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PTOS - 3.xx User`s Manual

1. NOTE If you REMOVE INACTIVE ACCOUNTS you MUST rerun PREPARE AGED ACCOUNTS and re print the YEAR TO DATE THERAPIST ACTIVITY REPORT to calculate the total payments in the system after the removal This gives you a new baseline so that the next time the YEAR TO DATE report is run the difference between two reports will represent total charges and total payments received in the period PROCEDURE SUMMARY REPORT When you update PROCEDURE CODES you tell PTOS the fee for a procedure and if you want the time it takes and cost to the practice to perform the treatment The PROCEDURE SUMMARY will then total the number of times each procedure was used during the period the charges billed for each procedure code and I individual codes You also have the option of choosing to include I codes ONLY If you choose I codes only all I codes individually entered charges are sorted and subtotaled by DESCRIPTION The report can be grouped by THERAPIST ACCOUNT TYPE or LOCATION You may run the report for a specific insurance or diagnosis code This breaks down procedures posted for patients covered by that insurance or with the selected primary diagnosis code The report will show what was collected for transactions that contain the code and by subtracting COST from COLLECTED PTOS is able to calculate PROFIT and PROFIT MARGIN PROCEDURE CODE BILLED COLLECTED DONE TIME PROFIT AE Aerobic Exercise 1168 00 985 00 84 2
2. 11 inch page The default is three patients per 66 line page each super bill would be 3 666 inches This is the format shown on the following page You can have custom forms printed to align with this format listing your procedures and charges and any other desired wording 1010RT TRERASSAS ROBERT 2005 07 31 GM MC 5 00 2052 63 MALIGNANT NEOPLASM OF BONE 1021GS SMALL GEORGE 2005 07 31 A1 10 00 131 12 INTRASPINAL ABSCESS OR DISC SPACE INFECT 1231NR RESTON NANCY 2005 07 31 B1 105 REMOVE OLD ACCOUNTS Periodically you should purge your patient files This will free up space on the computer and enable the system to operate more efficiently If the patient s data will not be needed for future MANAGEMENT REPORTS the account can be REMOVED To mark an account to remove the balance must be zero and a discharge date must be entered You then enter an A in the EDIT field of the patient s account At the end of a month or any other time frame select the REMOVE OLD ACCOUNTS option and the following menu appears INACTIVE ACCOUNTS 1 MARK ACCOUNTS TO REMOVE 2 LIST ACCOUNTS TO REMOVE 3 REMOVE OLD ACCOUNTS 4 LOST REMOVED ACCOUNTS 1 MARK ACCOUNTS TO REMOVE Instead of marking individual accounts selected the following menu appears MARK ACCOUNTS TO BE REMOVED INACTIVE IF DISCHARGE DATE IS PRIOR TO INACTIVE IF LAST VISIST DATE PRIOR TO INACTIVE IF LAST PAYMENT DATE PRIOR TO All accounts in the date range yo
3. When you install PTOS the first step is entering various codes including procedure diagnosis and insurance codes Using codes will save you a lot of typing For example on the insurance billing form you need to show the patient s diagnosis This diagnosis is entered in the Patient Data File which is described in a later section Instead of typing a description like SHOULDER SPRAIN OR STRAIN you can just type the code 840 and the appropriate description is automatically filled in Creating codes is found under SYSTEM TASKS Click on the SYSTEM TASKS bar or type ALT S Then select UPDATE CODES 10 UPDATES CODES ICD9 Codes Insurance Carrier Referral Sources Procedure Codes Therapist Codes Payment Adjustment Codes City Codes Account Type Codes Employer Codes UPDATE ICD9 CODES PTOS comes to you with a set of diagnosis codes You can revise or add to the standard list by selecting UPDATE ICD9 CODES Print a list of the existing codes through the OTHER LISTS menu to see what s already in the system and see which you want to add or change To modify or add a code select UPDATE ICD9 CODES and type the code You can also double click to list codes already in the system You can add new codes or modify any existing field except the code itself If you change the description of an existing ICD9 code PTOS will ask if you want the description to be automatically updated into all patient records th
4. The NPI number will print in box 32b and 33b on the HCFA 2007 form Frequently a therapist will have different PIN or GRP numbers for various account types By filling out the PIN GROUP and Box 24K numbers along with the account type the appropriate numbers will be used when printing HCFA forms NOTE If you have filled in the PIN and or GRP numbers under INSURANCE CODES the therapist s PIN and or GRP numbers will override the insurance numbers If you want the assigned therapists name to appear as part of the header on the PATIENT STATEMENT fill in the therapist s name in the PATIENT STATEMENT HEADER field UPDATE PAYMENT ADJUSTMENT CODES Different types of payments and credit and debit adjustments to patient accounts are described in detail in ENTER OR ADJUST TRANSACTIONS When you post a payment or adjustment you can type the description each time or set up standard PAYMENT ADJUSTMENT CODES If descriptions like Blue Cross Payment will be used over and over just create a code BCP A sample entry for a Blue Cross Payment is shown below This will also allow you to run a LIST OF TRANSACTIONS to see how much was received or written off for that description during any given time period Adjustment Codes Code NON UPDATE CITY CODES You probably use the same city state and zip code in the address of many patients referring doctors attorneys and payors Instead of typing the same information over an
5. After the insurance has paid their portion of the bill PERCENT TO BILL PATIENT can be changed to 100 and the patient will be billed the balance due 2P PCT TO BILL PT Sometimes the percent to bill the patient may change during the course of treatment Perhaps a Co pay applies up to a certain amount or a new patient percent is activated after a charge limit is reached Fill in the new percent to bill here and the starting date for the new percentage in the START DATE FOR 2 field CALCULATE OF EXPECTED AMOUNT Y N When a percent to bill the patient is calculated normally the amount billed is used If the patient is billed 100 and they are responsible for 20 they will be billed 20 For some accounts Medicare for example you may wish to bill the patient their percent of the EXPECTED AMOUNT Expected amounts were covered in UPDATE PROCEDURE CODES This option will calculate from the patient deductible and expected amounts If you bill Medicare 100 and the EXPECTED AMOUNT has been entered as 80 you have the option of billing the patient 20 of 80 rather than 20 of the 100 To base the patient percent on the expected amount enter YES in this field If this is set to YES the expected amount is also used when calculating the CHARGE LIMIT for the patient CO PAY BILLING Y N Many insurance plans designate a co pay amount which is the portion of the charge that the patient must pay If you enter Y for yes in this
6. DAV NNA R Account Type BC Referral Dr AMAYA CELESTE Pin E99999 NPI 1234567890 Primary Dr Pin NPI Employer CED PR Mc Employment Related Address 18 vD S City A State CA Zip 91356 Occupation Admit Condition Discharge Condition Attorney Discharg Info Notes Line 1 Notes Line 2 REFERRAL DR PIN AND NPI Referring physician PIN and NPI if required can be entered here This will be printed on various insurance forms where referring doctor is requested and is also used to group patients on the REFERRAL REPORTS and various patient lists For grouping on lists and reports to be accurate the referring doctor must be entered the same each time AMAYA CELESTE AND CELESTE AMAYA are two different people as far as PTOS is concerned To make entering the referral the same each time we recommend that you pull in the name with a referral code To find the proper referral code DOUBLE CLICK or press F2 PRIMARY DR PIN AND NPI In many cases the primary care physician also needs to be tracked and may need to be used on the insurance form instead of the referring doctor PTOS looks at the patient s account type to see if the primary or referring doctor should print on claims EMPLOYER NAME The patient s employer can be entered here It will print on the Patient Statement and various lists and reports If as in a Worker s Comp case the EMPLOYER is the same as the PAYOR
7. One billing technique that many practices find effective is to bill active patients for their portion of charges on a weekly basis Inactive accounts can then be billed monthly By filling out the FROM and TO dates you can print statements only for patients who had new charges during that period The above options allow you to specify which groups of patients should receive statements You only need to fill out the options that you require to qualify the group of patients to be billed If you want statements printed for all patients including all activity since they ve started treatment just click PRINT when the above Billing Screen appears If you want all patients to be billed regardless of account type but only for the last month s activity don t fill in any of the six types just fill out the INCLUDE ACTIVITY FROM TO line 56 The final option on this screen is STANDARD OPTIONS These are settings that you normally set once and won t change from one billing run to the next The options on the above screen such as date range to print do change from one billing cycle to the next 4 Standard Options Patient Billing x Patient Billing Standard Options v Order Send To Include Balance Forward Note This is not a Permanent Change V Include Aging V Include Patien an Billed in Patient Account V Include Billed Lines cription PA AMOUNT DUE V Include Notes on Statement The first option is t
8. PD is printed The TOT PD amount is a total of all payments in the system credited to the therapist even if the payments were not made in the year being printed The CHANGE in TOT PD from one report to the next indicates the total payments credited to the therapist during the period between reports This TOT PD amount looks at the treating therapist rather than the assigned therapist as described in the monthly report above If you want to see total payments made against charges generated by a therapist this is the report to look at To appear on this report the therapist does not have to have any patients assigned in the Patient file The therapist must however be entered in the THERAPIST File 76 THERAPIST YEAR TO DATE FOR 2004 PRINTED 04 10 31 15 LINE CHARGES 2 LINE NEW PATIENTS 3 LINE VISTITS 4 LINE PAID 04 0 04 02 04 03 04 04 04 05 04 06 04 07 04 08 04 09 04 10 04 11 04 12 28244 27412 29231 2945 29972 29812 28913 29523 28512 29231 NEW 23 35 32 23 27 39 31 25 22 39 VIS 22 262 242 270 227 279 260 230 220 283 21244 23412 24231 2745 25672 24312 23313 21123 27612 24231 GEORGE MOORE TOTAL CHARGES 391201 NEW PATS 331 VIS 3403 PD 212231 23944 25112 23331 2233 22655 23112 22383 24423 26611 23131 NEW 25 22 30 26 27 31 25 39 28 31 VIS 214 220 215 270 267 269 250 270 214 263 21244 23412 22231 2345 22672 24312 23313 21123 27612 24231 JAMES JELLISON TOTAL CHARGES 327810 NEW PATS 321 VIS 3533 PD 301982
9. Relation to Insured Accept Assignment 2000 Gender F 32 PRIMARY INSURANCE Insurance carrier information is entered in Update Insurance Carriers under System Tasks Entering the code in this field will cause the appropriate insurance name and phone number to be displayed and to be printed on insurance claims DOUBLE CLICK or use the F2 key to quickly find the right code If you want the insurance claim addressed to the PAYOR enter PA as the PRIMARY INSURANACE CODE NOTE YOU MUST HAVE A CODE ENTERED IN THE PRIMARY AND OR SECODNARY INSURANCE FIELD IF YOU WANT AN INSURANCE FORM TO BE PRODUCED Otherwise PTOS assumes they have no insurance coverage and they can only be billed on the patient statement ADJUSTER A specific claims adjuster for the account can be entered and will print as part of the address on the insurance form Some HCFA 1500 forms have BAR CODES in the top left corner There is no room for the ADJUSTER to print on these forms GROUP Group number of the primary insurance subscriber prints in Box 11 on HCFA form and box 62 on UB92 form ID Insurance ID number of the primary insurance subscriber This is frequently the Social Security Number If you ve entered the Social Security Number on the second PATIENT screen just type SSN in this field and the number will be copied automatically Prints in Box 1A on HCFA for and box 60 on the UB92 form EMPLOYER The employer for the primary in
10. You can type LAST DATE SEEN BY DR enter the date then update it as needed BOX 20 Outside lab information can be entered BOX 22 Can be filled out if required with Medicare resubmission codes BOX 23 A PRIOR AUTHORIZATION number may be required and should be entered here 37 ADDITIONAL UB92 BOXES If your office is a Certified Rehabilitation Agency and you billing on the UB92 form you can use these fields to override the PTOS defaults VISIT REV CODE 0 OR 1 i e 420 421 Some intermediaries require treatment codes to end with 0 others require a 1 For example 420 or 421 are used as physical therapy treatment codes This parameter allows you to control the codes printing on the UB92 BOXES 24 29 Enter any codes here to print in these boxes BOXES 32 36 Lines A and B Normally PTOS prints 11 35 44 and or 45 with the appropriate dates in boxes 32 to 36 of the UB92 If you are required to print the code 29 or 17 you can add in the first slot the required occurrence code followed by the appropriate eight digit date in the format shown below for October 1 2006 BOXES 324 36A 2910012006 BOX 63 CODES You can enter three TREATMENT AUTHORIZATION CODES as needed BOX 80 amp 81 CODES You can enter upto three dates and procedure codes here Corresponding to the format of boxes 80 and 81 PRINT DATES IN BOX 84 Y N Each date of service covered on the UB92 ca
11. 00 INSURANCE PAID 2965 70 TOTAL 3191 70 ADJUSTMENTS This is a similar reference list to the PAYMENTS list described above You can select the specific type of adjustments from the following menu Adjustments All Adjustments v All Adjustments Credits 92 CHARGES AND PAYMENTS FOR PRIMARY INSURANCE This is a special printout that lists charges and payments grouped and subtotaled by the patient s primary insurance For this list to print properly you must indicate P or S for primary or secondary insurance payment when you post payments If you neglected to enter the P or S on all payments this list can still be utilized When PTOS prints the total charges payments and adjustments for an insurance carrier it prints two totals for payments and two for adjustments INS PD MARKED P totals all payments that were marked P indicating they were made by the primary INS PD TOTAL includes all insurance payments The same criteria are used for printing WRITE OFF MARKED P and WRITE OFF TOTAL TRANSACTIONS WITHOUT VALID ACCOUNT NUMBER In rare instances you may accidentally delete a patient account Periodically running this list will show any transactions that do not have a corresponding patient account If the transactions are invalid or were made in error you also have the option to automatically delete them REPRINT A DAILY TRANSACTION REPORT You should keep all DAILY TRANSACTION REPORT printouts as permanent audit l
12. 000120 Aetna Life Ins billed 58 00 f 10 09 10 15 1 58 00 13 10 31 000060 Warner Life billed 1321 00 f 10 11 10 15 1 1321 00 44 TOTALS 14 CLAIMS 8 973 70 AMOUNT BILLED 358 95 AVERAGE PER BILL 16 00 SMALLEST AMOUNT BILLED 1321 00 LARGEST AMOUNT BILLED PHAONRFRPPWA EB on ie gt INSURANCE TRACER REPORT After sending an insurance claim you should keep track of whether or not it has been paid If you can spot an unpaid claim in a few weeks rather than a few months it will make a big difference in accounts receivable and collection efficiency First enter the date range to print All open insurance claims that were generated during this period will be listed This means they have had no payments posted to the claim The CLAIM NUMBER is included as a reference to be used when posting insurance payments For this list to be accurate when you do insurance billing you MUST tell PTOS to enter an INSURANCE HAS BEEN BILLED entry into the patient account and you must enter the claim number being paid when posting insurance payments Sometimes a claim may be sent but there are no payments on the claim since it applies to the patient deductible To prevent that claim from appearing on this report you can mark it as having been applied to the patient s deductible This option is available by using FIND to pull up the INSURANCE HAS BEEN BILLED entry and marking it as applying to the deductible 78 INSURANCE TRACER REPO
13. 07064 461 A 1101AU Adams Rich 0720 07209 207501763 052619 MEDI 07264 1502 E 4 1144MR Agliis Kent 0628 07139 192529044 050101 BC01 07284 618 F 1913KE TOTALS NUMBER OF PATIENTS 10 8078 00 1615 60 6462 40 PAGE 2 KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK PAT PTCHARG VIS OTCHARG VIS SPCHARG VIS OTHER INSPAID PATPD CREDIT O001AR 780 50 12 0 00 0 0 00 0 00 80 00 0 00 00 003RO 103 00 1 0 00 0 0 00 00 0 00 00 00 0140P 796 00 10 0 00 0 0 00 00 0 00 00 00 O1AU 1109 00 18 0 00 0 0 00 00 130 00 00 00 44MR 1318 00 27 45 00 2 135 00 00 172 74 00 26 0 00 0 384 00 00 OTIZ 00 00 al le 9 E 428 50 12 TOTAL PTCHARGES PTVIS OTCHARGES OTVIS SPCHARGES SPVIS OTHER 6307 50 109 848 50 9 922 00 16 0 00 TOT INSPAID PATPAID CREDIT 1795 28 0 00 245 26 7 PATIENT LISTS Patient Lists provide the administrative staff with information needed to conduct day to day business Patient Lists are divided into three types Treatment lists Financial lists and Demographic lists The Patient Lists menu is shown below PATIENT TREATMENT LISTS FINANCIAL LISTS DEMOGRAPHIC LISTS By Doctor Patient Number Name Return To Doctor Account Type City Diagnosis Primary Insurance Zip Code Injury Area Secondary Insurance Birthdate Therapist Social Security Number Employer Injury Date Payor Employer City First Visit Attorney Occupation Last Visit Notes Cover Sheet Remaining Visits Zero or Small Balance Accts Sort Authorization
14. 2006 PRINTED 20061103 FOR ALL OFFICES PAGE NUMBER 1 DIAGNOSIS NEW DISC TREAT PCT CHARGES PCT VIS PCT VIS 715 16 1 o 2 2 430 00 1 17 2 0 90 215 00 715 90 o Q l1 2 2 1835 00 5 00 12 5 42 152 91 715 96 o Q l 22 350 00 0 95 2 0 90 175 00 719 41 l 0 2 4 5 1680 00 4 58 9 4 07 186 66 719 47 1 o l1 2 2 1840 00 5 02 8 3 61 230 00 720 2 o Q 1 2 2 365 00 0 99 4 1 81 91 25 721 0 1 0 2 45 1195 00 3 26 6 2 71 199 16 722 10 o 9 L 22 460 00 1 25 4 1 81 115 00 722 52 1 0 l1 2 2 1665 00 4 54 9 4 07 185 00 722 80 o Q l1 2 2 1400 00 3 82 5 2 26 280 00 722 83 o Q T A2 705 00 1 92 4 1 81 176 25 723 1 o Q 3 6 8 3285 00 8 96 22 9 95 149 31 723 4 1 0 i 22 345 00 0 94 2 0 90 172 50 724 2 3 o 8 18 1 4817 59 13 14 30 13 57 160 58 724 4 3 o 4 9 0 2195 00 5 99 13 5 88 168 84 726 0 o Q 1 2 2 975 00 2 66 5 2 26 195 00 726 10 o Q l1 2 2 1160 00 3 16 8 3 61 145 00 728 85 0 Q i 2 2 790 00 2 15 6 2 71 131 66 805 4 1 0 l1 2 2 1430 00 3 90 12 5 42 119 16 TOTALS 13 0o 33 23764 59 163 165 78 OUTCOME REPORTS Prepare Outcome Reports Ta Prepare Outcome Reports entr then cal n of Ac Condition 79 Outcome Reports provide important management data When you select this option the following menu appears You must first select Prepare Outcome Reports option This compiles outcome data for all discharged patients It is similar to Prepare Aged Accounts It only needs to be run once for each batch of reports you may select After the data has
