Payments

 

8.3 ENTERING INSURANCE PAYMENTS IN MEDISOFT

 

The Deposit List Dialog Box

 

The Deposit Dialog Box

 

Exercise 8-1: Entering a Deposit: ChampVA

 

8.4 APPLYING INSURANCE PAYMENTS TO CHARGES

 

Exercise 8-2: Applying Payments to Charges: ChampVA

 

Exercise 8-3: Entering a Deposit and Applying Payments: East Ohio PPO

 

Exercise 8-4: Entering a Deposit and Applying Payments: Blue Cross and Blue Shield

 

8.5 PROCESSING A PATIENT PAYMENT RECEIVED BY MAIL

 

Exercise 8-5: Entering a Patient Payment Received by Mail

 

8.6 ENTERING CAPITATION PAYMENTS

 

Exercise 8-6: Entering a Capitation Payment

 

Exercise 8-7: Entering a Zero Amount Payment

 

Exercise 8-8: Adjusting a Capitated Account

 

8.7 CREATING STATEMENTS

 

Statement Management Dialog Box

 

Create Statements Dialog Box

 

Exercise 8-9: Creating Statements

 

8.8 EDITING STATEMENTS

 

General Tab

 

Transactions Tab

 

Comment Tab

 

Exercise 8-10: Reviewing a Statement

 

8.9 PRINTING STATEMENTS

 

Selecting a Format

 

Selecting the Filters and Printing the Statements

 

Exercise 8-11: Printing Statements

 

Applying Your Skills 8: Enter Insurance Payments

 

Applying Your Skills 9: Create Statements

 

Chapter 9: Creating Reports

 

9.1 CREATING REPORTS IN MEDISOFT

 

Selecting Print Options

 

Selecting Data for a Report

 

9.2 THE IMPORTANCE OF ACCOUNTS RECEIVABLE REPORTS

 

Daily Reports

 

Monthly Reports

 

9.3 CREATING DAY SHEETS

 

Patient Day Sheet

 

Exercise 9-1: Printing a Patient Day sheet

 

Procedure Day Sheet

 

Payment Day Sheet

 

9.4 CREATING ANALYSIS REPORTS

 

Billing/Payment Status Report

 

Practice Analysis Report

 

Exercise 9-2: Save a Practice Analysis Report as a PDF File

 

Insurance Analysis Report

 

Referring Provider Report

 

Referral Source Report

 

Unapplied Payment/Adjustment Report

 

Unapplied Deposit Report

 

Co-payment Report

 

Outstanding Co-Payment Report

 

Appointment Eligibility Analysis—Detail and Summary

 

Electronic Claims Analysis—Detail and Summary

 

9.5 CREATING PATIENT LEDGER REPORTS

 

Exercise 9-3: Printing a Patient Account Ledger

 

9.6 CREATING STANDARD PATIENT LIST REPORTS

 

Exercise 9-4: Printing a Patient by Insurance Carrier List

 

9.7 NAVIGATING IN MEDISOFT REPORTS

 

The Medisoft Reports Menus

 

The Medisoft Reports Toolbar

 

The Medisoft Reports Find Report Box

 

The Medisoft Reports Help Feature

 

9.8 CREATING AGING REPORTS

 

Exercise 9-5 Printing a Patient Aging Report

 

9.9 CREATING CUSTOM REPORTS

 

Exercise 9-6: Printing a List of Patients

 

Exercise 9-7: Printing a List of Procedure Codes

 

9.10 USING REPORT DESIGNER

 

Exercise 9-8: Modifying a Report

 

Applying Your Skills 10: Print a Patient Day Sheet

Applying Your Skills 11: Print an Insurance Payment by Type Report

 

Chapter 10: Collections in the Medical Office

 

10.1 FOLLOWING UP ON INSURANCE CLAIMS

 

Prompt Payment Laws

 

Working Claim Denials

 

Aging Insurance Claims

 

Resubmitting Claims

 

10.2 THE IMPORTANCE OF A FINANCIAL POLICY

 

10.3 LAWS GOVERNING PATIENT COLLECTIONS

 

Using Payment Plans

 

10.4 WORKING WITH COLLECTION AGENCIES

 

Exercise 10-1: Posting a Payment from a Collection Agency

 

10.5 WRITING OFF UNCOLLECTIBLE ACCOUNTS

 

Exercise 10-2: Writing Off a Patient Balance

 

10.6 USING A PATIENT AGING REPORT FOR COLLECTIONS

 

Exercise 10-3: Identifying Overdue Accounts

 

10.7 ADDING AN ACCOUNT TO THE COLLECTION LIST

 

Using the Collection List Window

 

Entering a Tickler Item

 

Exercise 10-4: Creating a Tickler

 

10.8 CREATING COLLECTION LETTERS

 

Exercise 10-5: Creating a Collection Letter

 

10.9 CREATING A COLLECTION TRACER REPORT

 

Exercise 10-6: Creating a Collection Tracer Report

Applying Your Skills 12: Print a Patient Aging Report

 

Applying Your Skills 13: Add a Patient to the Collection List

 

Applying Your Skills 14: Create a Collection Letter

 

Part 3: APPLYING YOUR SKILLS

 

Chapter 11: Appointments and Registration

 

Exercise 11-1: Scheduling an Appointment: Lawana Brooks

Exercise 11-2: Scheduling an Appointment: Edwin Hsu

 

Exercise 11-3: Scheduling an Appointment: Anthony Battistuta

 

Exercise 11-4: Scheduling an Appointment: Stewart Robertson

 

Exercise 11-5: Scheduling an Appointment: Hannah Syzmanski

 

Exercise 11-6: Making an Appointment Change

 

Exercise 11-7: Juggling Schedules

 

Exercise 11-8: Scheduling an Appointment: Michael Syzmanski

 

Exercise 11-9: Print a Provider Schedule

 

Chapter 12: Cases, Transactions, and Claims

 

Exercise 12-1: Entering Transactions

 

Exercise 12-2: An Unscheduled Visit

 

Exercise 12-3: Changing a Transaction Record

 

Exercise 12-4: Scheduling an Appointment: Diane Hsu

 

Exercise 12-5: Entering Charges and Payments: Stewart Robertson

 

Exercise 12-6: Entering Charges and Payments: Diane Hsu

Exercise 12-7: Entering Charges and Payments: Michael Syzmanski

 

Exercise 12-8: Entering and Applying an Insurance Carrier Payment

 

Exercise 12-9: Creating Insurance Claims

 

Exercise 12-10: Finding a Patient’s Balance

 

Chapter 13: Reports and Collections

 

Exercise 13-1: Creating a Patient Day Sheet Report

Exercise 13-2: Creating a Patient Aging Report

 

Exercise 13-3: Creating a Practice Analysis Report

Exercise 13-4: Adding Items to the Collection List

Exercise 13-5: Create Collection Letters

 

Chapter 14: Putting It All Together

 

Exercise 14-1: Scheduling Appointments

 

Exercise 14-2: Rescheduling and Canceling Appointments

 

Exercise 14-3: Printing Schedules

 

Exercise 14-4: Creating Cases

 

Exercise 14-5: Entering Transactions

 

Exercise 14-6: Creating Claims

 

Exercise 14-7: Entering Insurance Payments

 

Exercise 14-8: Creating Patient Statements

 

Exercise 14-9: Printing Reports

 

Exercise 14-10: Entering Collection Agency and Patient Payments

 

Exercise 14-11: Reviewing Overdue Accounts

 

Exercise 14-12: Adding Patients to the Collection List and Creating Collection Letters

 

Part 4: SOURCE DOCUMENTS

 

Glossary

 

Index