Posting charges

You can post a charge to a patient's account.

Note: If you post a procedure when the insurance is not effective (due to the date), insurance is not considered, and the entire responsibility for payment goes to the patient. However, consider the following situations:

·        If you change the effective date to a date that is on or prior to the date that work was posted, you can transfer money from the patient’s balance to insurance’s (remembering to select the check box to create a claim) for the desired procedures in the Ledger.

·        If you add insurance after a procedure is paid in full, you cannot transfer money from the patient’s balance to insurance’s, but you can create a claim.

To post a charge

1.   In a patient’s Patient Information Center, on the Control Panel, under Transactions, click Billing. Alternately, under Transactions, from the Other menu, click Billing.

If the patient has medical insurance coverage, the Choose Up To 4 Diagnosis Codes dialog box appears. Otherwise, the Post New Charges window appears, so skip steps 2 - 4.

2.   For each diagnosis code (ICD10 and ICD-9) that you want to include, select that code in the left list box, and then click Add to move the code into the right list box.

Tip: To search for a diagnosis code, type the Code or first word of the Description. You can also click Advanced Search, type any part of the description that corresponds to the diagnosis code you want to search for, and then click OK.

3.   If you want the selected diagnosis code to apply to all of the procedures for this posting session, select the Apply to all posted items check box. This option is available only if only one diagnostic code has been selected.

4.   Click OK.

The Post New Charges window appears, and a line item is created automatically. For your reference, a summary of the patient's insurance information is displayed in the list box on the right.

Note: Treatment-planned procedures that are attached to an appointment appear automatically if you are posting on the day of the appointment and at or before the time of the appointment.

5.   To manually calculate and enter insurance estimates for procedures you are going to plan, select the Estimator Off check box. This option is unavailable if Do not use Estimator and/or Estimate by percentage of UCR? is selected in the Edit Insurance Profile dialog box for the patient's insurance carrier.

6.   For the line item (the new line item has a pointing hand icon  next to it), do the following:

a.   If necessary, change the service Date of the procedure to be posted. The default is the current date.

b.   If necessary, change the treating or rendering Provider of the procedure to be posted. The default is the provider in the blue section on the General tab of the patient's Patient Information Center.

c.   Type a procedure Code, or double-click in the field to select and paste in a procedure.

Tip: You can drag a procedure from the bottom pane of the window into the Code field. (See step 7.)

d.   When you add a procedure, and the patient has an insurance profile that is a Medicaid Plan, a dialog box appears so that you can enter the pre-authorization number for the treatment.

With a certain preference setting enabled, for any additional procedures (with a fee greater than $0) that you treatment plan on a given day, the field in the dialog box that appears and asks you for the pre-authorization number is automatically populated with the number you entered for the previous procedure. Enter a different number if necessary, and then click OK.

e.   If the procedure has at least one requirement for a claim, a reminder message appears. Click OK.

f.    From the Tth/Quad list, select the appropriate tooth number or quadrant, if applicable. Also, for a procedure that requires a tooth number, to post the procedure to multiple teeth at one time, click the button next to Tth/Quad, select the teeth, and then click OK.

Tip: You can use the numbers on the number keypad as shortcuts to select a quadrant as follows:

1=Lower Left (LL)
2=Upper Anterior (UA)
3=Lower Right (LR)
5=Full Mouth (FM)
7=Upper Left (UL)
8=Lower Anterior (LA)
9=Upper Right (UR)

Note: Pressing the numbers on top of the keyboard selects the tooth number instead of the quadrant.

g.   From the Surf/Root list, select a surface or root, if applicable.

h.   Type the fee to charge in the Charge field, or leave the default charge from the fee schedule entered.

i.    Select the type of insurance Claim that you want to include the procedure on: All, Medical Only, Dental Only, or Medical 1st. Select “None, no ins” or "None, calc ins" if you want to exclude the procedure from the claim.

j.    If the procedure has been completed and you want to create a claim for the procedure, select the Complete check box. If you want to post the procedure but mark it complete in the Ledger at a later time, clear the check box. The default for this option is set up by procedure in the fee schedule. For additional information, see the topic about posting multi-visit procedures.

k.   Click Details to set up any of the following options for the procedure:

·        Suspend Allocation – To suspend the allocation to the provider, select this check box.

·        Units – Enter the number of time units for the procedure.

·        Tax – Type the tax rate.

·        Office Visit – Type the office visit fee.

·        % Write-off – Type the write-off percentage.

·        Preauth # – Type the pre-authorization number for the procedure.

·        Procedure Type – Select Original, Void, or Adjustment. For a voided or adjusted procedure, type a Reference Number.

l.    For a patient with medical insurance coverage, if you want to cross code the ADA code being billed to the corresponding CPT codes, click X-Code.

m.  For a patient with medical insurance coverage, you can select up to four (ICD) Diagnosis codes to a procedure. For each of the first three selections that you make, as you make a selection from the menu, a new menu appears after the previous one automatically. Also, if there are multiple procedures listed, the first time you change one of the diagnostic codes in a column of (ICD) Diagnosis codes, a message appears and asks if you want to change the diagnostic codes in that column for the other procedures to be the same as the code you have just changed; click Yes to change the other codes in the same column or No to change only the one that you changed.