15. A R by Account Number Expected A R by Patient Name Expected A R by Account Type Expected A R by Insurance Expected A R by Therapist Prepare amp Print Extended A R Display A R Balances A R With Estimated Responsibility 70 PREPARE A R FOR ALL PATIENTS Preparing Aged Accounts should be run before any of the PRINT A R options This recalculates all balances When you select PREPARE A R PTOS first tells you the system date it is preparing for The system date is the date you enter when you first start PTOS PTOS ages the accounts up to this date For example if there was a 50 charge on July 14 2004 and you prepared Aged Accounts with a system date of July 30 2004 the charge will fall in the CURRENT category since it s less than 30 days old If you were to Prepare Aged Accounts with a system date of August 15th the charge would be in the 80 DAYS category NOTE When calculating ACCOUNTS RECEIVABLE transactions AFTER the SYSTEM DATE are NOT included If you change the system date to run reports for prior months you MUST when finished re start PTOS with the current date and again PREPARE AGED ACCOUNTS so that transactions are re calculated up to the current date Keep in mind the affect of Line item or Date range payments and or adjustments on your Accounts Receivable One of the advantages of these methods of posting is that the payment or adjustment is applied directly to the proper charge This means the tracki
16. DATE CAN BE ADDED DELETED OR MODIFIED ENTER OFFICE NAMES If yours is a multi office practice you are able to enter an office number in the patient account showing where the patient is being treated By filling out the corresponding office names here PTOS will include the proper office name on reports and lists If you want different names and or addresses to print on patient statements or insurance claims call APS for assistance Office Name Code Office Name EY PT LEJ 23 MONTHS FOR YEAR TO DATE REPORTS Several MANAGEMENT REPORTS can be run showing totals for each month s activity during the year Selecting this task lets you define the months you want to see on the reports SET MONTHS FOR YEAR TO DATE REPORTS PERIOD MONTH yYYY MM 1e N m e a e a amp w 2k A DATE FORMAT PTOS for windows allows you to select the date format you wish to use When you select this option the following screen appears ENTER DATE FORMAT FORMAT OPTIONS ARE 2001 MM DD 2 201 MM DD 3 MM DD 2001 4 MM DD 201 Options 1 and 3 are self explanatory With options 2 and 4 you enter a ONE DIGIT CENTURY and TWO DIGIT YEAR March 14 2004 would be entered 204 03 14 and March 14 2005 would be entered 205 03 14 This allows you to save one keystroke per date It may not seem like a big savings but think of the number of times you need to enter the date You can start by selecting one date format and later t
17. Employers TRANSACTION LISTS This allows you to list transactions using different parameters The lists can be used to verify that charges and payments were posted properly It can also be used as a list of activity by therapist or to show all charges for a certain account type such as all Medicare treatments for a month Some practices use the list as a bill to a nursing home or other contract type situation When you select this task the following menu appears 89 mag Al Transactions v First Date v List Only Therapist List Only Account Type Print Report First specify the type of transaction list All Transactions All Charges Unbilled Charges Unpaid Charges Appealed or Denied Charges Payments Adjustments Chare Payment For Primary Insurance Transaction Without Valid Account Number and Reprint A Daily Transaction Report then fill out any desired parameters Any of the Transaction Lists allow you to specify a range of dates and patients to include You can also indicate whether to sort by date patient transaction code account type or therapist or you can sort by the first ten characters of description All transactions can be listed in detail or YOU can print just the summary for the dates patients etc that you ve selected If you enter a DESCRIPTION only transactions that include the description will print You can also select one office therapist or account type If you enter only the first character
18. PAT CHECK PD 15 00 FOR 10 13 10 13 6 10 15 06 97110GP THERAPEUTIC EXERCISE 10 15 06 97035GP ULTRASOUND 72 00 18 00 12 28 22 72 10 26 06 CA BLUE CROS billed 320 00 for 10 13 10 15 6 10 26 06 97110GP THERAPEUTIC EXERCISE 10 26 06 97140GP59 MANUAL THERAPY TECH 10 26 06 PAT CHECK PD 30 00 FOR 10 15 10 26 6 10 27 06 PRIMARY INS PYMT pt 162 92 FOR 10 13 10 15 6 10 27 06 Insurance Writeoff ce 127 08 FOR 10 13 10 15 6 YOUR PROMPT PAYMENT WILL BE APPRECIATED THANK YOU CO PAY STATEMENT PHYSICAL THERAPY CLINIC ARGS RRVEARLY AND LOS ANGELES CA 90068 213 550 7777 FED TAX ID 95 1762531 THOMAS ADAMS PT STATEMENT DATE 10 27 2006 PATIENT DAVIS BRUCE INJURED 456 ELM ST PHYSICIAN SPOKANE WA 99026 EMPLOYER GIANNA R DAVIS 10 01 2006 AMAYA CELESTE APS ADVANCED PRACTICE SYSTEM ARSAS RUABANE SLYD ATE SAR TARZANA CA 91356 ACCT 060501 BC TA DIAGNOSIS PAIN IN JOINT SHOULDER DESCRIPTION 10 13 06 97001 PT EVALUATION 10 13 06 97110 THERAPEUTIC EXERCISE 10 13 06 PAT CHECK PD 15 00 FOR 10 13 10 13 6 10 15 06 97110 THERAPEUTIC EXERCISE 10 15 06 97035 ULTRASOUND ADJUSTS PATIENT CO PAY CHARGES INS PAID 15 00 150 00 135 00 45 00 45 00 15 00 50 00 75 00 35 00 35 00 10 26 06 CA BLUE CROS billed 320 00 for 10 13 10 10 26 06 97110 THERAPEUTIC EXERCISE 10 26 06 97140 MANUAL THERAPY TECHNIQUES 135 00 10 26 06 PAT CHECK PD 30 00 FOR 10 15 10 26
19. Send Letters allows you to interface PTOS with a stand alone word processing program Most word processing systems will work with PTOS but any modifications will be your responsibility You can also print labels using various options To SEND LETTERS first type a standard letter evaluation or other report format using your word processing program These documents must be set up in a merge print format so that data from PTOS can be merged into the letter or report Setting up a document in this manner will be described in a Merge Print section of the word processing manual Sample merge letters are found on the following pages Once the merge document has been prepared select criteria to determine who will get the letter The menu of Send Letters options is shown on the next page PTOS will find the appropriate patients to receive a letter based on which of the options you ve selected and copy the required patient data in a usable format to a Merge Print file called PTOSLETR TXT Some letter and label selections should not be sent to patients whose HIPAA Authorization date has passed PTOS lets you automatically suppress these SEND LETTERS 1 Delinquent Accounts 2 Diagnosis OR Injury Area 3 Doctors OR Attorneys 4 By Birthdate 5 New Patients 6 Labels for Patients 7 Labels for Doctors OR Attorneys 8 Labels for Insurance Carriers 9 Labels for Payors A Archived Patients B Labels for Employer
20. already been billed to an insurance carrier the billing date is shown If Line item or Date range payments or credits have been applied the amounts paid or credited will be indicated CO PAY is included along with the remaining BALANCE on the charge after applying any Line item or Date Range credits or payments If payment on the charge has been denied by insurance you can mark itas APPEALED or as DENIED To view entries from previous or following days click the VCR buttons BILL PATIENT NOW If while reviewing transactions you wish to produce a patient statement for the account click this button BILL TO SECONDARY INSURANCE If you wish to transfer the balance on the charge to the secondary carrier click this button REBILL If the transaction has been billed to an insurance carrier and you wish to rebill this one particular charge click REBILL This removes the BILLED DATE and adds the amount into UNBILLED CHARGES See Patient and Insurance Billing for a more detailed explanation of rebilling one or a group of charges MODIFY To maintain the integrity of data entry and audit lists not all data in a transaction can be modified There are however some fields that you can revise If you click MODIFY in a charge entry such as the one shown above the following fields can be changed THERAPIST PLACE OF SERVICE TYPE OF SERVICE _ VISIT Y N DIAGNOSIS BILL TO PATIENT SECONDARY ALL EXPECTED AMOUNT CO PAY OFFICE ACCOUNT TYP
21. also should be deleted When you delete the DEBIT for the NEGATIVE LINE ITEM PAYMENT to reverse the error PTOS asks if you want to AUTOMATICALLY REVERSE the entries Normally you would want the entries reversed but in this case you DO NOT since you already reversed them individually If the entries are reversed you will have undone the process of deleting an erroneous DATE RANGE or LINE ITEM entry LIST TRANSACTIONS This option lists and totals all transactions for a patient and is useful in answering inquiries or auditing entries for an account Different types of transactions appear in different colors to make viewing easier Charges are displayed in GREEN payments are YELLOW credits are RED and debits are WHITE Just click LIST in the main TRANSACTION screen 53 The list shows information about each transaction as well as total charges expected amounts payments and adjustments for the patient As you move down the screen the balance charge amount and payment adjustment total is shown at the right of the screen for the highlighted charge You can use the arrow buttons in the LIST BOX to see more information and if you click in the far left box PTOS will go into FIND mode and take you to the FIND screen for the entry Note the BILLED column If a charge has been billed to the insurance the bill date is entered here If the entry is a payment the BILLED column shows the CHECK NUMBER Jit LIST TRANSACTIONS lolx 20 OFFI
22. be asked to select REBILL ALL UNPAID ONLY PAID ONLY THOSE MARKED FOR SECONDARY OR CHARGES PRIMARY HAS JUST MADE PAYMENT ON These are self explanatory with the exception of the last option CHARGES PRIMARY HAS JUST MADE PAYMENT ON When posting LINE ITEM or DATE RANGE payments for the primary insurance you have the option of telling PTOS to bill the remainder to the secondary insurance If you do so PTOS will mark the WHO TO BILL field with an X You can then select secondary insurance billing and tell PTOS to rebill previously billed charges You don t need to enter a date range because the system already knows which charges have been marked as having been just paid by the primary insurance PTOS will automatically bill ONLY those charges that the primary insurance has just made a payment on regardless of the date range covered by the payment After billing the charges WHO TO BILL is automatically replaced with an S The above options can vary from one billing run to the next As with PATIENT BILLING there are the STANDARD options that once set probably won t change If you click STANDARD OPTIONS from the INSURANCE BILLING screen the following options can be set Li Standard Options Insurance Billing Insurance Billing Standard Options Bill Pyt ech or Blank for All ECS Electronic Billing File Name l Force Page End ei fix Change Line Format USE BAR CODES There are two versions of the HCFA 150
23. box PTOS will know to calculate the co pay amount as the patient s responsibility PTOS will then bill the patient for all charges up to the DEDUCTIBLE AMOUNT entered above and then bill only the co pay amount after the deductible is reached CO PAY AMOUNT When you set up ACCOUNT TYPE codes you entered a CO PAY amount for applicable account types By filling in ACCOUNT TYPE on Screen 1 this field is filled out You can also enter your own amount here If CO PAY is set to yes but no amount is entered here PTOS will use the CO PAY in the PROCEDURE CODE when a charge is posted IMPORTANT If CO PAY is not set to YES and transactions are posted those charges will not be billed the CO PAY amount CO PAY must be set to YES in this field at the time the charge is posted If necessary you can go back and MODIFY charges that should have a co pay and enter the appropriate amount This is described in the next section Also co pay will override the PERCENT TO BILL PATIENT and 2ND PCT TO BILL PT above If you want the second percent to bill patient to take effect you must change CO PAY to NO at the time that START DATE FOR 2ND is to take effect CHARGE LIMIT If the patient can only be treated up to a maximum amount of charges or Insurance CAP i e Medicare 1740 00 CAP either determined by the insurance carrier or your credit policy enter that amount here PTOS will flag you if the charge limit has been reached as charges are
24. calculations can accurately reflect what has been collected on each procedure BILLING EFFICIENCY REPORT When you run patient and insurance billing PTOS will enter a PATIENT or INSURANCE HAS BEEN BILLED entry into the patient account You can then generate a BILLING EFFICIENCY REPORT This will show every claim or statement that was sent during the period you specify Also shown is the total number of bills sent the total amount billed and the smallest largest and average size of a bill We recommend the ideal size of an insurance claim to be 200 to 250 So you may want to try different billing options to achieve this goal INSURANCE BILLING EFFICIENCY REPORT FOR 04 10 01 04 10 31 PRINTED 04 10 31 DATE PAT DESCRIPTION AMOUNT CLAIM 10 15 000003 Aetna Life Ins billed 1144 00 f 10 01 10 09 1 1144 00 10 15 000007 Great West billed 154 00 10 01 10 09 1 154 00 10 15 000011 General Americ billed 196 00 f 10 01 10 05 1 196 00 10 15 000017 Henry Ford Hos billed 240 70 f 10 01 10 09 1 240 70 10 20 000058 Aetna Life Ins billed 428 00 f 10 04 10 12 1 428 00 10 20 000062 BC BS of NY billed 150 00 f 10 08 10 12 1 150 00 10 27 000066 Business Men s billed 144 00 10 08 10 22 1 144 00 10 30 000092 Henry Ford Hos billed 26 00 f 10 13 10 23 1 26 00 10 31 000106 Warner Life billed 269 00 f 10 27 10 28 1 269 00 10 31 000112 Creative Risk billed 132 00 f 10 08 10 12 1 132 00 10 31 000116 A amp P billed 67 00 10 10 10 12 1 67 00 23 10 31
25. dF 12 Y B v1003 Pam Simmons 97118 Electrical Stimulatio 32 00 AR 11 Y RA v1004 Kent LangenForth 95833 Comprehensive Exam 122 50 JT 11 Y RA v1004 Kent LangenForth 97110 Therapeutic Exercise 45 00 JT 11 N RA v1004 Kent LangenForth 99070 Cervical Collar 35 00 AR 11 N RA v1013 Pat Telen 97012 Traction Mechanical 40 00 AR 11 Y CB TOTALS 370 00 CHARGES 250 50 PAID 0 00 ADJUSTMENTS 5 VISITS 95 PRINT TRANSACTIONS SORTED BY THERAPIST This prints a list similar to the DAILY TRANSACTION REPORT sorted and subtitled by the treating therapist PRINT TRANSACTIONS SORTED BY DATA ENTRY ID This prints a list similar to the DAILY TRANSACTION REPORT sorted and subtotaled by the two ID code of the PTOS user who entered the transaction As explained in CHANGE PARAMETERS each user should be assigned a five character password which may be shared by several users and a unique two digit ID code When you start PTOS and enter this seven character USER ID PTOS tracks it and prints the two digit ID code on NEW AND DELETED TRANSACTION lists OTHER DAILY TASKS OPTIONS 1 VIEW ON SCREEN Instead of printing you can View on Screen to see what will be printed If you spot an incorrect entry you can go into ENTER OR ADJUST TRANSACTIONS and delete it BEFORE running the DAILY TRANSACTION REPORT If an entry is deleted BEFORE it s printed on the audit list it never becomes part of the patient s permanent record and therefore isn t included as a deleted
26. describe Hot packs Ultrasound Massage using RVS codes while CHUM could describe the same visit using CPT codes You may also have BHUM if you were using special codes for Blue Cross or any other coding systems When you establish insurance codes the first digit of the code MUST correspond to the procedure code type Let s say Prudential wanted RVS codes The code for Prudential would have to start with an R such as RPRU If Metropolitan wanted CPT codes used their insurance code would start with a C such as CMET When you post the transaction don t include the first digit of the procedure code the character that describes the coding type In our above example just post HUM PTOS will know that if the first digit of the primary insurance is R an RHUM should be posted to the account If the primary carrier was Metropolitan posting HUM would cause CHUM to be posted to the patient account If a patient has RPRU as primary carrier and CMET as secondary when the primary insurance is billed the RHUM code will be printed on the HCFA 1500 billing form and the CHUM code printed when the secondary is billed If you already have established Insurance codes and wish to change them see RENUMBER ACCOUNTS under SPECIAL TASKS NOTE Z codes are NOT translated Also PROCEDURE CODES to be translated MUST be at least 3 characters UPDATE PROCEDURE CO
27. entry on the report This just gives you a cleaner audit list When viewing the list you can show new transactions only deletions only or both new and deleted You can also sort the list by account number or the actual order they were entered into PTOS 2 BANK DEPOSIT SLIP If you wish PTOS can automatically print a bank deposit slip Since PTOS will only include NEW payments on this slip it MUST be run before the DAILY TRANSACTION REPORT is printed ONLY NEW PAYMENTS THOSE WHICH HAVE NOT PRINTED ON THE DAILY TRANSACTION REPORT ARE INCLUDED AND ONLY THOSE PAYMENTS WITH AN ENTRY IN THE BANK FIELD This field should contain the bank number for checks and may contain the entry CASH for a cash payment if you want cash included on the deposit slip When the slip is printed you have the option of subtotaling by check If one insurance check was applied to several patients you ll probably want it subtotaled You can also select that CASH be subtotaled again this is the preferred option UPDATE CODES This subject is covered in the first section of this manual CHANGE PARAMETERS This is covered in the first section of the manual ADD FINANCE CHARGES If you desire finance charges can be added to overdue balances This can help motivate patients to pay their bills in a timely manner PTOS allows you to select who should be billed finance charges and the interest rate to bill Before adding the charge Aged Accounts Rece
28. for each therapist by enter the therapist code and changing time slots as needed NOTE TIME PERIODS MUST BE SET FOR EACH THERAPIST BEFORE YOU CAN SCHEDULE PATIENTS FOR THAT THERAPIST THIS IS TRUE EVEN IF THEY WILL USE THE DEFAULT FORMAT You may view data for more than one therapist on the same screen as explained under VIEW AND UPDATE SCHEDULE HOWEVER time slots SHOWN will be for the first therapist listed To block out time for a therapist select this task Enter the date therapist code time slots to block and a description The block description will then be filled out in the patient name field for each of the slots This could be LUNCH MEETING or any other use Patient number is assigned XXXXXxX for these blocked out slots so if you wish you can run Schedule Lists for patient XXXXXxX to see what has been blocked BLOCK OUT TIME SLOTS ENTER DATE ENTER THERAPIST CODE ENTER SLOT 1SLOT 2 SLOT 2 SLOT 3 SLOT 4 ENTER BLOCK DESCRIPTION 102 REMOVE A PATIENT SCHEDULE Sometimes you may have a series of appointments scheduled for a patient and that patient drops out of therapy You can clear the patient out of the schedule by selecting this task and entering the patient account number LIST SCHEDULE MONTHS As mentioned above the schedule file will hold six months of scheduling for each therapist Select this option to see what is in the file and what can be cleared out 1 VIEW amp UPDA
29. format for billing If you want to bill only Medicare with Medicaid co pay type MM for account type If you want all Medicare whether they are MM MP or any other M account simply type M This means bill any patients whose first character is M If you want ALL account types just leave the field blank BILL BY NUMBER OR NAME RANGE If you re printing statements in Patient Number Order explained in STANDARD OPTIONS below a range of patient numbers can be specified to bill from and through This allows billing for a single location or other grouping of patients It can also be used if some statements are lost damaged or destroyed and you need to rebill a group If you ve selected the statements to print in Alphabetical Order then you want to specify a starting and ending patient last name either to group the patients or re run a set of lost or damaged bills LIMIT BILLING TO 55 CHARGES THAT INSURANCE HAS MADE PAYMENTS ON Checking this box will bill only charges that an insurance carrier has already made payments against or charges that have had WHO TO BILL marked as P bill to patient A Certified Rehab Agency for example may only bill the patient for a charge after Medicare has made a payment against that charge This option can only work if insurance payments are posted using the Line Item or Date Range format PATIENTS WHO HAVE NOT BEEN BILLED SINCE By typing the date to b
