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Required Changes
ANSI 837 (4010 A1): BCBSM Secondary: requires loop 2400 - segment AMT with AAE qualifier even if 0.00 - except for chiropractic xrays.
CMS-1500 (08/05) and ANSI 837 (4010 A1):
Alaska Medicare: does not allow individual NPI in 24j (if sole proprietor).
Indiana Medicare: Removed "Onset date ??/??/???? New Level of Subluxation" and "Acute Exacerbation of a Chronic Condition" from service line 6. Removed visit number from modifier 3 column.
Pennsylvania Medicaid cannot have address printed at the top of the form.
Utah Medicare: Removed rendering provider loop 2310B if billing as an individual provider.
Wisconsin Medicaid requires taxonomy codes in box 24j, and 33b.
6. Chiro Alliance Corp. (CAC) requires their name, address, and Corp NPI in box 33. Also, box 25 must contain CAC's tax id. In addition, Box 29 must contain a total of the patient charges (co-pays). The insurance company name at the top of the form must begin with "CAC/" followed by the actual insurance company name
Patients who live in Ontario but work in the United States: Allow for alpha numeric zip codes. Enter "ON" as the patient's (and insured's) state code. Also enter the Canadian zip code.
General Changes
Added color to fields that are required for billing: Master File, Insurance Header, and Claim screens.
Appointments (on Screen)
Activate Patient (checkbox): If you checkmark this option, then the current patient highlighted in the schedule will become the active patient. Therefore, when you navigate to another screen (under the patient menu) then the active patient will be displayed. If this option is left un-checked, the patient you were working on prior to viewing the appointment schedule will continue to be the active patient.
Status (field): if the status of an appointment is changed to Canceled or Rescheduled, then the amount of time the appointment was taking up will be removed (minutes will be changed to 0). This opens up the appointment slot to be filled for another appointment.
Register Patient (button): The clinic date will change to the date of the appointment when you click on the Register Patient button.
Patient Menu - Registration
HIPAA (field): Added the HIPAA date field to determine (at a glance) if new forms need to be signed.
Is Next Appointment Correct (popup box): This will display the appointment message along with the next appointment.
Billable Purchases: When a billable purchase (type of service "P") is entered, it will default to charge insurance (rather than charge the patient).
Patient Menu - Post Insurance Payment
Group Post (button): If the claim only has 1 insurance - that insurance will be the default when group posting.
Post Adjustments (button): Claim adjustment reason code records that were auto posted - can now be changed or deleted when on the high password.
Patient Menu - Master File
Ref Patient (field): Referring patient's id number.
List Referrals (button): List patients that were referred by the patient currently displayed.
Screen Message (popup box): When a patient (with a screen message) is selected the screen message popup box will appear. This used to popup on all other screens except the Master File screen.
Patient Menu - Claims
Diagnosis 1 - 10 (fields): If you <Right Click> on a diagnosis, you will have an option to remove blank diagnosis. Eg: if dx1 and dx3 are filled out but dx2 is blank, this option would move dx3 to the dx2 position.
Patient Menu - Insurance Headers
Payment Source (field): When you add a Medicare insurance header that is going to be billed as commercial insurance thru BCBS MI, the payment source will default to "F-Commercial".
Patient Menu - Transactions
Quick Statement (button): Added option to "Include Only Purchases" to print only transactions that have "ITM" in the [vst] column.
Patient Menu - Exams (SOAP Notes)
Private Notes (tab page): This new tab page can be used as a doctors worksheet. The doctor can type in private notes which will not get printed on visit notes. The private notes can however be printed separate from the visit notes by clicking on the [Print] button on the [Private Notes] tab page.
Exam Findings: When the mouse is clicked on a test, it will only rotate through the answers if the cursor is already in the field or if the field is blank - this way an answer is not accidentally changed.
Claim Tracking: New button to view the Claim Tracking tab page (on the claim screen) from the Exam Screen.
Exam Findings: <Right Click> or press <F4> to list choices. This option now displays more choices and allows for you to select multiple answers. When multiple answers are selected, they will be brought into the current test and all tests below (until answers selected run out).
Print Visit Notes (button): Added the following options …
1. Report Title: select from "Visit Notes", "Initial Report", or "Final Report".
2. Print Diagnosis: option to include / exclude diagnosis on the visit notes.
3. Print Procedures: option to include / exclude chiropractic care procedures on the visit notes.
Edit Template (button): Added personalized merge codes that will be converted when the [Insert Template] button is used:
~he,she~
~his,her~
~his,hers~
~him,her~ will be replaced with the appropriate choice based on the patient's gender.
~FIRST~ will be replaced with the patient's first name.
~LAST~ will be replaced with the patient's last name.
~PREFIX~ will be replaced with the patient's prefix (Mr,Mrs,etc).
Exam Findings Headings: Added the option to left click on the heading of a specific test to display a list of options for that test. This provides a way for a list of options to be displayed when using a touch-screen. Normally you would right click on the test (rather than the heading) to view a list of options.
Subluxation Level: Added the following options.
OC : Occipital region (C0-C2)
PA : Parietal region (C0-C2)
TE : Temporal region (C0-C2)
FR : Frontal region (C0-C2)
Billing Menu - Insurance Billing
New Form per Visit (field): New option to print a new CMS-1500 form per visit date.
Dx Ref: Diagnosis reference with forced diagnosis - self correcting.
Transmit Billing (button): If BCBS of Michigan is your electronic billing clearinghouse, you can <right click> on the [Transmit Billing] button to allow billing dates to get posted without transmitting the billing. This allows you to run a "fake billing" then post the dates as if the file was sent.
Pre Billing Worksheet (remark): The "InsId?" pre billing worksheet remark will appear if the insured's id is less than 2 characters in length. Prior to this change this remark would only appear if the insured's id was blank. An insured's id that is 1 character in length will cause the entire billing to reject - as this is a HIPPA requirement.
Reports Menu - Appointments
Patients w/out Appts (report type): The patient's primary phone number will be displayed on the report - rather than the home and work phone #'s.
Mail Codes (field): Allows you to include / exclude patients with specific mailing codes (from the master file). This option is only allowed on the "Patients w/out Appts" report. You could setup mail codes such as "A" for patients that should be scheduled for their next appointment, and "O" for open patients that call as needed. The "Patients w/out Appts" report can be used as an Appointment Book Black Hole report.
Standard and Detailed Schedule (report type): Removed Rescheduled and Canceled appointments from the appointment schedule report.
Reports Menu - Transactions (Daily)
Bank Deposit (button): Added additional options for the Bank Deposit report. Additional options include date range, session, exclude insurance companies, exclude credit cards, exclude EFT (electronic funds transfer), exclude 0.00 amounts.
Reports Menu - Insurance Follow Up
New Page per Patient (field): New option to start a new page per patient.
Reports Menu - Patient Correspondence
Referral (report type): Added referring patient to the referral list if "w/Names" is selected.
Labels (Avery 5160): New option to print the family name (eg: The Smith Family) only when 2 (or more) patients have the same address (otherwise it will print the patients name rather than the family name).
Labels (Avery 5160): Names and addresses on labels will print with upper and lowercase characters (as opposed to all capitals). Also the patients prefix will print out (Mr, Mrs, etc.)
Customize Menu - Word Processing
Insert Merge Codes (button): Added referring patient merge fields. This allows you to create correspondence thanking your patient's for referring other patients.
Customize Menu - Exam Tests (SOAP Notes)
Color: Added a [Color] button to set the color of the Exam Test Heading.
Type (field): Added "Assessment" as an option for type of exam test.
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