7.   To add a new line item, do any of the following:

·        Click the Create a new procedure line button.

 

(The new line item has a pointing hand icon  next to it.)

·        To use a procedure from the bottom pane of the window, click a category (yellow folder) to view the procedures associated with that category, and then drag a procedure from the list onto an empty spot where the line items are listed (or double-click the procedure). The most commonly used procedures may appear at the top of the list, as determined by a certain preference setting.

  

Tips:

·        To change the fee schedule being viewed, type a Fee Schedule #.

·        To have the most frequently used codes in a selected category appear at the top of the list, select the Experience-based sort check box.

·        To have only the most recent codes from all procedure categories appear in the list, select the Recent codes check box.

·        To view the procedures that have a description that most closely matches specific text, in the Service field on the blue header of the procedure list, type the name of a service, and then select the Service Search Filter check box.

·        To duplicate a procedure, select a line item (the pointing hand icon  appears next to the selected line item), and then click the Duplicate selected line button to add a new item with all the same information as the original except the treatment area (for example, the tooth number).

Note: You can select more than one item at a time by clicking each line item that you want to delete. Click a line item again to deselect it.

·        To post multiple procedures at once, from the Speed Codes list, select a speed code.

·        To use a treatment-planned procedure from a treatment plan, from the Options button menu, click Treatment Plan to select and paste in a procedure. If the selected procedure requires a pre-treatment estimate but has not been approved or denied, on the message that appears, click Yes to continue posting the procedure.

8.   To delete a line item, select a line item (the pointing hand icon  appears next to the selected line item), and then click the Delete selected line button.

Note: You can select more than one item at a time by clicking each line item that you want to delete. Click a line item again to deselect it.

9.   Use the Options button menu to perform additional posting-related tasks.

Click any of the following options:

·        Medical Prescriptions - To write a medical prescription for the patient.

·        Dental Labs - To view, add, edit, or delete lab information.

·        Narratives - To select a narrative and/or enter customized text to attach to a selected procedure. Narratives appear on dental claim forms.

Select Experience-based sort to show the most commonly selected narratives, click a Show option (Linked Narratives or All Narratives), select a narrative and/or type customized text, select Append? to have the next narrative you select be added to the current narrative instead of replace the current narrative, and then click Save.

·        Ledger Note - To add a ledger note.

·        Missing Teeth - To specify any missing or extracted teeth for the patient.

Select the teeth that are missing or extracted to remove them from the chart and add them to the list on the right. Previously extracted teeth associated with a Ledger entry are shown with a check mark. When you are finished, click OK.

Note: You can still post procedures to missing teeth if the code allows it.

·        Diagnosis Codes - To add diagnosis codes.

·        Modifiers/Cross-Coding - To cross-code the ADA code being posted to the corresponding CPT codes.

10. Set up any of the following options:

·        Tx. Counselor – Select a treatment counselor to attach to the procedures being planned. You can click the Remove button to clear any previous selection.

·        Remove Sig. on File - Select this check box to omit the text "Signature on File" from an insurance claim. This check box is available only if the Estimator Off check box is selected. Selecting the Remove Sig. on File check box will override the preference to always assign insurance checks to the office.

·        Description – If necessary, change the description of the selected procedure.

·        Location – Select the location where the all procedures of the treatment are to be performed.

·        Place of Service – Select the place of service for medical claim forms. The default for the list can be set up for each location.

·        Box 49 on ADA form - Select the option that you want to have appear on medical claim forms in box 49: Office, Hospital, ECF, or Other.

11. Click the Exit/Continue button.

One of two results occurs:

·        If the button is an open door icon , there are no procedures being posted, so the Post New Charges window closes. Ignore the steps that follow.

·        If the button is a check mark icon , the Billing Summary window appears with the following account information in the upper-right pane: Previous Balance, Previous Patient Balance, Today's Charges, Tax, Office Visit, New Balance, and New Patient Balance. Proceed to the next step.

12. If you have sufficient security rights, under 1. Process Payment, set up the following payment options as needed:

·        Amount - Type the payment amount.

·        Method - Select the method of payment. The methods of payment shown in the list come from the Payment Types dialog box.

·        ePayment - Select this option if the payment is to be an electronic payment. The availability of this check box depends on the method of payment that you selected.

·        Check # - If the method of payment selected is a check or money order, type the check number.

·        Bank # - If the method of payment selected is a check or money order, type the bank routing number.

·        Payor Info - Click this button to enter the payor's name, driver's license number, Social Security number, phone number, and credit card number.

13. If you have sufficient security rights, under 2. Process Adjustment, set up the following adjustment options as needed:

·        Amount - Type the adjustment amount.