30. is used to add a new patient or to change or review information about an existing patient When selected the screen below will appear The top left box shows information about the currently selected patient Patient 040001 SMARTLEY MEGAN Birth Date 6 0244 08 14 1195 Pat Num To find a patient by name phone patient number social security number or primary insurance number id type the search criteria in the text box and click the appropriate button You don t need a complete name or phone number In the example below typing RO in the text box and clicking NAME causes BOB ROBERTS to be selected You can click the PATIENT button OR double click the highlighted account OR type ALT P to bring up the main patient data entry screen If you click the TRANS button or right click on the selected account or press ALT T the main transaction entry screen will come up Search Patient 040001 SMARTLEY MEGAN Phone Last Name ADELSTEIN ADLERSON ALEXANDER AMINE ANDERSON AQUINO BAKER BAKEWELL BOGGS BONNEY BONNEY 26 Assigning account numbers correctly is important The PATIENT NUMBER can be alpha or numeric The first digit MUST indicate the Revenue Center or LOCATION as it is referred to in PTOS lists and reports Most practices have one revenue center and will use patient numbers that all begin with 1 You can however use several revenue centers for a new office or perhaps a work ha
31. is useful in measuring the productivity of therapists The statistics can be used to assign patient loads calculate bonuses and analyze treatment trends It is important to keep in mind that the data shown on the MONTHLY report is calculated from the patient file This means it is a summary of PATIENTS ASSIGNED TO THE THERAPIST Charges payments and visits are totaled for patients assigned to each therapist If a therapist other than the assigned therapist treated a patient it is still calculated into the assigned therapists totals To see charges visits and payments by treating therapist you must use the YEAR TO DATE REPORT NOTE A therapist MUST be assigned to at least one patient that is have their code entered as assigned THERAPIST in the Patient File If the therapist doesn t appear at least once in the Patient File they won t be included on this report even if their code was used in posting transactions THERAPIST ACTIVITY REPORT FOR 04 10 01 04 10 31 ALL LOCATIONS THERAPIST PAID DISC TREAT PCT CHARGES PCr VISITS GM GEORGE MO 9783 90 55 4 11274 00 45 30 318 JJ JAMES JELLISON 10221 50 44 6 13605 00 54 68 23T TOTALS 20005 40 24879 00 549 The Therapist Year To Date Report shown below looks the same as the Referral report with the addition of a fourth PAID line for each therapist The PAID line shows total payments for each month of the year These four lines are totaled for each therapist and an additional amount TOT
32. no longer considered new If you later want a list of all transactions for a given day just go into OTHER LISTS and select TRANSACTION lists When you select Print New andDeleted Transactions the following menu appears PRINT NEW AND DELETED TRANSACTIONS 1 PRINT DAILY TRANSACTION REPORT 2 Sort by Therapist 3 Sort by Data Entry ID PRINT DAILY TRANSACTION REPORT The most important of these options is PRINT DAILY TRANSACTION REPORT This is your KEY audit list if you ever have questions of what was posted into PTOS When you run this list ALL new and deleted transactions will print for all offices and all locations The ENTER LOCATION and ENTER OFFICE parameters are not functional If you have the APS Accounting Module and have instructed PTOS to automatically update your General Ledger accounts the updating will take place as Print New and Deleted Transactions is run See the ACCOUNTING MODULE SUPPLEMENT for an explanation of how accounts are updated The automatic updating of General Ledger is set in the CHANGE PARAMETERS option of SYSTEM TASKS The following is a sample DAILY TRANSACTION REPORT Before you Print New and Deleted entries there are several other options you can select DAILY TRANSACTION REPORT FOR 07 01 2005 REPORT 746 PAT NAME CODE DESCRIPTION AMOUNT PT POS V ID 05 06 30 vV1001 DELETED 97128 Ultrasound 20 00 JT TD Y CB 05 07 01 V1021 Alex Roberts 97128 Ultrasound 20 00
33. of account type all account types that start with that character will print By filling out the parameters above in different ways you can get many types of audit lists If you want to see all entries for one patient fill in the FIRST and LAST PATIENT with the same account number and leave everything else blank If you want to see only one location such as location A the FIRST and LAST PATIENT numbers should be A through AZZZZZ By using five zeros and five Z s following the location letter A all patients for location A will print To list transactions for one day only use the same date for both first and last date ALL TRANSACTIONS If you select option 1 all transactions charges payments and adjustments will print in a format shown below Any confusion about which transactions were posted on a certain date or range of dates can be resolved with this audit listing If you select to sort the list by DATE the default all transactions are grouped in date order similar to the DAILY TRANSACTION REPORT and subtotals for each date are included If you sort by patient all entries for a patient are grouped together similar to the PATIENT STATEMENT and subtotaled by patient You may also sort by therapist transaction code or account type in which case all transactions are grouped and subtotaled accordingly Sorting by the first ten characters of description is very useful in grouping all transactions of a similar
34. on other reports that look for total payments it will be included It s important to retain your DAILY TRANSACTION REPORTS described in the section on SYSTEM TASKS so that if there is a discrepancy you can find out why The various reports provide productivity and statistical analysis of your practice Many of the PTOS reports use the same column headings so we ll explain them here in detail NEW are new patients for the time period A new patient is one whose DATE FIRST SEEN field in the Patient File is within the time frame of the report DISC The number of patients who were discharged during the report period For PTOS to know the patient was discharged you MUST fill out the DISCHARGE DATE in the Patient File ONGOING is the number of ongoing patients those still being treated A patient is ongoing if the DISCHARGE DATE has not been entered TREAT is total patients treated during the time period NOT the number of active patients For example if you ran the report for a one week period and even though some patients hadn t been discharged they didn t come in for treatment during that week those patients would not be counted under TREATED 68 NOTE The above four groups are NOT meant and probably won t balance from one report to the next For reasons like the one described under TREAT New patients plus Ongoing minus Discharged patients will only sometimes equal Treated patients CHARGES are total charges for the
35. on the next page This lets you post a write off to the charges you just recorded a payment against You can click NONE the default and skip posting a write off You can click MANUAL and the same range of dates will be pulled up on a screen similar to the above You can then enter an amount to write off against each charge If you select AUTOMATIC PTOS will calculate the difference between the amount posted and the expected amount of each charge you posted the payment against The system will show the TOTAL CHARGES and EXPECTED AMOUNT on these charges and the AMOUNT TO WRITE OFF on these charges If you select OK PTOS will automatically write off the difference With either a MANUAL or AUTOMATIC write off you can enter a WRITEOFF DESCRIPTION or use the F2 key to pull in a standard description from the PAYMENT ADJUSTMENT CODE library 48 Line Item Writeoffs You can either NOT POST WRITEOFFS default Y CHARGES LINE ITEM DATE RANGE INSURANCE PAYMENT This is similar to LINE ITEM only instead of FIRST DATE TO APPLY TO PTOS will ask FIRST DATE TO APPLY TO LAST DATE TO APPLY TO As with Line item enter WHO PAID the first date to apply it to and the last date the payment covers PTOS will calculate the balance that remains for the period specified and display it with other internal calculations in the format below Jil DATE RANGE PATIENT for ahars Bok OFFICE ACCOUNT TYPE MM Hiki PRIMARY INSURANCE PAYS 90 TOTAL C
36. period PAID or PAYMENTS are total payments received for the period Some reports break out patient PAT and insurance INS payments separately ADJUSTS shows NET adjustments debits less credits for the time frame of the report The number would be positive if debits exceed credits or it can be negative if credits exceed debits Some reports break out CREDITS and DEBITS separately to give detailed picture of the adjustments made to accounts VISITS or VIS represents the total number of treatments during the period A visit is a charge transaction where you have told PTOS that VISIT Yes UNITS are total treatment units When you create a PROCEDURE CODE or post an INDIVIDUAL transaction PTOS asks for units The total of these units are printed here PCT This is the PERCENT the previous column represents of the total AT or TYP is the patient s account type For many reports report such as the DELINQUENCY report knowing the type of account can be important AVG is the average of the preceding column for example average charges per patient may follow the CHARGES column The Daily Transaction Report from the Daily Tasks menu in System Tasks menu MUST be run before any Management Reports This assures that any newly entered transactions are included in the analysis Remember when you REMOVE OLD ACCOUNTS all data for those patients is deleted from the system Any payments or other activity for those patients will not be includ
37. post a 112 payment for the date range 11 10 to 11 15 PTOS would calculate that this equals 70 of the total charges and would apply 42 70 of 60 to the first charge and 70 70 of 100 to the second DATE RANGE POSTING offers the advantages of being almost as simple as BALANCE FORWARD POSTING while being much more accurate in applying the payment It is nearly as exact as LINE ITEM POSTING while involving much less work There is a fourth method of posting which applies only to patient payments If you designated CO PAY billing for the patient on the PATIENT DATA screen then a CO PAY amount will be tracked for each charge When you post a patient payment select CO PAY posting PTOS will ask for a date range to be covered similar to DATE RANGE posting If there were three visits during the date range selected with a CO PAY amount of 5 per charge PTOS would show an open CO PAY amount totaling 15 If the patient paid 12 PTOS would apply 5 to each of the first two charges and 2 against the third charge within the date range PAYMENTS If you want to post an INSURANCE or PATIENT payment click the PAY button on the main TRANSACTION screen PTOS then asks if you wish to post a PATIENT or INSURANCE payment and whether to use B alance forward L ine item or D ate range posting If you select a BALANCE FORWARD insurance payment the screen below appears PAYMENTS AND ADJUSTMENTS X PATIENT 060501 DAVIS GIAN OFFICE 1 ACCOUNT TY
38. post a patient payment for 300 00 Post any insurance payments credits write offs or debits in the same fashion 54 NOTE If you use an I code to post total charges to date these MUST be marked as having already been billed or the I code will be rebilled to the insurance To mark the I code as having been billed go into the SPECIAL TASKS menu select SEND LETTERS and type X as the selection This hidden option marks all charges in the system as having been billed and should only be run once after all beginning balances have been entered 4 PATIENT BILLING Billing is broken into two categories patient or insurance billing Both are flexible and can be accomplished in a variety of ways The screen below shows the Patient Billing selection which is displayed when PATIENT BILLING is selected from the task bar Insurance Billing Bill by Patient Number Range Patient from to Ending with Bill by Patient Name Range Patient from e not been billed since Bill by Date R Bill Only if There Send Patient Billing to ey Print There are three different ways of generating statements by Last Date Sent amp Account Type by Overdue Amount and by Patient Number The screen above shows the selection BY LAST DATE SENT amp ACCOUNT TYPE ACCOUNT TYPES First enter up to six account types to bill All patients in the selected categories will receive statements This is the most flexible
39. printed on October 27 2006 NAME Patient ADDR1 ADDR2 Account H PHONE FED TAX ID 12 3456789 pent Type Injured Physician Employer Prim Ins Diagnosis 71941 PAIN INJOINTSHOULDER Charge Patient Patient Insurance Open Amoun Amount Payment Credt Payment Credt Balance Customer Receipt Company Name Address1 Address2 TIN Patient GIANNA R Phone Accout 060501 Amex Discover MasterCard isa Cash Cheque Money Order Other Card Amount Signature Exp fo PRINT ORDER In addition to selecting the statement type STANDARD OPTIONS allows you to select whether you want the statements printed in alphabetical order or in account number order You can also indicate what data to include on the statements INCLUDE PAYMENTS amp ADJUSTMENTS When sending a statement for a legal case the attorney sometimes requests that no payments 61 and or adjustments appear on the statement You have the option of indicating not to include payments and or not to include adjustments INCLUDE AGING The patient statement normally includes a line at the bottom showing the aging of the account You may want to suppress account aging and can do so The rationale is as follows Some people like to show aging so the patient knows you are aware of the age of their account and you know they have an old balance Other people feel that if you show aging it implies you are willing to carry an account fo
40. selecting this option you determine who has access to which tasks ARDS AND SECURITY LEVELS D 8 TY LEVEL It is important that all passwords be filled out If you leave one blank anyone who signs on with a blank password can access the system 21 USER ID At startup PTOS asks for a USER ID There are 5 password settings but you may have a dozen or more users who need access to PTOS Everyone should be assigned a five digit password that corresponds to their security level In addition each person is assigned a two digit suffix In this way several people can share the same password level You do not need to enter the two digit suffix in PTOS only the five standard passwords Debbie XXXXXDB Sally XXXXXSA Bob XXXXXBO When you start PTOS and enter your USER ID enter the five digit password followed by your two digit ID This will be automatically entered when transactions are posted and when patient notes are entered for data entry tracking BILLING CODE TRANSLATION This is covered in UPDATE PROCEDURE CODES To turn the feature on type Y here PRINTER DIRECTION In most cases you will use LPT1 which is the PTOS Default You can however re direct your printer either permanently or for a temporary print run by selecting this option When selected the line below appears You can enter the appropriate code for printer direction INCLUDING AN ASCII FILE SUCH AS REP1 TXT FOR A MANAGEMENT REPORT You can then pul
41. sets a new baseline to measure collections for the next period Whenever you run option 2 a new baseline set Only payments posted after this will be in the next Monthly Collection Report 82 MONTHLY COLLECTIONS REPORT PRINTED 04 10 31 ALL LOCATIONS PATIENT AT CURRENT 30 60 60 90 90 120 120 PT 120898 Straman Larry L 0 00 70 00 100 00 300 00 0 00 AR 120909 Delon John L 0 00 100 00 200 00 90 00 0 00 AR 120936 Hansen May S 138 00 215 00 0 00 0 00 0 00 GM 120181 Irelan Harry L 0 00 60 00 60 00 150 00 1100 00 GM 120231 Sullivan Olive wW 50 00 0 00 12 00 78 00 218 50 BC GRAND TOTALS 188 00 445 00 372 00 618 00 1318 50 COLLECTION EFFICIENCY REPORT This report show TOTAL charges in the time frame you request It also shows the amount of UNPAID charges those with no insurance payments and PAID charges those that have had an insurance payment posted The total insurance payments patient payments and adjustments are included along with the balance still outstanding for these charges The most important information on this report is the last column AVERAGE DAYS This shows the average number of days from the time a charge is posted until the first INSURANCE payment is received COLLECTION EFFICIENCY REPORT FOR 10 01 2004 10 31 2004 PRINTED 10 31 2004 TOTAL UNPAID PAID INSURE PAT PD CHRG AVG INS CODE CHARGES CHARGES CHARGES PAID PAID ADJUSTS BALANCE DAYS AARP 75 00 75 00 0 00 0 00 0 00 0 00 0 00 BLSH 105 00 70 00 35 00 35 00 0 00 0 00 0
42. slip there is a special circumstance to be aware of Sometimes an insurance carrier will write one check to cover several accounts You must then make sure to enter the same bank and check numbers in each of the accounts Then when the BANK DEPOSIT SLIP is printed you will be asked if you want to SUBTOTAL BY CHECK PRIMARY SECONDARY INSURANCE The primary and secondary carriers are shown as a reference Enter a P or S in the PAID BY field so that PTOS can track who made the payment AMOUNT This is where you enter the amount of the payment LINE ITEM INSURANCE PAYMENT If LINE ITEM is selected as the payment type the same screen as on the previous page is shown except instead of amount PTOS asks IF PAID BY PRIMARY BILL REMAINDER TO ONLY P atient OR S econdary INS If this is a primary insurance payment and you type P the charges we ve just posted to will only be billed on a patient statement in the future If you enter S then the charges will be billed to the secondary insurance carrier and to the patient PTOS will also ask for the FIRST DATE TO APPLY TO After you enter the first charge date being paid by this check a screen similar to the following page appears All charges posted on or after the FIRST DATE TO APPLY TO are shown There is room for eight transactions per screen The first line for each charge shows the transaction date procedure code and description date billed to insurance and any co
43. t apply a Line item or Date Range payment to a debit To enter a Debit click DEBIT on the TRANSACTION screen and enter the description and amount A debit could be used to add interest to an overdue balance or to reverse an overpayment A DEBIT is also posted automatically by PTOS for some functions When you post a Date Range or Line item payment or adjustment or when a patient statement or insurance claim is sent PTOS creates a DEBIT to describe the transaction FINDING A TRANSACTION At times you may want to review or modify transactions which have already been posted When in the main TRANSACTIONS screen enter the first date you wish to view Click FIND or Press ALT F If atransaction was entered on or after the date requested it will be summarized on the 51 Jil FIND TRANSACTIONS Read Only PATIENT 1001 Rob AM MUST COLLECT COUNT TYPE mm OFFICE THERAPIST cP PLACE OF SERVICE _ ADJUSTS INS PAID PAT PAID INS BILL PAT BILL 1ST VISIT VISITS BILL TO P atient Sjecond Ins OR BLANK For All 4 AUTH VIS DATE BILLED EXPECTED AMC 65 00 PAT PAID 0 00 9 0 INS PAID 0 00 DESCRIPTION OV who gt RECORD 150 Bill to Patient LIST DELETE MODIFY QUIT Bill to S screen to find the first entry for the patient just click LIST The transaction will appear in the above format Different information is shown depending on the type of transaction The above example is a CHARGE If the transaction has
