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Required HIPAA Changes
ANSI X12N 837 4010A1: National Provider Identification Number (NPI) can now be reported when billing electronically.
To apply for your NPI:
Click on the [Customize] menu then [Providers]. Click on the [Print] button to print all of your current provider id numbers.
Go online to www.HerfertSoftware.com then click on Apply for your National Plan Identifier (NPI) (at the bottom of the page).
Once your NPI is assigned, call Herfert Software at (586)776-2880 to enter it.
ANSI X12N 837 4010A1: The payment adjustments (from the primary insurance) will be reported when billing secondary insurances electronically. This eliminates having to paper bill secondary insurance with a copy of the primary insurance Explanation of Benefits (EOB).
ANSI X12N 837 4010A1: Required changes for BCBSF when billed through Availity. Requires the 1B qualifier in the REF01 of the Rendering Provider loop 2310B. REF02 requires the BCBSF assigned provider ID for the Rendering Provider.
BCBSM
Blue Cross Paper Billing: The Medicare allowed amount will be reported in box 24k when billing Medicare Supplemental claims to BCBSM.
Medicaid
Medicaid Paper Billing: Your clinic name and address will be printed in box 32 when billing Medicaid claims.
General Changes
Screen Message (popup box): Increased the size and print of the Screen Message box.
Appointment Schedule (screen): Press <Ctrl A> to display the on screen Appointment Schedule.
Patient Menu - Appointments
Age (field): Added field to display the patient's current age.
Patient Menu - Post Patient Payment
Reprint Receipt (button): Added option to re-print a receipt from this screen.
Patient Menu - Post Insurance Payment
[Reject/Deduct], [Additional Options] and [Post Adjustments] (button): The currently highlighted transaction (from the posting grid) will automatically be selected in the "popup" grid when any of these buttons are clicked.
Post Adjustments (button): Payment adjustments are the amounts(s) and reason(s) that an insurance payment was reduced from the original service charge.
Service Charge - Adjustment(s) = Amount Paid
You must enter the primary insurance adjustments if you want to bill secondary insurance electronically. This eliminates having to bill secondary insurance on paper with a copy of the primary insurance Explanation Of Benefits (EOB).
This option displays adjustment(s) for insurance payments that were posted automatically from an 835 electronic billing response file. You will not be able to change or delete adjustments that were posted automatically.
This option also allows you to enter adjustment(s) for insurance payments that were posted manually. Be sure to click on the [Verify Adjustments] button after entering adjustments manually to verify that: Service Charge - Adjustments = Amount Paid.
Patient Menu - Master File
Age (field): Added field to display the patient's current age.
Patient Menu - Account Adjustments
Fix Balance (button): Automatically fix the patient and insurance balances for the current patient (based on the remaining balance for each service).
Billing Menu - Insurance Billing
Billing Form (field): Old AMA (form 6) and New AMA (form 5) will now print diagnosis 5 thru 10 (from the claim screen) in block 23.
Pre-Billing Worksheet Remarks:
Xray(old): If an x-ray is older than 1 year, it will not be reported in the ANSI 4010 A1 electronic billing file (for Medicare claims only).
2. CAS?: The primary insurance adjustments were not entered. Go to the Post Insurance Payments screen, select the service you are billing, and then click on the [Post Adjustments] button. This will not cause a rejection - if adjustments are not entered, then adjustment reason 192 (non standard adjustment code) will be reported.
CAS!: The service charge minus the primary insurance adjustments do not equal the amount paid for this service. Go to the Post Insurance Payments screen, select the service you are billing, and then click on the [Post Adjustments] button. This will not cause a rejection - if adjustments are not entered, then adjustment reason 192 (non standard adjustment code) will be reported.
PriPay!: The primary insurance payment (or rejection) has not been posted. Go to the Post Insurance Payments screen, then post the payment (or rejection) made by the primary insurance. This will not cause a rejection - if the primary insurance payment (or rejection) is not posted, then today's date will be reported as the payment date.
Reports Menu - Appointments
Detailed Schedule (report): Added patient balance to the report.
Reports Menu - Transactions (Daily)
Pre Pay Totals (field): Added option to display "DrPrePayCr" and/or "PatPrePay" info per doctor.
Security: If passwords are setup per provider, then providers will only be able to print a daily report for themselves.
Reports Menu - Patient Correspondence
Patient Tracking (report): This report is now double spaced to allow room for comments.
Reports Menu - Transaction Listing
Display (field): This new report option allows you to display either the procedure key codes or the procedure CPT codes.
Utilities Menu - Word Processing
Insert Merge Code (button): Added "Cell Phone" and "Primary Phone" as merge options. Also, when "Work Phone" is selected, the work phone extension will also be included.
Customize Menu - Procedure Codes
Taxable (field): Added field allow sales tax to be automatically calculated (at Registration) for selected procedure codes. You must also enter your state sales tax: Click on the [Customize] menu then [System Configuration] and enter your state sales tax in the "Sales Tax" field.
Customize Menu - Time Factors
Print (button): Added color to the time factor report.
Customize Menu - System Configuration
Use Previous Procedure (field): When entering a procedure at registration, you can choose to use charges, write offs, modifiers, and diagnosis pointers from a previously entered procedure (with the same procedure code) as defaults for the new procedure. New options have been added to this feature giving you the following choices:
No
Charges, Write Offs, Modifiers
Charges, Write Offs
Charges, Modifiers
Charges Only
Modifiers Only
Sales Tax (field): Enter your state sales tax. If the state sales tax is entered in this field, then sales tax will automatically be calculated on taxable procedures at Registration. To make a procedure code taxable, click on the [Customize] menu then [Procedure Codes]. Select the appropriate procedure and change the "Taxable" field to "Yes". A "TAX" procedure code will be added (for taxable procedures) when registration entries are saved.
Senior (field): Enter the age you consider a patient to be a senior citizen. Set to 0 if you do not want senior citizen graphics to be displayed.
Help Menu - System Information
Installation Folder (field): Displays the path that Herfert Software is installed in.
Recs Used (field): The number of records used (for a file) will be displayed in red if it exceeds 75% of the records allowed.
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