·        Type - Select the adjustment type. The adjustment types shown in the list come from the Adjustment Codes dialog box.

·        Minimum payment - Type the minimum amount that is required to be paid by the patient. The default amount is determined by the patient's discount plan.

14. Under 3. Create Insurance Claim, set up the following claim options as needed:

·        Type – Select the type of claim: Printed, Electronic, or None.

·        Generate – Select the coverage options that correspond to the carriers for which you want to generate a claim: Primary, Secondary, Tertiary, or Quaternary. These options are available only if the selected Type is not None.

·        Extras – Click this button to set up extra information for the claim. This button is available only if the selected Type is not None.

The dialog box provides the following options:

·        Accidents - If the patient's treatment is necessary due to an accident, select Occupational, Automobile, and/or Other, type a description for any selected option, and then enter the date of the accident in the box in a mm/dd/yyyy format.

·        Prosthetics - Leave the 1st Placement check box selected if this is not applicable or if this is the patient's first prosthetic treatment, or clear the option if this is not the patient's first prosthetic treatment. If the option is cleared, type a description and the date of the placement.

·        Orthodontics - Select Tx. is for Ortho if this is an orthodontic treatment. Then, you can enter the Total Months, Months Left, and Placed date.

·        In-Patient/Out-Patient Care - Enter the Admission and Discharge dates. Also, enter the Service Facility ID and Name.

·        Referral Date - Enter the date of the referral.

·        Number of Radiographs - Enter the number of radiographs.

·        Special Codes - Select the Delay Reason, Special Program, and Service Authorization Exception.

·        HCFA Box 18 - Type what you want to have appear in box 19 on the medical claim form.

·        Outside Lab Charges - Type the outside lab charges.

·        Attachments - Click this button to add attachments to the claim. This button is available only if the selected Type is not None.

Click Attachments to attach a file that has been saved on your computer, a document or image in the patient's Document Center, or an image that you capture from a third-party digital imaging program, a Windows program, or a file. Then, click OK to save the attachments with the claim.

Note: You can attach only images (.jpg file type only) and plain text files (.txt file type only) to electronic claims.

·        Print Now – Select this check box if you want to print the claims after you click OK. For Canadian claims, this check box is labeled Print/Submit Now; select it to print or submit the claims after you click OK. This check box is available only if the selected Type is Printed.

15. Under 4. Options, set up the following options as needed:

·        Mark treatment complete – Select this check box if all treatment, except future recalls, is now complete.

Note: If this check box is not selected (because the patient is still actively being treated), a yellow box appears in the Tx column next to the patient’s name in the Patient Lookup dialog box.

·        Progress note – Select this check box to generate a progress note after you click OK.

·        Post-op call tickler – Select this check box if you want to place the patient on the post-op call list after you click OK.

·        Claim Status Note - Click this button to attach a note to all the completed procedures on the claim that will be created. A claim status note is an internal note that you can reference when an insurance payment is received. This button is available only if the selected Type is not None.

The dialog box provides the following options:

·        Note - Type the text of the note.

·        Note is for all completed work for this claim - This option is not available. The first procedure of the completed work that is being posted for the claim will have this note attached. To attach a claim status note to specific or all procedures individually, add the note to the desired transactions in the patient's Ledger.

·        Pop up when posting insurance payments - Select this check box to have the specified note appear when you post an insurance payment.

·        Initials - Type your initials.

·        Note Date - By default, the date of the note is the current date, but you can change it if necessary.

·        Insurance claim type - Select whether to have the note be attached to procedures on the primary claim, secondary claim, or both.

16. Under 5. Print, set up the following options as needed:

·        Post-op instructions – Select this check box if you want to print the post-op instructions in addition to the claims after you click OK.

·        Receipt – Select this check box if you want to view or print the patient’s receipt after you click OK. Also, you can select the include superBill check box if you want to include a super bill (this check box is available only if a super bill has been set up in the Preferences dialog box).

·        Quick Statement - Select this check box if you want to generate a billing statement for the patient. After you click OK, the Quick Statement for dialog box will appear so that you can specify what you want to have appear on the statement.

17. Click Letters / Labels if you want to choose letters and/or label sets to print after creating the treatment plan. Select the check boxes of the desired letters, and then click Save.

18. Click OK.

19. For Canadian claims, if a confirmation message appears, click Yes to continue with or No to stop the claim submission. (The appearance of this message is controlled by a preference.)

20. Also for Canadian claims, if there is no secondary insurance attached to the patient, a message appears and asks if you want to assign secondary coverage. Click Yes to stop the submission and set up the patient's secondary insurance or No to continue.

Note: The status of the claim is "incomplete" while you are waiting for the CDA to respond. Once you receive a response, you can print the response and give it to the patient before he or she leaves the office. You can also, look at the response to see if it is rejected, fix the error, and then resubmit the claim.

 

Need more help?

You can visit our website, contact OMSVision Customer Support, or suggest a new feature or improvement on User Voice.