44. them If you ve filled out TOS in the PROCEDURE CODE it is automatically pulled in here If you ve entered a DEFAULT POS on the fourth patient screen this is automatically pulled in Both TOS and POS can be changed if needed COUNT AS VISIT YES or NO is used to calculate the number of patient visits on management reports The default is count as visit YES but if posting a supply item or possibly posting several procedure codes to cover the same visit you could change it to NO If the PROCEDURE CODE begins with a Z ZCANE PTOS will automatically set COUNT AS VISIT to N BILL PATIENT ONLY defaults to blank NO unless it has been set to YES for the specific PROCEDURE CODE If you specify YES to only bill this transaction to the patient then it will not be included on the HCFA 1500 billing form You can also enter an S here telling PTOS to bill the charge to the secondary insurance but not the primary CO PAY will only appear if you selected CO PAY BILLING YES for this patient on the second 43 Patient Data Screen It will show the co pay amount you have entered in the patient file If CO PAY has been set to yes but no co pay amount has been entered in the patient file then the co pay amount entered in the PROCEDURE CODE will be selected You can type a different amount including 0 under CO PAY if it needs to be customized for this entry DIAGNOSIS The patient s diagnoses are shown here and th
45. using procedure codes Using PROCEDURE CODES is one of the biggest time savers in PTOS Since every office has it s unique charges and even different descriptions of various procedures we ve found that a standard set of procedure codes just doesn t work you need to create your own BILLING CODE TRANSLATION It is becoming more and more common for the patient s primary insurance to use one type of coding system such as RVS and the secondary carrier to use something different such as CPT We have incorporated a feature called BILLING CODE TRANSLATION that makes translation to the appropriate coding automatic If one or more of the following cases apply to you BILLING CODE TRANSLATION may be a solution 1 Do you have different insurance carriers that require different CPT RVS codes on HCFA 1500 or UB92 forms for the same procedure 2 Do you have different fee schedules for different types of insurance coverage 3 Do you want to track different EXPECTED PAYMENT amounts from various insurance carriers i e the expected payment from Medicare is different than from Work Comp To use Billing Code Translation first select CHANGE PARAMETERS from the SYSTEM TASKS menu then select BILLING CODE TRANSLATION For the translation to work the following coding rules MUST be followed 13 THE FOLLOWING ONLY APPLIES IF BILLING CODE TRANSLATION IS USED The first character of the procedure code MUST indicate the coding type RHUM could
46. you can include a second line for each day which will show the expected amount and total payments received TOTALS print at the bottom of the page as well as Net Change in 73 accounts receivable charges plus debits for the month less payments and credits for the period included along with average visits per day and average charge per visit This is the second management report that is used to balance MONTH END ACTIVITY COLLECTION ANALYSIS FOR 07 10 04 07 10 04 PRINTED 07 10 04 DATE CHARGES INS PAID PAT PAID 04 10 01 92 50 0 00 0 00 04 10 02 376 50 40 00 0 00 04 10 03 286 00 30 00 20 00 04 10 04 200 00 0 00 0 00 04 10 08 132 00 0 00 0 00 04 10 09 157 00 360 00 0 00 04 10 10 92 50 0 00 0 00 TOTALS 2197 00 420 00 20 00 NET CHANGE 1645 00 WORKING DAYS 7 DELINQUENCY REPORT When the delinquency report shown on the next page is printed you can select accounts with balances over 30 60 90 or 120 days You can also only print accounts with no recent payments to find the truly delinquent accounts DEBITS 0 00 00 00 00 0 0 0 00 0 0 0 0 00 AVG VISITS DAY 3 CREDITS 0 00 25 10 85 00 0 00 8 80 118 90 VISITS 2 5 00 6 00 3 is 5 PAA 26 AVG CHARGE VISIT 00 00 ALL LOCATIONS UNITS 7 00 16 25 18 25 8 50 7 50 15 25 6 75 79 50 84 50 This report uses 2 or 3 lines for each patient The first line shows patient number and name aging category totals tot
47. you have selected the correct patient account PTOS asks for the transaction date you wish to work with The date defaults to the SYSTEM DATE but you can enter any date needed Next indicate if you want to add find or list transactions If you have entered a CLOSING DATE in the ACCOUNTS RECEIVABLE section of CHANGE PARAMETERS in the SYSTEM TASKS menu no transactions prior to the closing date can be entered deleted or modified 41 ADDING CHARGES If you wish to add a charge single charge click CHARGE PTOS will then ask for a TRANS CODE You may enter on the PROCEDURE CODES you ve created or enter I to enter an INDIVIDUAL charge PROCEDURE CODE This is usually the most efficient way to enter information Just type the appropriate PROCEDURE CODE If you aren t sure what the code should be look to the top of the ENTER OR ADJUST TRANSACTIONS screen where the LAST CODE used is displayed If this isn t the right code for today s visit you can press the F2 key or double click to display any codes that might apply If the treatment consists of Ther Ex type THER EX as the name to search and press lt enter gt Any PROCEDURE CODE which contains THER EX anywhere in the STATEMENT DESCRIPTION is listed After selecting the code all procedure data is displayed for verification including descriptions codes and fees This is shown on the screen below If this is the right code click ACCEPT or you can use the VCR buttons to find anoth
48. you send letters to patients who have been removed from the active data files The same field formats are used as described in DIAGNOSIS letters above LABELS FOR EMPLOYERS This lets you print labels for an employer or group of employers SCHEDULING AND SUPERBILLS This option allows you to schedule patient visits review schedules and print superbills or charge tickets for patients who are scheduled When this task is selected the menu on the next page appears SCHEDULING AHD SUPERBILLS 1 View amp Update Schedule 2 Print New and Modified Entries 3 Print Schedule Lists 4 View Schedule for a Patient 5 Print Schedule for a Patient 6 Print Superbills 7 Maintain Schedule File 7 MAINTAIN SCHEDULE FILE Before you can start entering patients into the schedule there are some setup procedures that must be performed We ll start by covering the Maintain Schedule File options MAINTAIN SCHEDULE FILE 1 ADD A NEW MONTH 2 DELETE A MONTH 3 RESET SCHEDULE FILE 4 SET TIME PERIODS 6 REMOVE A PATIENT SCHEDULE 7 LIST SCHEDULED MONTHS 101 ADD A MONTH You must create a monthly schedule for each therapist that will use the system When you select option 1 you are asked for the two digit therapist code to schedule and the month to create the schedule for PTOS then creates a schedule with forty four time slots for each day of the month you ve selected Repeat this for each therapist in each month
49. you wish to schedule If the month s schedule has already been created for the therapist PTOS warns you and won t let you duplicate it If the therapist does not already have any schedule PTOS tells you in case you are accidentally scheduling an invalid therapist code DELETE A MONTH Each therapist monthly schedule takes up about 100KB of disk space It then is important to free up space when possible You can not have more than six months scheduled for any one therapist If for example you had January through June scheduled for therapist GM January would have to be deleted before July can be added To delete a month select this option enter the month to delete and PTOS lets you select a specific therapist or you can delete the entire month for all therapists RESET SCHEDULE FILE As with other PTOS data files the Schedule File should be reset weekly to keep it in its most efficient format SET TIME PERIODS We supply a standard schedule format for time slots This can and should be modified for your practice To modify time periods select this option and the screen on the next page will appear SET TIME PERIODS ENTER THEREAPIST CODE OR XX FOR DEFAULT FORMAT TO SET To change your default settings enter XX and the standard time periods shown on the next page will be shown for editing You can then go through and enter your own time slots This XX code is now your default format You can further customize the schedule
50. 0 207 00 384 00 0 00 792 00 120925 Rumph George L 108 00 114 00 60 00 0 00 0 00 282 00 120935 Coulter Fred 1 78 00 306 00 100 00 0 00 0 00 484 00 120936 Hansen May S 138 00 215 00 174 00 0 00 0 00 527 00 120080 Bormalham Mason L 24 00 180 00 270 00 226 00 892 00 1592 00 120181 Irelan Harry L 90 00 360 00 306 00 539 00 1140 00 2435 00 120231 Sullivan Olive WwW 138 00 84 00 12 00 72 00 258 52 564 52 SUB TOTAL 8 PATIENT S 1050 00 2294 00 2041 00 1773 00 3184 52 10342 52 PERCENTAGE OF SUB TOTAL 10 15 22 18 19 13 17 14 30 76 A R BY ACCOUNT TYPE This prints in the format described above grouped and summarized by Account Type If this option is selected you can specify one account type to print A R BY INSURANCE This format is shown in the example above Itis grouped and summarized by PRIMARY insurance carrier If you wish you can print the report for one specific insurance carrier A R BY THERAPIST Prints in the same format described above only grouped and summarized by Assigned Therapist NOTE A R by Account type Insurance or Therapist can be printed in Summary format if desired This means that instead of printing a line for each patient only a one line summary for the Account Type Insurance Carrier or Therapist will print EXPECTED A R Expected accounts receivable reports print in the same formats as the above They are based on the amounts you have designated as EXPECTED when you created the PROCEDURE CODE o
51. 0 form One version has several black bars in the top left corner the other version does not The bar code version is not very common but some insurance may require it If you don t use the bar code version PTOS will automatically type the name and address of the insurance carrier in the top left corner and this is the standard format for the HCFA If you need the bar code version you can indicate that here 66 This moves the insurance carrier name and address to the far right of the top of the form CHARGES PER LINE In the charge section box 24 there is room to fit two lines per block This is acceptable by most insurance and cuts the number of forms you send in half Sometimes an insurance carrier may insist that only one line per block be used If this box is checked two charges will print on each line If it is not checked only one charge per line will print INCLUDE LINE ITEM PAYMENTS ADJUSTMENTS If you have used Line Item or Date Range posting described under Enter Transactions payments and or adjustments can be applied against individual charges If you are billing a secondary carrier you can select to have payments and or adjustments already received for the charge included under the Payments total on the claim ENTER INSURANCE BILLED You may include an Insurance has been billed statement in the patient account This is a regular DEBIT transaction in a format which states the carrier name the
52. 00 23 BLUE 200 00 0 00 200 00 140 00 50 00 10 00 0 00 25 DWP 70 00 20 00 50 00 0 00 20 00 543 25 00 MCAR 175 00 75 00 100 00 50 00 20 00 10 20 00 21 GRAND TOTALS 625 00 240 00 385 00 00 90 00 25 45 00 23 MEDICARE LOG This report is designed as a summary of activity for Rehabilitation Agencies It contains a great deal of information and therefore prints on two pages as shown on the next page The last column on the first page and the first column on the second page show the patient number By aligning these columns you in effect have a double wide report The first page contains patient name date range of treatment primary insurance ID HIC patient birthdate primary insurance code and last date the insurance was billed for the date range being printed Total charges are shown along with a 20 and 80 standard Medicare breakdown The second page breaks down total PT OT Speech and OTHER charges and visits Proper coding must be used as explained in UPDATE PROCEDURE CODES for Rehab Agencies Total insurance and patient payments and credits for these charges are included 83 MEDICARE LOG REPORT FOR 2004 07 01 2004 07 31 PRINTED 04 07 31 NAME DATE RANGE HIC BIRTH INS BILL TOTAL PAT Roberts Bob 0515 07089 554672234 122120 780 F 1001AR Aaron Robert 0621 07089 176549895 100423 MEDI 07084 1109 F x 1003RO Abbott Phil 0610 07129 172543199 011918 MEDI 07264 1498 y 4 10140P Abrams Gerry 0702 07089 186288944 121515 MEDI
53. 11 15 9 18 11 VIS 14 20 11S 70 67 69 150 70 114 63 DENNISON NEIL M D TOTAL CHARGES 27810 REFERRALS 113 VISITS 533 NOTE A doctor MUST be in the REFERRAL FILE to be included in this report OUT OF BALANCE REPORTS If you are posting payments or credits using the Date Range or Line Item method and entries are deleted incorrectly or a data file is damaged it is possible for the account to become out of balance This results if the amounts paid or credited to each charge do not match the corresponding debit that PTOS creates during posting Running this report lists any accounts which are out of balance showing whether patient or insurance payments or credits are out of balance and by how much You can then list transactions for the patient to see where the error has occurred 75 ACCOUNT TYPE SUMMARY This provides an analysis by account type similar in content to the Referral report You can select Monthly or Year To Date report formats ACCOUNT TYPE SUMMARY FOR 04 07 01 04 07 31 PRINTED 04 10 31 LOCATION 1 AT PAID NEW ONGOING DISC TREAT CHARGES POY VLISITS PCr C 2340 00 31 3 rL 3132 00 23d 43 11 81 L1 5640 00 3 15 f 2941 00 208 38 10 44 MC 2259 20 s 4420 00 56 45 12 Pil 1859 20 lt 8420 00 72 95 26 WC 8198 00 11458 00 73 143 39 TOTAL 20296 40 30371 00 364 THERAPIST ACTIVITY REPORT As with the previous two reports Therapist Activity can be run in a monthly or year to date format The monthly report
54. 1500 is referring doctor but some insurance types especially HMO s may require the primary care physician PRINT I CD9 OR D ESCRIP IN BOX 21 On the HCFA 1500 the standard format is to print the ICD9 code rather than a descriptive diagnosis If you want to print the description for this account type enter D here PRINT DECIMAL IN ICD9 CODE Y N Normally a decimal in the ICD9 code will print on the HCFA form You can suppress it for an account type by selecting N here ADD DESCRIP TO MODIFIER IN 24D Y N There are six spaces after the modifier in BOX24D If you enter YES the first six characters of the procedure description will print PRINT PROVIDER CODE IN BOX 24K Sometimes treating therapist PIN numbers should be printed in BOX 24K of the HCFA 1500 This can be specified here by entering Y TREATMENT PLAN DESCRIPTION FOR LINE 1 BOX24 Some account types require a description such as PLAN OF TREATMENT ON FILE to print on the insurance form Enter an appropriate description here or leave the line blank if no description is needed UB92 VISIT REVENUE CODE This and A3 below apply only to Certified Rehab Agencies When billing on the UB92 some intermediaries require treatment codes to end with 0 other intermediaries require a 1 for example 420 or 421 are used as physical therapy treatment codes Depending on the account type this parameter allows you to control the codes printing on
55. 3 522 s 296 00 EMG EMG Biofeedback 768 522 84 68 32 388 19 84 CB Contrast Bath 496 412 86 83 24 201 A 62 86 GT Gait Training 260 171 78 66 LO 93 130 41 78 HP Hot Packs 240 237 14 01 L8 189 156 81 14 ICE Ice 1050 931223 89 21 775 649 282 23 MS Massage 580 545 35 94 4 449 309 236 35 MB Mobilization 780 770359 OL 27 602 467 303759 PAR Paraffin 120 103 57 86 4 201 104 ic ee PHNP Phonophoresis 108 93 21 86 5 72 67 52 21 RM Range of Motion 612 540 36 88 31 475 340 200 36 ST Strength Testing 5724 542 14 95 L6 448 300 270 14 TR Traction 695 664 34 96 20 523 380 284 34 US Ultrasound 390 382 68 98 33 224 240 232 68 WP Whirlpool 560 390 78 70 8 301 302 00 88 78 TOTALS 9641 00 8204 04 6369 5671 00 3891 00 77 Collection and profit information can only be computed if LINE ITEM or DATE RANGE posting is used to enter payments This way PTOS knows what was paid for each procedure Remember payments for a charge may not come in for several weeks So collection and profit amounts for the CURRENT month will probably be understated You may want to run this report twice once to get a report of what was billed for the current month and a second report for two or three months prior which would show what was billed collected and the profit from past billing You can select the Procedure Summary report for Zero balance charges only This means the charge has either been completely paid or adjusted off so that the report
56. 6 10 27 06 PRIMARY INS PYMT pd 162 92 FOR 10 13 10 1 10 27 06 Insurance Writeoff cx 127 08 FOR 10 13 10 510 00 290 00 YOUR PROMPT PAYMENT WILL BE APPRECIATED THANK YOU CURRENT WER 30 OVER 60 OVER 50 175 00 0 00 0 00 0 00 OVER 120 PATIENT AMOUNT DUE 0 00 59 PAYMENT STATEMENT PHYSICAL THERAPY CLINIC ARIA REVERLY RIND LOS ANGELES CA 90048 213 550 7777 FED TAX ID 95 1762531 DAVIS BRUCE 456 ELM ST SPOKANE WA 99026 ACCT 060501 BC TA DIAGNOSIS PAIN IN JOINT SHOULDER 10 13 06 10 13 06 10 13 06 10 15 06 10 15 06 10 26 06 10 26 06 10 26 06 10 26 06 10 27 06 10 27 06 CURRENT 175 00 57001 PT EVALUATION 97110 THERAPEUTIC EXERCISE PAT CHECK PD 15 00 FOR 10 13 10 13 6 57110 THERAPEUTIC EXERCISE 97035 ULTRASOUND CA BLUE CROS billed 320 00 for 10 13 10 15 6 97110 THERAPEUTIC EXERCISE 57140 MANUAL THERAPY TECHNIQUES PAT CHECK PD 30 00 FOR 10 15 10 26 6 PRIMARY INS PYMT pt 162 92 FOR 10 13 10 15 6 Insurance Writeoff cxe 127 08 FOR 10 13 10 15 6 STATEMENT DATE 10 27 2006 PATIENT INJURED PHYSICIAN EMPLOYER YOUR PROMPT PAYMENT WILL BE APPRECIATED THANK WER 30 OVER 60 OVER 90 OVER 120 0 00 0 00 0 00 0 00 GIANNA R DAVIS 10 01 2006 AMAYA CELESTE APS ADVANCED PRACTICE SYSTEM ABSAS AUABANE SLYD ATE 408 CA 91356 14 69 86 28 50 16 50 l I 57 00 18 00 12 28 22 72 92 127 08 60 GRAPHICAL SUMMARY STATEMENT Patient Bill
57. 93 00 1523 00 1054 00 0 00 5233 70 60 9323 0 420 320 90 0 0 230 546 232 90 00 00 00 00 00 00 00 00 00 00 11157 00 30 60 0 00 0 00 146 00 70 00 70 00 0 00 0 00 98 00 0 00 270 00 7029 00 CURRENT 0 0 0 40 0 1000 00 00 00 00 00 00 00 00 00 00 1603 00 04 04 04 04 PAID 04 11 2112 00 03 21 02 21 04 12 453 34 04 01 24 880 00 04 03 19 74 REFERRAL REPORT When the Referral Report option is selected there are two formats from which to choose The Monthly Referral Report asks if you want Primary Doctor Referring Doctor or Attorney The report then lists all physicians or attorneys who have referred patients with a summary of activity represented by each referral including the last date a new patient was referred This report is valuable in analyzing which doctors are sending profitable referrals Running the report on a monthly basis provides an accurate gauge of increasing or decreasing activity of various physicians NOTE Since this report uses the entries you place in the REFFERAL SOURCE or ATTORNEY fields in the patient file the referral or attorney may print more then once on the report IF YOU HAVE SPELLED THEIR NAME DIFFERENTLY for different patients REFERRING DR REFERRALS FOR 2004 07 01 2004 07 31 PRINTED 04 07 31 LOC
58. ATION 0 REFERRAL SOURCE NEW DISC TREAT PCT CHARGES PCT VISITS PAID LAST REF CARLSON BILL MD 15 27 3 4114 00 26 09 65 100 00 04 06 30 DEBBANS JOSEPH MD 11 20 0 2138 00 13 56 45 234 40 04 07 22 DRAKE ERNEST MD 1 148 390 00 2 47 10 70 00 04 07 02 MARTIN RONALD MD 14 25 5 86 00 32 89 61 1020 00 04 07 04 JAMES JOHN DDS 3 5 5 1138 00 7 22 31 234 10 04 05 21 JAMES WILLIAM M D 6 10 9 2132 00 13 52 33 2301 00 04 06 20 JOHNSON ED M D 1 148 08 00 70 12 20 00 04 07 13 STEVENS JOHN D D S 4 es 560 00 3 55 48 134 00 04 07 02 TOTALS 55 15766 00 305 12457 20 GS Qo CAE oB UR YN ok lt 7 ORE WD ae e SO OA SS gt N The second Referral Report format is a Year To Date summary an example of which is shown on the following page You define the months to show under CHANGE PARAMETERS in SYSTEM TASKS PTOS then calculates the charges visits and new referrals for each month of the year In order to fit all 12 months on one line cents are dropped from monthly charges only the dollar amount is shown REFFERALS YEAR TO DATE FOR 2004 PRINTED 04 10 31 FIRST LINE CHARGES DOLLARS SECOND LINE REFERRALS THIRD LINE VISITS 04 0 04 02 04 03 04 04 04 05 04 06 04 07 04 08 04 09 04 10 04 11 04 12 1244 3412 2231 3451 2672 4312 3313 1123 7612 4231 REF 3 5 12 3 7i 9 Pi 5 12 9 VIS 2 62 42 70 47 719 60 30 120 83 CULLMAN JOHN M D TOTAL CHARGES 39120 REFERRALS 93 VISITS 603 944 1112 5331 2431 2655 3TI2 5383 2423 5611 331 REF J 6 10 6 7
59. CE Joare__ cope Description _ fa 2003 05 2 2003 05 21 aooaiosi29 HP 1 2oosiosiaqmus zose 2oosioemog HP KI Charges Expected Patient Paid Insurance Paid Adjustments Total of Co Pay Total Balance 59200 0 00 D 86 00 E mon If you want to see all payments and adjustments that have been made on a specific charge click the SHOW DETAIL button at the top left A DETAIL box will open showing all activity on the transaction The screen below shows detail on the charge from May 19 It indicates that a payment and write off were posted and that 55 of the payment was applied CHARGES PAIDIADJ Charges 00 0 00 PdJAdjusts 65 00 QUIT ENTERING BEGINNING PATIENT BALANCES When you first install PTOS you need to post the patients current balances into the system The simplest method is to use a DEBIT to each account with the description Balance Forward and the amount of the patient s current balance By entering all patients current balances in this manner your accounts receivable totals will be accurate from the start The approach above gives an accurate balance but does not let you see the total charges adjustments or payments made on each account A second method is to take total charges payments and debit and credit adjustments for each patient and post the totals into PTOS If total charges were 1200 00 post an I code as explained above If the patient has paid 300 00
60. CHANGE PARAMETERS section Once you select a format all dates must be entered the same way NOTE This is only for entering data and will not affect printing of reports or lists SHORTCUT KEYS Many options have shortcut keys These are underlined letters that call the option just as though you had clicked the entry with your mouse To select PATIENT DATA from the task bar for example hold down the ALT key and press P CANCEL PRINT If you have sent output to your printer whether a report insurance claim or other output you can cancel the print job by pressing the ESCAPE KEY lt ESC gt Note that if you have a print spooler or a large print buffer output already sent to the printer will continue to print INSERTING VS OVERTYPING When you type data into a field it will normally overtype replace what is already there You can use the cursor arrow keys to move to exactly where you want to be when overtyping If you wish to insert something rather than overtype press insert key on your keyboard Press it again to go back to the overtype mode When typing data into a field press lt tab gt or lt enter gt when you are finished This tells PTOS to move to the next field If you fill a field PTOS will know you are finished when the last character is filled and will move to the next field There are three delete keys that you can use when entering data CTRL G deletes a character CTRL T deletes a word CTRL Y
61. CODES If you bill for mileage usually for a contract or home health there is a special type of procedure code that can automatically calculate the fee Mileage codes begin with ZMI as explained in the UPDATE PROCEDURES CODES section The per mile fee is the AMOUNT entered in the PROCEDURE CODE When you post the mileage procedure code enter the number of miles driven in the DIAGNOSIS field PTOS will multiply this number by the per mile fee and post an I code to the patient account with the proper description and charge BILLING CODE TRANSLATION Billing code translation is explained under UPDATE PROCEDURE CODES If you elected to use the option when you post a charge don t include the first character of the code This is the character that describes the coding type For example if HUM is used for Hot Packs Ultrasound and Massage you would have a code BHUM for Blue Cross and PHUM for Prudential Typing HUM as the procedure code would pull in BHUM for any accounts whose primary insurance code starts with a B Blue Cross If the first digit of the primary carrier code was P such as PRU for Prudential posting HUM would cause PHUM to be posted NOTE If BILLING CODE TRANSLATION has been selected and you use the F2 KEY to pull up a PROCEDURE CODE then you will cursor down highlight and select the ACTUAL CODE you need For example select RHUM not HU
62. COPYRIGHT 1983 2006 APS Advanced Practice Systems LLC 18455 Burbank Blvd Suite 408 Tarzana California 91356 818 705 0963 COPYRIGHT NOTICE This software and operations manual are both protected by U S Copyright Law Title 17 United States Code This software and publication have been provided subject to a license agreement which restricts their use No part of this software or user manual may be copied or distributed disclosed transmitted or reduced to any electronic medium without the express written permission of APS Advanced Practice Systems LLC Infringement of copyright can result in criminal prosecution fines and imprisonment in addition to civil damages DISCLAIMER This software and manual are provided on an as is basis Except for the warranty described in the Physical Therapy Office System software license agreement there are no warranties expressed or implied including but not limited to implied warranties of merchantability or fitness for a particular purpose and all such warranties are expressly and specifically disclaimed In no event shall APS Advanced Practice Systems LLC be responsible for any indirect or consequential damages or lost profits even if APS Advanced Practice Systems LLC had been advised of the possibility of such damage LOADING PTOS FOR WINDOWS Minimum Requirements IBM PC Compatible Computer Windows 95 98 2000 XP or NT 64 Megabytes Memory 256 Meg Recommended Display capab
63. DES You are now ready to lay out the combinations of individual procedures that you will commonly use The unusual combinations used infrequently can be ignored Now assign PROCEDURE CODES of up to five digits to each SAMPLE PROCEDURE CODES HP1 Hot Packs 15 min HTX1 Hot Packs 15 min Ther Ex 15 min HTX2 Hot Packs 15 min Ther Ex 30 min HTX3 Hot Packs 15 min Ther Ex 45 min HTX1 Hot Packs 15 min Ther Ex 15 min Traction 15 min HTX2 Hot Packs 15 min Ther Ex 30 min Traction 15 min HTX3 Hot Packs 15 min Ther Ex 30 min Traction 30 min kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk Important IF YOUR OFFICE IS A CERTIFIED REHABILITATION AGENCY AND YOU WILL USE THE UB92 FORM TO BILL MEDICARE ALL PROCEDURE CODES MUST START WITH ONE OF THE FOLLOWING NUMBERS TO GET THE PROPER REVENUE CODES ON YOUR BILLING 1 Physical Therapy Visit 4 Speech Therapy Evaluation 2 Physical Therapy Evaluation 5 Occupational Therapy Visit 3 Speech Therapy Visit 6 Occupational Therapy Evaluation For example Hot Packs 15 min Ther Ex 45 min would be 1HTX3 instead of HTX3 If you offer other services and use other codes such as Nursing Services or Psychological Services call the Support Center for assistance in assigning codes to this services 14 If you will use BILLING CODE TRANSLATION the first digit of the Procedure code must correspond to the in
64. Date Credit Balance Accounts Discharged Pre Billing Edit Dropout Co Pay Accounts No Activity Patients At Charge Limit Payment Plan Deductible Balance Calculated on Expected Amount HIPAA Dates TREATMENT LISTS BY DOCTOR When you select a list there are several questions PTOS asks to let you specify exactly who you 84 want included and how you want the data sorted and totaled Much of this is the same regardless of which list you select If you select PATIENTS BY DOCTOR the following screen appears Primary Doctor Last Patient Account Type List Only Therapist List Only Account Type CO Include Discharged And Dropout Patients O Include Patien Print Report Many of the above parameters appear on each of the PATIENT LIST options These parameters allow you to specify a range of patient account numbers You can also select one office one therapist or one account type NOTE If you enter only the first character of account type all account types that start With that character will print Some parameters vary from list to list In this example you select whether to list the referring or primary care doctor the default being referring doctor You can also ask for one specific doctor such as listing only patients referred by Dr Smith PTOS also asks if you want only doctors who referred patients after a certain date allowing you to suppress inactive doctors The SORT BY field appears on most lists This is a su
65. E APPEALED DENIED DELETING A TRANSACTION If a transaction has been entered incorrectly and the incorrect data is in a field that CANNOT be 52 modified such as patient number date or code it must be deleted and re entered properly This prevents any accidental or unauthorized changes to patient charges or payments First FIND the incorrect entry then click DELETE If an entry is deleted in this manner the patient balance is adjusted immediately When you delete a transaction that has already been run through Daily Tasks the deleted transaction will appear as a Newly Deleted Transaction so that it will print on the Daily Transaction Report as an audit of deleted entries If you need to delete a CHARGE that has had a Date Range or Line item payment or credit posted to it the amounts under CREDITED INSURANCE PAID and PATIENT PAID must first be reversed Otherwise your payments or adjustments would be out of balance To do this either delete the DATE RANGE or LINE ITEM payments or adjustments that posted an amount to the charge or post a NEGATIVE Line item entry to the CHARGE as described below DELETING DATE RANGE OR LINE ITEM ENTRIES If you want to delete a LINE ITEM or DATE RANGE payment or adjustment it can become a little more involved When you posted the payment or adjustment PTOS put the amount paid or credited in the INSURANCE PAID PATIENT PAID or CREDIT fields of the charge being paid or credited If for exampl
66. ENT DATA ENTRY screen NOTES LINE 1 and 2 are the most significant and we suggest using them for tracking specific information For example you could dedicate NOTES 1 for insurance authorization information so it s always easily accessible NOTES LINE 1 Notes can be entered and tracked for each patient Any notes relating to the account can be entered for example collection notes or missing items from the patient chart A list can be printed from the PATIENT LISTS menu of any patients with entries in these fields NOTES LINE 2 We recommend this line to enter the most current collection information When you run DELINQUENCY REPORT PTOS asks if you want NOTES LINE 2 on the report for each of the delinquent accounts allowing the most current collections notes to be printed EMPLOYMENT RELATED Indicates if the patient is being seen for an employment related condition Y es or N o This field will print in box 10A on the HCFA form OCCUP Patient s occupation DISC INFO A description of the patient s condition on discharge can be entered and is printed on various reports PATIENT DATA SCREEN 3 INS 4 Patient Date Screen 3 Ins Locked 3 Patient 060501 Primary Insurance BCOC Adjuster Group 0 ID Employer Relation to Insured 2 Accept Assignment Y i a 1979 Gender M Secondary Insurance AET AETNA 800 424 4047 2nd Account Type PC v Adjuster Insured Name Group ED PRACTICE SYSTEME
67. EPHONE TRAINING SESSIONS APS has developed a series of one hour phone training modules to make learning PTOS even easier You can purchase individual beginning or advanced modules or a package of several introductory modules Call the APS Support line for more information SEMINARS APS continually offers basic and advanced training seminars across the country These help you learn PTOS as a new user and gain additional expertise as you become familiar with the system For more information call the APS Support line STARTING PTOS If you have set up an ICON for PTOS just click on it Otherwise select VPTOS from the PROGRAMS list The system first asks for System Date This can be different from the actual date If today is February 3 and you are still inputting data and running reports for January you can type a system date of January 31 USER ID After entering a valid date PTOS asks for your User ID When you first receive PTOS there are no user ID s set you can just press lt enter gt to proceed The office manager should select CHANGE PARAMETERS in SYSTEM TASKS to create user ID s and password levels This process is explained in CHANGE PARAMETERS The TASK BAR below is displayed showing options which you can select Each of the selections will be covered in detail in the following sections Patient Data Transactions Billing Reports Patient Lists Other Lists System Tasks Special Tasks UPDATE CODES
68. EXPECTED AMOUNT of each charge If CO PAY BILLING was selected then the deductible is calculated and the co pay amount of each charge is added after the deductible has been reached If the balance on the charge has been transferred to the patient by marking WHO TO BILL with a P then the patient is responsible for the remainder on the charge All C patient credits and S patient payments are then credited against the patient portion of the bill the result of all the above being the AMOUNT DUE total It s possible for the AMOUNT DUE total to be printed as a negative number a credit balance This would happen if you have entered zero as the PERCENT TO BILL PATIENT in the Patient Data File and then you ve posted patient payments or credits indicating to PTOS that the patient has paid more than they were responsible for SUMMARY STATEMENT H INIC PAYMENT WILL BE APPRECIATED 60 58 DETAILED STATEMENT PHYSICAL THERAPY CLINIC AGS BRVERLY AID LOS ANGELES CA 90068 213 550 7777 FED TAX ID 95 1762531 DAVIS BRUCE 456 ELM ST SPOKANE WA 99026 STATEMENT DATE 10 27 2006 PATIENT GIANNA R DAVIS INJURED 10 01 2006 PHYSICIAN AMAYA CELESTE EMPLOYER APS ADVANCED PRACTICE SYSTEM ARSAS BURBANK BLVE ATE 408 TARZANA CA 91356 ACCT 060501 BC TA DIAGNOSIS PAIN IN JOINT SHOULDER DATE RVS CPT 10 13 06 97001GP PT EVALUATION 10 13 06 57110GP THERAPEUTIC EXERCISE 28 50 16 50 10 13 06
69. HARGES IN DATE RANGE EXPECTED AMOUNT IN DATE RANGE INSURANCE OF TOTAL CHARGES INSURANCE OF EXPECTED AMOUNT TOTAL OPEN AMOUNT AMOUNT TO POST 240 00 Let s go over what these totals mean When you created the INSURANCE CODE you specified a percent that the carrier normally pays when they are the primary insurance In the case above it was 90 PTOS displays the percent you ve entered then shows the total charges for the date range you ve selected When you created the procedure code you entered the amount you expect to receive as opposed to what you bill The total expected amount is also displayed PTOS then multiplies and displays the insurance percent of total charges and expected amount The insurance payment should be equal to or between these two numbers If it s not they probably disallowed some charges and depending on the difference you may want to check into why there is a discrepancy If this seems complicated at first don t worry It s only meant as an additional guide to you and is not required to take advantage of DATE RANGE posting 49 The next line shows the total open amount in the date range In many cases this will be equal to the total charges If however payments or credits have been already posted the open amount could be lower Finally PTOS asks you to enter the AMOUNT TO POST Enter the amount of the check and PTOS distributes it across the open charges performs more calculations and asks if you w
70. HEDULE DATE 2005 08 01 THERAPIST GM TIME SLOT 21 PATIENT NUMBER PATIENT NAME NOTES VISIT CODE ROOM NUMBER You can fill in the patient number or use the HELP KEY to find the patient If the patient has already been entered into PTOS their name is automatically filled in If the patient isn t already in the system you can type in the name You could also enter a description such as STAFF MEETING to block out a time slot You can also enter any notes about the patient and a Visit Code and Room Number Visit Codes can be established by you such as E3 for a thirty minute eval or E6 for a one hour exercise session The example above shows a two column display If you select a one column display either the morning or afternoon schedule will appear including the NOTES field If a three column display is selected The morning or afternoon schedule for three consecutive days is shown If you wish to see the schedule of two or three therapists at the same time enter the three therapist codes and the column format automatically changes to 3 In each column instead of different days as shown above you will see the morning or afternoon schedule of the three therapists for the day you ve selected MODIFYING THE SCHEDULE If you need to change atime slot perhaps a patient canceled or needs to be changed just select the time slot to update and space or press CTRL Y to delete the patient name number and notes 2 PRINT NEW AND MODIFIED ENTRIE
71. M PAYMENTS AND ADJUSTMENTS Once charges have been entered into the system payments and or credits can be applied to them There are several methods for posting credits or payments LINE ITEM VS BALANCE FORWARD VS DATE RANGE POSTING VS CO PAY The simplest method for posting payments is Balance Forward This means when you post a payment or credit instead of applying it to a specific charge or group of charges it is applied to the oldest balance automatically Line Item posting allows you to break a payment up and apply parts of it to specific charges For example a patient had a 60 charge on November 10th and a 100 charge on November 15th The insurance carrier sent a payment for 112 with an explanation of benefits indicating 45 that 45 of the payment applies to the first charge and 67 to the second charge Line item posting allows you to pull up each charge and post the appropriate amount to it Line item posting is more exact It also means you need to take a little more time posting payments and credits since you must indicate the amount applied to each charge We have developed a unique method of posting payments for PTOS called DATE RANGE POSTING As its name implies a payment is distributed across a range of dates PTOS calculates what percentage of the open charges for the date range is being paid and automatically posts the appropriate amount to each charge In the above example if you
72. PE BC COLLECT C BALANCE INS BAL PAT BAL 0 00 Claim 1 2 Who Paid BANK PRIMARY INSURANCE SECONDARY INSURANCE AETNA PAID BY P S IF PAID BY PRIMARY BILL REMAINDER TO ONLY Patient OR Sjecondary Ins FIRST DATE TO APPLYTO contmue Quit CLAIM Up to three CLAIM NUMBERS which are being paid by this check can be entered The claim number is generated by PTOS when the insurance claim is printed All insurance claims 46 which have had no payments applied to them are then included on the Insurance Tracer Report see MANAGEMENT REPORTS If you intend to generate Insurance Tracer Reports which are highly recommended for collections you MUST fill out the CLAIM when a payment is posted or PTOS will have no way of knowing that the claim has been paid To find the appropriate CLAIM NUMBER double click in the CLAIM NUMBER field WHO PAID Next you are asked for a description of WHO PAID which could be pd by Prudential You can type a description or use PAYMENT ADJUSTMENT CODES to pull in the payment descriptions Using PAYMENT ADJUSTMENT codes not only saves time in posting but adds consistency when printing lists of payments or adjustments The code can be typed in the WHO PAID box or can be pulled in with F2 KEY BANK and CHECK The bank and check numbers are only necessary if you are having PTOS generate your bank deposit slips through the DAILY TASKS option If you have PTOS generate your bank deposit
73. R S econdary Insurance Next select POST or QUIT to post the entries or quit without posting any of the entries CREDITING AN INSURANCE PAYMENT TO PATIENT DEDUCTIBLE If an insurance claim has had no payments made on it the claim will continue to print on the INSURANCE TRACER report Sometimes the insurance will send an EOB indicating that the claim was applied to the patient s deductible You can mark the claim as having been applied to the deductible by using the FIND option as explained on the following pages to find the claim If the claim has had no payments posted against it the following line will appear on the screen APPLY THIS CLAIM TO DEDUCTIBLE YIN By clicking MODIFY and answering YES this will be no longer considered an OPEN claim 50 PATIENT PAYMENTS The process of posting Balance Forward Line item and Date Range patient payments is identical to posting insurance payments with a couple of simple exceptions There are no CLAIM s to apply the payment to and no PRIMARY or SECONDARY insurance information is displayed There is also one additional method of patient payment posting CO PAY PAYMENTS CO PAY PAYMENTS If there is a co pay for visits you should so indicate on the PATIENT BILL SCREEN PTOS then tracks the open co pay amount of each charge When you select CO PAY payment posting the system functions the same as DATE RANGE posting except the TOTAL OPEN AMOUNT is the outstanding co pay amount for the date
74. RT 04 08 15 THRU 04 08 31 LOCATION S DATE PATIENT DESCRIPTION 04 08 19 S0021 Flanders Alice American Gener billed 166 00 for 07 19 07 21 4 04 08 19 S0026 Waxler Nancy Aetna Life Ins billed 260 00 for 07 19 07 29 4 04 08 19 S0032 Clark Alan Blue Cross Ins billed 168 00 for 07 19 07 31 4 04 08 22 S0040 Erwing Lance Aetna Life Ins billed 172 00 for 07 22 07 28 4 04 08 22 S0044 Prescow Bob AAA Insurance billed 294 00 for 07 22 07 31 4 04 08 25 S0058 Young Paul Williams amp Lee billed 328 00 for 07 25 07 31 4 04 08 25 S0062 Winston Karen BC BS of NY billed 250 00 for 07 25 07 29 4 TOTALS OPEN CLAIMS 11 2 572 70 TOTAL AMOUNT 233 88 AVERAGE PER BILL DIAGNOSIS REPORT This report prints in two different formats depending on whether you select all patients of DISCHARGED PATIENTS ONLY If you select only discharged the format on the following page is used This looks only at discharged patients with a ZERO balance on their account Since the account has been closed the patient is discharged and the balanced has been either paid or adjusted off more extensive reimbursement data is available Each diagnosis or injury area is summarized showing average DAYS from first visit to discharge how many patients are in the category and the total and average of CHARGES VISITS and PAYMENTS received for each diagnosis PTOS also includes the average charge per visit VIS and average paid PD VIS DIAGNOSIS REPORT FOR 04 01 2006 04 30
75. S After you ve added to the schedule or modified existing entries the changes can be printed on an audit list similar to the Daily Transaction Report When you select this option the following screen appears allowing you to choose the most useful printout format PRINT NEW AND MODIFIED ENTRIES SORT LIST BY 1 THERAPIST 2 PATIENT NUMBER 3 PATIENT NAME 4 DATE 5 UNSCHEDULED PATIENTS ENTER SELECTION ENTER LOCATION OR LEAVE BLANK FOR ALL ENTER OFFICE OR LEAVE BLANK FOR ALL ENTER THERAPIST OR LEAVE BLANK FOR ALL ENTER FIRST DATE ENTER LAST DATE 104 4 VIEW SCHEDULE FOR A PATIENT All appointments scheduled for a specific patient can be viewed at any time 5 PRINT SCHEDULE FOR A PATIENT If a hard copy is needed for example hand the patient their schedule for the next two weeks this task can be selected 6 PRINT SUPERBILLS Superbills or charge tickets can be printed for any day for which patients have been scheduled Normally these will be printed first thing in the morning for patients scheduled that day The format for superbills is shown on the next page PTOS prints the patient number and name the date of treatment therapist code account type and co pay amount on the first line The second line shows the current account balance and primary diagnosis If you wish a Bar Code patient number can print in place of the regular patient number You can select printing one two or three superbills per
76. TE SCHEDULE Once therapist schedules have been created option 1 and the following screen appears VIEW AND UPDATE SCHEDULE THERAPSITS TO VIEW THERAPIST 1 THERAPIST 2 THERAPIST 3 DATE TO VIEW 2005 08 01 FORMAT 1 2 PR 3 COLUMNS 2 In addition to the date to view you can select the column format and which therapists to view The default is a two column format If you entered GM as Therapist 1 the following will appear a SCHEDULE FOR 05 08 0 8 1 THERAPIST GM TIME PAT NAME VS RM TIME PAT NAME VS RM 01 8 00 223 1330 02 8 15 24 1 45 03 8 30 225 23 00 04 8 45 2 26 2 15 05 9 00 1001AR Roberts Alex E2 2 27 2 30 06 9 15 n 728 2 45 07 9 30 29 3 00 08 9 45 230 S215 09 10 00 1002TS Salmon Tom G3 1 31 3230 10 10 15 732 31 45 11 10 30 33 4 00 1034HR Robinson Harry ri d 12 10 45 2 34 4 15 3 1 00 235 4 30 4 1 15 36 4 45 5 1 30 237 5200 6 1 45 738 5 15 17 12 00 STAFF MEETING 732 5330 te T2715 a a 2 40 5 45 19 12 30 a m 41 6 00 20 12 45 742 6 15 21 1 00 243 6 30 22 1 15 244 6 45 N ext P revious E nd OR ENTER SLOT TO UPDATE BERR RRR The above shows the schedule for August first for George Moore He has patients scheduled at 9 10 and 4 and a staff meeting at noon At the bottom of the screen PTOS asks if you want to skip to the next day move backward to the previous day or you can enter the time slot to update If you enter time slot 21 the following screen appears 103 UPDATE SC
77. TTORNEY You can select a specific attorney or print all patients grouped by their attorney The fields used in PAYOR list above are included except attorney is substituted for payor 87 NOTES As explained under ENTER OR CHANGE PATIENT DATA different types of notes can be entered into the system NOTES LINE 1 and 2 are the most significant since they are displayed on the Patient Data Screen When this task is chosen PTOS asks whether NOTES LINE 1 or NOTES LINE 2 are to be printed As stated above NOTES 1 and 2 should be dedicated to a specific purpose such as treatment authorization in line 1 and collection notes in line 2 This way if you want a list of collection notes select NOTES LINE 2 Only accounts with an entry in NOTES LINE 2 will print showing anyone with missing chart data When you select this task PTOS asks if you want to list only entries with a specific description Let s say that when you make collection calls you put an entry in Notes line 2 that say the week a payment is due You can then list notes with the description CHECK DUE 7 10 04 you ll get a list of everyone who should have made a payment that week SMALL BALANCE ACCOUNTS All patients with a balance due less than an amount you enter will be printed This is a reference of accounts that may need to be adjusted off or Removed from the active files CREDIT BALANCE ACCOUNTS This list prints all patients who have a credit or negative balance showing f
78. XTEND from the main TRANSACTION screen and a grid appears allowing you to post multiple procedure codes for the day s entry You can also post an I code by either typing I as the code or by clicking the ui Office Account Type BC Ins Unbilled Last Code TEX1 Charges Last Tx J i i 1 Balance Adjusts 0 00 Ins Bal Units Amount Manual Entry Delete 44 MANUAL ENTRY button see I CODE description below If you make a mistake move under the CODE you wish to delete and click DELETE You can then enter the proper code When finished click NEXT and the same additional information as in single CHARGE entry is displayed QUICK CHARGES The final method to enter charges is through selecting QUICK CHARGES from the SEARCH screen This displays a grid similar to EXTENDED above however not only can you post several different codes for one patient you can also change the date and account number This allows you to post several days entries for one patient charges for several patients on one day or several charges for different patients on different days You can also use the LAST button to pull in the codes used in the previous visit INDIVIDUAL I CODES Sometimes you won t have a procedure code that describes a specific treatment Enter I as the code for the charge and PTOS lets you enter the CPT code a unique description units amount and the expected amount MILEAGE PROCEDURE
79. a 1832 00 0 00 0 00 1876 00 04 07 11 04 07 08 000181 Ireean Jennifer 2435 00 0 00 0 00 2435 00 04 07 02 04 06 21 000256 Sundberg Sarah 1231 00 0 00 0 00 1231 00 04 06 16 000257 Bimer Debra 1128 00 0 00 0 00 1128 00 04 07 02 000271 Iorham James 1468 00 0 00 0 00 1468 00 04 07 04 000290 Sedrick Sara 606 00 209 74 100 00 452 26 04 06 18 04 03 13 000293 Menninger Donna 398 00 0 00 0 00 398 00 04 07 02 000295 Christoffer Jane 381 00 0 00 165 48 381 00 04 02 14 TOTALS 21072 00 468 94 265 48 10174 67 ACCOUNT TYPE Patients are sorted and subtotaled by account type Charges payments adjustments and patient insurance and total balances due are shown PRIMARY OR SECONDARY INSURANCE All patients will be listed sorted by their insurance carrier You can select the list for Primary insurance or Secondary insurance and can select only patients covered by a specific carrier be printed The patient s group number and ID number are included on the list SOCIAL SECURITY NUMBER This list sorted by Social Security Number shows the patient s social security number account type primary and secondary insurance codes balance due and the last time the patient or insurance was billed PAYOR This is a reference for groups of patients with the same payor Included are payor account type patient and total balance due and the last date the patient statement was sent You can select a specific payor or print all patients grouped by their payor A
80. a contract or home health there is a special type of procedure code that will automatically calculate the fee Mileage codes must begin with ZMI Enter the description as you would for any code with the amount being the PER MILE FEE For example you could have a code ZMIH and an amount of 35 for a home health mileage charge of 35 cents per mile and another code ZMIC with an amount of 37 per mile for another contract When you post the procedure code to an account enter the number of miles driven in the field that is normally used to enter the diagnosis code see Enter Transactions PTOS will multiply the miles driven by the per mile charge and post this to the patient s account Creating PROCEDURE CODES needs to be well thought out They are the most complex part of setting up your PTOS system and will be one of your biggest time savers when in place UPDATE THERAPIST CODES This allows you to assign a two digit code for each therapist The therapist code appears on several lists and reports and can also be used to show the name and provider number of the treating therapist on patient and insurance billings On the HCFA 1500 there are several references to the treating therapist These are Boxes 24K 31 and 33 If you wish PTOS to automatically fill out these boxes you can enter the information here NOTE A THERAPIST MUST BE ENTERED HERE BEFORE THEIR CODE CAN BE ASSIGNED TO NEW PATIENTS All Others 17 NPI
81. acters can follow the RVS CPT code printed on either the HCFA 1500 or the UB92 If you want the modifier to print indicate so here The default codes referred to for box 42 of the UB92 are 1 420 421 3 440 441 5 430 431 2 424 4 444 6 434 If the UB92 is the selected form you can indicate if you want to ADD A LEADING ZERO to revenue codes i e 0421 instead of 421 BILL PT OT OR SPEECH This allows each category to be billed separately on the UB92 If you wish you can bill only PT charges for a patient or group of patients then make a second pass and bill all OT charges for the same patient As with PATIENT BILLING you should start by setting these standard options to meet your needs You can later modify them permanently or change them for an individual run of insurance claims 67 INSURANCE FORM ALIGNMENT After the first claim has printed PTOS will stop and ask if the form is aligned properly If the alignment is too far off you may need to SET PRINTER LINE FORMATS as explained previously NOTE When the HCFA 1500 is printed Box 26 contains the patient account number account type and claim number The claim number is automatically assigned by PTOS and can be used for tracking the claim Each patient starts with claim 1 the number increasing each time a claim is generated for the patient 6 MANAGEMENT REPORTS Management Reports are available to provide you with practice analysis data Th
82. ained on the following pages You do not need to fill in all information If the patient is covered by only one insurance carrier you would have nothing to enter for SECONDARY INSURANCE Skip any unused fields you can always come back and fill them in later There are three fields that must be filled in patient number first and last name All others are optional and are used in various reports and billings CODE FIELDS There are several Code Fields in the patient file Payor Referring Dr Primary Dr ICD9 Primary and Secondary Insurance Employer and Attorney You ve created a library of doctors attorneys diagnoses etc in the Update codes option of System Tasks Now instead of typing the names and addresses over and over you type the code and all appropriate data is automatically pulled in Also remember that anywhere a city state and zip code are needed you can enter a CITY code Using CODES to pull in descriptions provides consistency in various LISTS and MANAGEMENT REPORTS FIELDS IN THE PATIENT DATA FILE Below are the PATIENT DATA ENTRY SCREENS along with brief descriptions of patient data fields listed in the order they are filled out PATIENT DATA TOOL BAR ARROW BAR Allows you to move from patient to patient in alphabetical order or from first patient to last BILL PATIENT AND BILL INSURANCE NOW Allows you to print a patient statement or insurance HCFA amp UB92 form for the current p
83. al balance due and the last date a payment was received The second line shows the patients account type phone number for reference and the total payments made on the account There is also a large blank space to enter a collection note If you are entering collection notes in the NOTES LINE 2 field of the Patient Screen you can elect to include these as line three of the patient s listing on this report PTOS asks if you want to print for only one account type and whether to sort by patient number or by account type so that all patients within an account type can be grouped together If sorting by account type is selected patients within each account type will be sorted by BALANCE DELINQUENCY REPORT FOR ACCOUNTS OVER 90 DAYS AND NO PAYMENT SINCE 05 01 04 Balance PAT 00005 00009 00021 00042 00044 00050 00058 00060 0072 00088 Totals NAME Craft William M 453 0944 Foreman Bob M 390 0922 Renkie James M 221 0923 Terpich Martin P 213 239 0933 Pepe Brian P 390 6373 Bliver Samuel P 390 2293 Wenne Susan wW 213 0392 Wimpell Sherry wW 213 341 0012 Sermon Diane wW 220 0113 Gead Nicholas wW 339 1187 2209 1433 566 582 494 378 228 1851 1600 1502 00 60 00 00 00 00 00 00 00 00 32894 30 120 1084 1433 0 0 94 378 228 7871 60 00 60 00 00 00 00 00 00 00 00 90 120 5
84. al line The POST total at the bottom however continues to accumulate If you then move back to the P revious you can post an additional amount against the charge which is added to what you ve posted You can also subtract an amount that has already been posted by entering a minus sign in front of the amount you re posting for example 50 00 06050 ip NNA R Office 1 Account Type BC INS PAYMENT 06 10 12 PEYI 001 PT EVALUATION PAY 15 00 POST AM 0 X 65 14 CR Di DON tP 0 067 2 TEX2 97110 THERAPEUTIC EXERCIS amp AU AU POSE AM 0 00 EX 57 00 CR 0 00 IP DDO CPE ALANI 06 10 13 TEX1 97110 THERAPEUTIC EXERCIS 00 POST are AM 5000 eee 28050 GR 07000 ce D200 PE 000 0 00 BALANCE 45 00 Amount Posted this Patient 89 00 Ap Amoun Post Amount Posted this Check Magri bee SSE Page 1 of 1 After you ve finished moving through the screens of transactions to post the payment click POST At this point all balances are updated There is also an entry automatically created that describes the payment or credit This is your reference of what was posted The transaction is posted with a D debit code and has a description that would look like this Blue Cross pd 119 00 FOR 10 13 10 13 6 PTOS takes what you ve entered under WHO PAID in this case Blue Cross and adds the description pd 119 00 FOR 07 10 07 17 3 which is calculated as the payment is posted The system then displays a LINE ITEM WRITEOFF screen shown
85. als without printing any reports You can also specify one office or location to total A R WITH ESTIMATED RESPONSIBILITY The following is a sample Estimated Responsibility Report Based on information you ve supplied such as patient deductible percent to bill patient and co pay amounts PTOS calculates the portion of each account s balance that is due from the patient and what is due from insurance Keep in mind that this is an estimate only of what is due from patient and insurance ESTIMATED RESPONSIBILITY A R REPORT AT PT PATIENT PAT CURENT 30 60 60 90 90 120 120 INSRSP PATRSP TOTAL L GM Straman Lar 120898 54 276 102 300 312 744 300 1044 L GM Delon John 120909 78 123 207 384 0 442 350 792 L KK Rumph Georg 120925 108 114 60 0 0 172 110 282 1 GG Coulter Fre 120934 78 306 100 0 0 304 180 484 S SR Hansen May 120936 138 215 174 0 0 527 0 527 L GM Bormalham 120080 24 180 270 226 892 1002 590 1592 L GM Irelan Harr 120181 90 360 306 539 1140 1435 1000 2435 W SR Sullivan O 120231 138 84 12 72 258 564 0 564 W SR Simer Bill 120355 144 258 402 84 240 1000 128 1128 TOTAL 1050 2294 204 1773 3184 7124 2288 10342 COLLECTION ANALYSIS Collection Analysis is another report which is best run on the last day of each month This report shows all charges insurance and patient payments debit and credit adjustments visits and units for each day of the month or other time periods you ve selected and totals each category If you wish
86. amount billed and the dates of service billed for example Blue Cross billed 650 00 for 09 01 4 thru 09 30 4 This will appear on the patient statement and any transaction lists as a billing reference It is necessary if you want be able to get BILLING EFFICIENCY or INSURANCE TRACER reports and is also important for various lists As with patient statements you may wish to suppress the Insurance has been billed statement if you are rebilling a claim PRINT SUBTOTALS This determines whether to SUBTOTAL ON EACH PAGE of a LINE ITEM UB92 or Box 28 of the HCFA 1500 form If you check this box page totals are printed in box 28 Otherwise PTOS will print CONTINUED ON NEXT PAGE INSURANCE LABELS PER LINE If you have PTOS generate labels you can select from one across or three across labels PRINT ONE DATE PER PAGE Usually you will want to fill a HCFA 1500 form printing several days activity on each form If you want to generate one form for each day check this box ELECTRONIC BILLING FILE NAME APS supplies interfaces with several major insurance companies as well as electronic intermediaries If you are taking advantage of electronic billing enter the transfer file name which has been supplied by your ECS intermediary You may also need to check the box to FORCE PAGE END ADD SPACE BEFORE PAGE END or ADD CARRIAGE RETURN depending on the requirements of your ECS intermediary PRINT MODIFIER A modifier of up to six char
87. ance code you can double click to list all carriers with a similar CODE NAME To add or revise insurance carrier information select UPDATE INSURANCE CARRIERS Then type the insurance code PTOS will search to see if that code already exists If it s a new code PTOS will tell you and you can add the code quit or find another code The screen below shows the layout for entering insurance carriers BEFORE CREATING INSURANCE CODES READ THE SECTION ON BILLING CODE TRANSLATION UNDER UPDATE PROCEDURE CODES BCOC Line 2 City Phone 0 Pin Group Line 1 Line The CODE NAME is only used as a reference to you The PRINT NAME is what will actually print on the billing form along with the address NOTE CITY is a code field You can press F2 to list all available cities or you can enter a three digit code This works the same with all CITY fields in PTOS CITY CODE creation is described below The PHONE NUMBER will be automatically referenced on the PATIENT DATA SCREEN as an additional aid for insurance follow up The address layout in BOX 9D will print on the HCFA 1500 as well as PIN and GROUP The ELECTRONIC CLAIMS PAYOR ID is used by some clearinghouses to transmit electronic insurance claims If you purchase a separate ECS module from APS necessary codes will be supplied by the appropriate clearinghouse There are also two note fields for any information you need to enter If you wish to change Insurance co
88. ant to adjust off all or part of the balance If you respond yes the following screen appears ADJUST OFF ALL OR PART OF NE BALANCE TOTAL EXPECTED AMOUNT W POST Write Off TOTAL INSURANCE C POST Credit TOTAL INSURANCE OF EXPECTED Leave BLANK for NO Adjustment lw TOTAL AMOUNT TO WRITE OFF CREDIT DESCRIPTION 2 NEW BALANCE Amount Posted this Patient Amount Posted this Check 240 00 This new addition to the DATE RANGE posting screen shows the balance after 240 00 was applied to the open amount of 544 51 These calculations show possible amounts to be adjusted You may want to adjust off the difference between the total charges and the expected amount the difference between total charges and the percent the insurance should pay or the difference between total charges and the insurance percent of the expected amount Again these are just calculations to help guide you You can enter any AMOUNT TO WRITE OFF CREDIT or you can change your mind and leave the amount blank so that no adjustment is posted PTOS will show the new balance after subtracting the adjustment amount The system also asks for a DESCRIPTION of the credit just as if you were posting a C or W adjustment If there is still an open amount after the adjustment was posted or if you decide not to post an adjustment the following appears This allows you to transfer the balance to the patient or the secondary insurance BILL REMAINDER TO ONLY P atient O
89. ar on the TRANSACTION ENTRY screen as a reminder CHARGE LIMIT If any payor limits charges for the patient or is using a CAP amount enter that amount here It will appear on the transaction screen as a reminder If a new fiscal year starts you can add the new year s CHARGE LIMIT to the old charge limit to continue tracking HCFA 1500 PARAMETERS BOX11D WHEN BILLING PRIMARY or SECONDARY You may want to suppress secondary insurance data Placing N here suppresses boxes 9 through 9D Medicare has requested a special format If you select M for Medicare as primary primary insurance data will print in boxes 4 7 and 11 11D will be checked NO and BOX 9 will be filled out If you select M for Medicare as secondary primary insurance data will print in boxes 4 7 and 11 11D will be checked YES and all of BOX 9 will be blank If you bill Medicare as PRIMARY you may need to use the S option which prints NONE in Box 11 and leaves other insurance boxes blank BOX 13 If you do not want SIGNATURE ON FILE to print in box 13 answer NO FILL OUT TO DATE IN BOX 24A Y N 19 Some carriers request that both FROM and TO dates be filled out in BOX 24A even though the date is the same Answering yes determines whether the TO portion of the box is filled out ACCEPT ASSIGNMENT This determines how BOX 27 of the HCFA will be checked PRINT R EFERRING OR P RIMARY DOCTOR The default for BOX 17 of the HCFA
90. at contain the ICD9 code If you fill in the number of allowed visits and the duration of treatment days PTOS will track patients that are approaching the authorized maximum ICD9 Code Description UNS ENTHE Duration Injury Area KNE To delete an existing code click on the DELETE button to add or change other codes click on QUIT to return to the previous screen NOTE THIS SEQUENCE OF ENTRY APPLIES TO ADDING DELETING OR REVISING ANY TYPE OF PTOS CODE UPDATE INSURANCE CARRIERS In most cases a patient will be covered by one or more insurance carriers PTOS allows you to enter the carriers name and address information once assigning a four digit code to the carrier When billing PTOS links the codes you ve entered in the Patient Data File with the name and address information you have entered in the Insurance Carrier File The appropriate sections of the insurance claim are then filled in When assigning insurance codes for the first time it s best to sit down with a list of all the carriers you normally deal with and assign codes to each The codes can be characters and or numbers and should be meaningful to you The code has a CODE NAME to indicate the specific carrier name and address For example you may deal with several Blue Cross plans with different addresses They could be designated 11 BCGM BCSE etc When you re entering patient data and aren t sure of the right insur
91. atient 27 SUSPEND RECALL In the bottom right corner of each PATIENT DATA ENTRY screen is a SUSPEND button If you are interrupted during data entry and need to pull up another account or go into transaction entry for another patient click the SUSPEND button This returns you to the SEARCH SCREEN You can pull up another account and at the bottom of their PATIENT DATA ENTRY and TRANSACTION screens will be a RECALL button When you are finished with this account press RECALL and it will close the current account and return you to where you were in the first patient s screen PRINT COVERSHEET Allows you to print a condensed print out of the patient information NOTES Takes you immediately to patient s note screen TRANS Takes you immediately to patient s transaction screen to view patient transaction history or post charges payments or adjustments DOC INS BILL HCFA Allows you to quickly go from one patient data screen to another PATIENT DATA SCREEN 1 4 Patient Data Screen 1 Locked X Office 4 First Nam AR Edit Injured 10 Last Name Therap TA First Visit Account Type BC BirthDate Discharge Date Sort Data 1 Home Phone 509 23 Accident Related Work Phone Address City lt ANE Default Diagnosis 1 EMail NONE lcd9 719 41 Dx PAIN IN JOINT SHOULDER Icd9 Dx Icd9 Dx PATIENT All information about the patient including charges and payments is linked together by the p
92. atient and transaction data relating to the account to be removed when the REMOVE OLD ACCOUNTS task is run A patient can only be removed if the balance due is zero If a balance is outstanding and you wish to archive the account an adjustment must first be entered in the transaction file to zero out the account PTOS also uses the EDIT field for several internal functions You may periodically see an N or and in the EDIT field These are just marks PTOS is using for tracking THERAPIST Each therapist was assigned a code in the UPDATE THERAPIST CODES task The primary therapist for the patient is then entered here PTOS will use the code of the assigned therapist to fill out boxes on the HCFA 1500 billing form This code will also be used when entering transactions to indicate which therapist treated the patient 29 The THERAPIST and ACCOUNT TYPE boxes both have DROP DOWN LIST options Clicking the arrow on the right of the field will display all valid codes You can right click the appropriate code or type it in ACCOUNT TYPE Account type consists of two characters The first is the basic classification if the patient is a Medicare account M must be entered as account type All other categories can be assigned by you Some suggestions are W worker s comp D dual private insurance S single private insurance L lien C cash A second digit for account type is optional and indicates a sub grou
93. atient number Once you create a patient number it can t be changed except through the RENUMBER PATIENT ACCOUNTS option in SPECIAL TASKS FIRST NAME Patient first name also can add middle name or middle initial of the patient after the first name i e Gianna R LAST NAME Patient last name also can add a suffix after the last name if required i e Davis Jr ADDRESS First line of patient s address LINE 2 Second line of patient address if needed for additional information such as apartment or space number 28 CITY STATE ZIP of patient address SS Patient s Social Security number PAYOR This is the party ultimately responsible for payment Usually the patient it could be a spouse or parent in a legal case it could be an attorney For Worker s Comp you can enter the employer insurance carrier or leave blank If the patient is also the payor simply type P in the PAYOR NAME field PTOS will pull the patient s name and address down for you If the payor has the same address but different name for example a spouse type in the name and type a P in the first address field This will copy the address of the patient You can enter an INSURANCE company as PAYOR enter the insurance code and the name and address are filled in If you don t know the insurance code DOUBLE CLICK or press F2 for a LIST ADDRESS Payor address line one LINE 2 Second line of payor address CITY STATE ZIP of payor a
94. b sort This list will print sorted by doctor but since there are probably many patients for each doctor these will be grouped by your sub sort criteria The final question is to include patients who have no doctor entered Instead of lengthy explanations of each list only the highlights of are described below To see a sample printout look at the PATIENT NUMBER LIST later in this section After you ve entered some patients into the system printout samples of all lists This will help you determine which lists to use regularly RETURN TO DOCTOR This is a listing of patients who have a return date to see their referring physician entered in the Patient Data File PTOS first asks the date range to print You may select to print patients who will be returning this week within the next month or all patients who have a return date scheduled You can also elect to sort the list by doctor therapist return date or patient name This report is useful in allowing the therapist to schedule treatment programs and progress reports Remaining visits are also shown to reflect how many authorized treatments the patient has remaining DIAGNOSIS PTOS asks if you want only primary diagnosis or all diagnoses You can choose whether to print the ICD9 code or descriptive diagnosis The list can be run for all diagnoses or a specific description Selecting PRIMARY DIAGNOSIS is more meaningful and much faster The list is sorted by diagnosis and you can choo
95. been prepared it will remain unchanged and available for any Outcome Report options until you again run the option at the end of the following month for example The information portrayed on your Outcome Reports will only be valid if you have entered data accurately into the system It is especially important that ADMIT COND and DISCHARGE COND levels have been entered consistently Also date of injury first visit and discharge must be correct To help verify accuracy of data Print Outcome Edit List option of the above menu prints an edit list showing key data for each discharged patient You should print and audit this list before printing any of the Outcome Reports You may want to exclude some patients from the outcome reports If you place an X in the first position of ADMIT CONDITION in the patient s file their data will not be included in outcome reports After running Prepare Outcome Reports and Print Outcome Edit List options you re ready to start printing reports There is a wide range of report formats available When you select Print Outcome Report option the menu below will appear You can select the formatting of data to be included on the Outcome Reports and run this option as many times as you desire to see the outcome data presented in different ways The first question is the date range in which the patient was discharged Only patients discharged between the Start and End date will be included You can se
96. being posted If CALC OF EXPECTED AMT has been set to yes the expected amount is used when calculating the CHARGE LIMIT maximum for the patient 35 POSTING NOTE You can enter a short reminder note here that will appear on the screen when you are posting transactions This note is frequently the same for all patients in the same account type It can therefore be pulled in from the account type file 2ND DEDUCTIBLE At the beginning of a new time period there may be a new deductible to satisfy Enter the new deductible here and date it takes effect in the START DATE field PTOS will then calculate this deductible PAYMENT PLAN AMOUNT When you send a patient statement PTOS will bill the patient for the entire portion of the balance for which they are responsible You may make PAYMENT PLAN arrangements with certain patients however to pay a specific dollar amount weekly or monthly If you enter an amount in this field such as 25 00 or 50 00 this is the amount the patient will be billed whenever a patient statement is sent AUTHORIZATION DATE Calling every insurance carrier for treatment authorization can make a BIG impact on collections and accounts receivable When called the carrier will frequently authorize treatment up to a specific date or for a fixed number of visits Enter the date that authorization expires You can then generate lists of patients whose insurance authorization is about to end so carriers can be called fo
97. ber 2003 charge on an INSURANCE FORM or on a DETAILED PATIENT STATEMENT PTOS will bill the charge as 50 even though the fee in effect the day it was originally posted was 40 This does not apply to billing on a SUMMARY PATIENT STATEMENT as the summary patient statement does not use the procedure code information when billing For more detailed explanation of billing options see PATIENT OR INSURANCE BILLING 16 If you need to make several changes to a fee on a given procedure over a short period of time and anticipate that this may affect billing instead of changing the old fee copy the procedure to a new code and change the fee of the new code COPYING A PROCEDURE If you wish to create another code similar to one that already exists as in the above example of HTX2 and HTX you can copy an existing code to a new code First pull up the PROCEDURE CODE you want to copy FROM and click the COPY button PTOS will ask for the new code to copy to You can then revise the new PROCEDURE CODE DELETING A PROCEDURE CODE Sometimes you ll find there are procedure codes you no longer need These can be deleted however there are some considerations If you have posted transactions with the code you wish to delete you will no longer be able to print insurance claims containing transactions posted with that code You should print PROCEDURE by LAST DATE USED in OTHER LISTS before deleting codes MILEAGE CODES If you bill for mileage primarily for
98. ce code here 2M2 INS TYPE The account type for secondary insurance is entered here This will control formatting of the HCFA 1500 form including appropriate therapist provider numbers ADJUSTER Adjuster for secondary insurance GROUP group number for secondary insurance subscriber ID Identification number for the subscriber to the secondary insurance You may enter SSN to pull the patient s social security number in EMPLOYER Employer for the secondary insured party is entered here If P is entered the patient s employer birth date sex and relationship code of 1 will automatically be pulled in PATIENT RELATION TO INSURED Relationship of patient to insured party for the primary insurance 1 self 2 spouse 3 child 4 other INSURED NAME Name of insured subscriber for secondary insurance As with the PRIMARY INSURED NAME you can enter a P PA or EMP ADDRESS Line one of subscriber address CITY STATE ZIP of secondary insured s address ACCEPT ASSIGNMENT This can be Y yes N no or blank BIRTHDATE Secondary insurer s birth date SEX Secondary insurer s sex PATIENT DATA SCREEN 4 BILL PATIENT DATA SCREEN 4 BILL Locked 06050 y 2 DAVIS NNA R Account Type Deductible Amount 0 00 2nd Deductible 0 00 Start Date Percent To Bill Patient 0 Payment Plan Amount 0 00 2nd Percent To Billl PT 0 Start Date for 2nd Authori
99. co BOX 8 S E RPI BOX 16 FROM BOX 10 B STATE BOX 18 FROM Box 10D BOX 20 Y N BOX 22 A BOX 23 Additional UB92_Boxes VISIT REV CODE 0 OR 1 ie 420 421 PRINT DATES IN BOX 84 YIN BOXES 24 29 PRINT A3 IN BOXES 39 41 Y N BOXES 324 364 BOXES 328 368 BOX 63 BOX 80 CODES PTOS fills out the HCFA 1500 and UB92 billing forms in a standard format specified by Medicare and common insurance carriers nationally This screen contains boxes that you can use to customize billing to your needs BOX 1 Enter 1 through 7 to indicate which of the seven boxes at the top of the HCFA form should be checked such as 1 for Medicare and 7 for other for primary and secondary insurance BOX 8 Patient status S single M married 0 other E employed F full time student P part time BOX 10B If an auto accident enter the state BOX 10D Any text to print in 10D is entered here BOX 15 Date of same illness can be entered if needed BOX 16 If UNABLE TO WORK DATES are entered they will be filled out on the HCFA 1500 and used in Outcome Reports and some patient lists BOX 18 Hospitalization dates can be filled out if needed BOX 19 Any data required by individual insurance carriers can be entered here Many carriers ask for the referring doctor s PIN Enter UPIN and PTOS will pull in the PIN from the DOC screen Entering the date last seen by the doctor is also commonly done
100. count type is entered as part of the data If a patient s account type changes the transaction account type is still shown as the original account type Selecting option 4 lets you update the new patient account type into all transactions posted for a specific patient UPDATE TRANSFER FILES This selection lets you interface PTOS with other programs such as scheduling or documentation programs supplied by other vendors or with custom programs designed for you by APS It will only be active if you have purchased such programs to interface with IMPORTED INSURANCE PAYMENT DATA This selection will allow you to interface PTOS with our new EOB reader If you have purchased the PTOS EOB reader this option will allow you to import ERA files for posting insurance payments into PTOS 107
101. d Code MmT71 Description Units Amount Old Amount 97140GP59 MANUAL THERAPY TECH 1 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 Totals 1 00 Statement Description 97140 MANUAL THERAPY TECHNIQUES 0 00 Time 0 Expected Amount 26 66 Bill To Patient Or yecond Insurance Only Or Blank For All Last Fee Change Prior Fee Change RVS CPT You may enter an RVS CPT or other code of up to eleven digits The first five digits print in BOX 24D of the HCFA 1500 form and the last six as the Modifier in 24D If you bill on the UB92 and select the Line Item format the first five digits print in Box 44 and the last six digits can print in Box 42 or as a modifier in Box 44 These options are described in the INSURANCE BILLING section DESCRIPTION There can be 25 characters under each description line which corresponds to spacing on many insurance forms On the 12 90 version of the HFCA 1500 form however there is only room for the first six characters Normally nothing in the description field will print on the HFCA 1500 you can however select printing these first six characters when running the billing option THERE CAN BE NO BLANK LINES WITHIN THE DESCRIPTION WHEN PRINTING BILLS IF PTOS SEES A BLANK LINE IT THINKS THE END OF THE DESCRIPTION HAS BEEN REACHED AND BILLING WILL BE INACCURATE UNITS If units are entered they will print on the HCFA form in Box 24G 15 AMOUNT The final part of each desc
102. d Finance Charges Backup PTOS Data Login as a Different User Reset Files Close All Files Delete Indexes and Reset SECTION 10 SPECIAL TASKS Send Letters Print Labels Scheduling amp Superbills Maintain Schedule File View amp Update Schedule Print Schedule Lists Print Superbills Sample Superbills Remove Old Accounts Renumber Accounts Update Transfer Files 1 INTRODUCTION Welcome to PTOS for WINDOWS When you first sit down to learn the system keep in mind that it will probably take four to six weeks for you to feel proficient At first it s totally new but soon operation becomes second nature Remember we re always available at 1 800 824 4305 to answer your questions Support hours are 6 00AM to 4 30PM Pacific Time Monday through Friday TYPICAL PTOS ACTIVITY SEQUENCES Before the specifics let s OUTLINE the process of setting up PTOS and using it on a daily basis INITIAL SETUP m SETUP YOUR SYSTEM Details on how to set up the computer and load the PTOS program are found below m LEARN PTOS Read the ENTIRE manual to learn how PTOS will work best for you E SET UP CODE FILES There are several types of coded data therapist codes referring doctor codes etc that need to be set up E CHANGE PARAMETERS These are options that let you tailor PTOS to your office DAILY ROUTINES ENTER PATIENT DATA Enter new patients and modify existing information UPDATE PATIENT SCHEDULES If you use the scheduling o
103. d Only will omit those charges marked with a P This can be a useful list in spotting any patients who have fallen through the cracks and have not been billed UNPAID CHARGES The following list only functions properly if you post payments using DATE RANGE or LINE ITEM posting This is the only way PTOS can know what has been paid against a specific charge You can select several criteria to specify which charges to list Insurance Paid L Total Paid Total Paid Adjustments Than Expected Amount Balance Not Zero First option lists charges with no payments of any kind Second option lists charges with no insurance payments Third option lists charges that the patient has not paid on Fourth option lists charges where the INSURANCE PAID is less than the EXPECTED AMOUNT Fifth option lists charges where patient and insurance payments are less than expected amount Sixth option includes charges where patient and insurance payments AND adjustments may 91 have been made but the total is still less than the expected amount Seventh option includes charges where patient and insurance payments and adjustments may been made but the total is still less than the TOTAL AMOUNT not expected amount of charge PAYMENTS Payments can also be printed for reference When this option is selected the screen on the following menu appears Payments All Payments v All Payments You can specify insurance patient or both t
104. d and the procedure code will only be billed to the patient If you want the secondary insurance and the patient but not the primary to be billed enter an S REVISING A PROCEDURE Once defined any part of a PROCEDURE CODE can be revised except the code itself Also you can not decrease or increase the total number of description lines If you have a code witha three line description don t edit the wording to create a two line description Instead create a new code with the two line description If you change the number of description lines your insurance claims will not print properly If during editing TOTAL AMOUNT of the fee changes PTOS will warn you NOTE The new fee takes effect the day after the SYSTEM DATE so make sure you entered the correct SYSTEM DATE when you siart PTOS When changing fees consider how it will affect transactions If the procedure has been posted to some accounts using one fee and you then change the total fee PTOS will keep track of the DATE OF FEE CHANGE and the PREVIOUS AMOUNT When generating bills or calculating financial data PTOS will look at what fee was in effect on the posting date PTOS TRACKS TWO FEE CHANGES Let s say you have a procedure with fee of 40 On January 1 2004 it will change to 50 and on June 1 2004 it was changed to 60 It is again changed to 70 on January 1 2005 PTOS shows the current amount as 70 the LAST FEE as 60 and PRIOR FEE as 50 If you rebill a Decem
105. d more often than one with fewer visits per week We find this has made some impressive improvements in cash flow ONLY PATIENTS WHO HAVE NOT BEEN BILLED SINCE If a patient has been discharged dropped out of therapy or just doesn t come in very often they may not have reached the AMOUNT RANGE you are billing By running a group of claims monthly filling out this parameter for patients who have not been billed in the last month you are able to pick up any account that has slipped through the cracks INCLUDE PREVIOUSLY BILLED CHARGES When running insurance claims normally only charges which have not been previously billed are included This eliminates duplicate billings 65 Sometimes you may need to rebill a patient Perhaps an insurance claim was lost in the mail and needs to be resent Or maybe a payment has been received from the primary insurance and you re ready to bill a secondary carrier If you wish to rebill a range of charges for a specific patient check this box and enter the date range to bill If you have only a few specific transactions to rebill you can tell PTOS to rebill these by clicking REBILL while FINDING TRANSACTIONS as explained in the section ENTER OR ADJUST TRANSACTIONS You may want to rebill a group of patients for example billing the secondary carrier one month after the primary carrier was billed This can be accomplished by billing by account type If you check INCLUDE PREVIOUSLY BILLED CHARGES you will
106. d over you can create CITY CODES We recommend using the last three digits of ZIP CODE as this will usually be unique By entering a CITY CODE like 031 you can create a standard city as shown below Code 922 City Name MEDICAL LAKE City MEDICAL LAKE Now whenever PTOS asks for a city type the code or DOUBLE CLICK or use the F2 key to find the appropriate city UPDATE ACCOUNT TYPES All patients within the same account type will have certain standard requirements By creating ACCOUNT TYPE CODES you tell PTOS the billing profile for each account type 18 Code 41 Account Type Name MEDICA Percent To Bill Patient gt g Co Pay Amount 9 99 Place Of Service 44 Charge Limit 1740 00 Treatment Plan Description For Line 1 Bo The PERCENT TO BILL PATIENT COPAY AMOUNT PLACE OF SERVICE TRANSACTION NOTE CHARGE CAP LIMIT and ACCEPT ASSIGNMENT are automatically pulled into a patient s record when you indicate the patient s account type on the first page of PATIENT DATA ENTRY PATIENT STATEMENT NOTES will be printed at the bottom of the patient s billing statement The other parameters on this screen determine how the HCFA 1500 form is printed PERCENT TO BILL PATIENT If insurance for this account type pay 80 of charges enter 20 here for the patient responsibility CO PAY If all patients within this account type have a set co pay amount enter it here TRANSACTION NOTE This short description will appe
107. ddress REMEMBER TO USE YOUR CITY CODES DEFAULT DIAGNOSIS If you wish PTOS will print the diagnosis line number or numbers in box 24E of the HCFA 1500 The appropriate diagnosis line for each treatment is entered at the time a charge is posted You can enter a default diagnosis line here that will automatically be pulled in when a charge is posted This could be the diagnosis line number such as a 1 or multiple s such as 1234 corresponding to the diagnosis code s found in box 21 on the HCFA 1500 form This field will automatically default to 1 ICD9 A standard set of ICD9 codes and descriptions is included with the system These can be modified or added to by you under Update Codes in System Tasks By entering the code here the appropriate description will be copied to the DX description field The primary ICD9 diagnosis code should be entered first with additional codes if necessary in the following ICD9 fields These can all be pulled in with the F2 key DX As described above this is usually filled in automatically by entering a code in the previous field but you can enter a unique description if you wish OFFICE If yours is a multi office practice you are able to enter an office number in the patient account showing where the patient is being treated EDIT After a period of time you may want to completely remove a patient from the system Entering A in the EDIT filed will enable all p
108. deletes the REST of the field STOPPING THE SYSTEM NEVER TURN OFF THE COMPUTER WHEN IT S RUNNING A TASK End a session by selecting END from the task bar MESSAGES you will frequently see messages on the screen They provide information about an action to be taken These guide you through various tasks A message may contain options such as C ontinue or E nd Type the first letter of the word describing the desired selection In the above example by pressing C the task will continue to process pressing E will end it UPPER VS LOWER CASE You must be consistent when using upper and lower case letters PTOS takes what you type literally for example John Doe and JOHN DOE are two different people as far as PTOS is concerned LIST BOXES PTOS uses many code fields to make data entry faster and more accurate All code fields can access a LIST BOX When you are in a code field double click the mouse or press the F2 key Let s say you are entering a new patient and want to pull in insurance carrier data With the cursor in the PRIMARY INSURANCE box double click and PTOS will list all insurance carriers in the system If you re only interested in BLUE CROSS PTOS can list only Blue Cross plans in the system You can move up and down through the list using the arrow button or sliding bar on the right of the list When you find the entry to select left click it with the mouse and the appropriate ins
109. des once they ve been created see RENUMBER ACCOUNTS under SPECIAL TASKS UPDATE REFERRAL CODES Referral codes can represent physicians or attorneys A Referral Code can be up to five characters You can DOUBLE CLICK OR USE THE F2 key to list existing referral sources If the code is new PTOS asks if you want to ADD and a screen like the one below appears 12 ROSEC Title mD Identifier D URSE EXT 210 F WED AFTERNOONS DO NOT FAX REPORTS The PRINT NAME is what appears on the billing forms and various reports It should be entered Last name and First name as in the above example This way physicians will print in the proper alphabetical order on reports If you revise a PRINT NAME for a referring doctor PTOS will ask if you want to automatically make the same change for all patients with that referral source FIRST NAME LAST NAME TITLE and the three ADDRESS lines are used so that you can send letters as explained in the SEND LETTERS option of SPECIAL TASKS SPECIALTY is used so that you may send letters to specific groups of doctors such as all neurologists or all orthopedic surgeons PROCEDURE CODES When a patient comes in for treatment a charge or transaction as we call it is posted to the patient s account This transaction details exactly what was done for example Hot Packs Ultrasound Massage You can type the description and charge each time or you can eliminate all the repetitive typing by
110. e NOTE If you are rebilling you may want to suppress the Patient has been billed statement so that the billing comment line is not duplicated AMOUNT DUE DESCRIPTION The AMOUNT DUE is the portion of the charges that the patient is responsible for You can enter a description here such as DUE FROM PATIENT or any other description that suits your needs NOTE If you leave this blank no AMOUNT DUE total will print INCLUDE NOTES When you set up ACCOUNT TYPE CODES you are able to enter four lines of notes that will print at the bottom of the patient statement for all patients in the account type You can override these notes by selecting INCLUDE NOTES ON STATEMENT YES and typing a different message 62 CHANGE LINE FORMAT M Printer Line Formats lect Form to Adjust Patient Statements Additional Controls TOP MARGIN 0 0 Report Page Length 58 Clicking this button calls the following screen which permits you to adjust the statement to best fit your printer Changing the HEADER and PAYOR lines adjusts how the statement will fit into a window envelope If your printer has room for more transactions on a page increase the END OF TRANSACTIONS line When you first use PTOS set up these STANDARD options and make them permanent Then when you run different billings you can make whatever modifications are desired If in the future you want to make changes to the standard options per
111. e a Line ltem insurance payment was incorrect you must first reverse the entry in the INSURANCE PAID field There are two ways of accomplishing this One method is to FIND the LINE ITEM payment Click DELETE and PTOS will automatically reverse the payment out of each charge that it was applied to and delete the Line Item DEBIT description entry You can the post a corrected payment This is the simplest approach and will be used in most cases The second method is to REVERSE the payment by posting a NEGATIVE Line Item payment to the charge that is equal to the positive amount already posted To do this start by telling PTOS to post an insurance or patient payment or credit Select Line Item even if it was originally posted using Date Range Enter the first date affected by the error When the charge is pulled up on the screen enter a NEGATIVE AMOUNT equal to the amount to be reversed Skip to the next charge affected by the deletion and continue to apply negative amounts until all entries affected by the error have been reversed As we covered before when LINE ITEM or DATE RANGE payment or credits are posted there is a DEBIT automatically created by PTOS that explains the payment with a description like Blue Cross pd 221 00 for 07 10 07 17 4 That debit MUST also be deleted When you posted the negative LINE ITEM payment to reverse the error this also creates a DEBIT stating Blue Cross pd 221 00 for 07 10 07 17 4 This DEBIT
112. e make sure the date range you prepare the AGED ACCOUNTS for is the same date range used when the reports are actually printed After ACCOUNTS RECEIVABLE has been prepared any of the Print Accounts Receivable selections can be run Each patient s account is summarized showing the total balance due and breaking the balance into amounts which are current 30 days old 60 days old 90 days old and over 120 days After all patient data is summarized totals for the practice are shown Also included is the PERCENT of the total balance that each aging category represents The PERCENT figures are very important information in determining collection efficiency and month to month improvement It is expected that the total dollar amounts over 30 60 days etc will vary from month to month the PERCENT in each category is a much more consistent indicator of collection efficiency PREPARE A R FOR ONE PATIENT This does not print but internally ages all transactions for one account and updates the Patient 71 Data File This could be run if a patient s balance doesn t seem right and you want PTOS to recalculate it A R BY ACCOUNT NUMBER The report is printed in patient number order similar to the format shown below AGED AIR BY INSURANCE FOR 2004 07 31 ALL LOCATIONS PATIENT AT CURRENT 30 60 60 90 90 120 120 BALANCE INSURANCE AETNA 120898 Straman Larry 120909 Delon John L 54 00 276 00 102 00 300 00 312 00 1044 00 L 7 8 00 123 0
113. e DEFAULT DX is pulled in It can be changed if desired This field is only used in box 24E of the HCFA 1500 and can be 1 2 1 2 2 4 or 2 3 4 in reference to which of the patient s diagnoses the visit applies to It could also be the ICD9 code of the applicable diagnosis or you could just enter ALL MODIFIER You can assign a modifier in the PROCEDURE CODE to print in box 24D of the HCFA 1500 You can also enter a modifier here which will override the procedure code All of the above entries are optional based on the requirements of specific insurance carriers When finished with this screen click POST The charge will be posted and PTOS returns you to the main TRANSACTION screen LAST VISIT Frequently the patient will have the same treatment from one visit to the next After you select CHARGE from the main TRANSACTION screen a LAST button appears which you may select Clicking LAST will list the codes posted for the last visit Up to five separate procedure codes and or I codes as explained later will be listed PTOS will then ask if you wish to POST the same codes or QUIT to return to the main TRANSACTION screen NOTE Transactions must be run through the DAILY TRANSACTION REPORT before they will appear under LAST VISIT EXTENDED CHARGES Sometimes you may want to post several procedure codes for one visit You may also have a unique entry for which there is no procedure code Select E
114. e PRIMARY INSURANCE or SECONDARY INSURANCE fields of the Patient Data Screen such as a cash account PTOS knows there is no insurance to track unbilled charges for In this case UNBILLED CHARGES will be reset to zero whenever AGED ACCOUNTS RECEIVABLE is prepared CHARGES Total charges to date PAYMENTS All payments received from insurance carriers and the patient ADJUSTS Total adjustments on the account Including items like credits for courtesy discounts or insurance write offs Adjustments are explained in detail later in this section This could be positive if there are debit adjustments or negative if there are credit adjustments INS PAID When a payment from the insurance carrier is posted the date is entered here You can easily see an account with a high BALANCE and no insurance payments PAT PAID The last date a patient payment was received 40 INS BILL When an insurance claim is printed the billing date is updated You can find when the insurance carrier was last billed PAT BILL The last date a patient statement was printed 1ST VISIT This is the first day of treatment and lets you know exactly how long the patient has been coming VISITS Total visits to date AUTH VISITS The authorized number of visits as you entered them in the patient account AUTH DATE The date treatment authorization expires as you entered LAST CD The last PROCEDURE CODE that was posted LAST TX This is the last date the pat
115. ed in reports Therefore run any reports that should include data for patients to be removed before removing the accounts 69 MANAGEMENT REPORTS Aged Accounts Receivable Collection Analysis Delinquency Report Referral Report Out of Balance Accounts Account Type Summary Therapist Activity Procedure Summary Billing Efficiency Report Insurance Tracer Report Diagnosis Report Outcome Reports Monthly Collections Collection Efficiency Medicare Log AGED ACCOUNTS RECEIVABLE A very important report for any practice is the Aged Accounts Receivable Report It shows what is owed by patient accounts PTOS gives you several ways of looking at receivables An example of an Aged Accounts Receivable printout is shown on a following page When you post an entry in PTOS it calculates the account so that your financial data is accurate Generally at the end of the month you ll want to recalculate prepare aged accounts so that they are aged to the current month and print out the receivable report for reference and follow up When Aged Accounts is selected from the Management Task Bar the following screen is displayed showing the accounts receivable options and showing the last time Aged Accounts Receivable was prepared AGED ACCOUNTS WAS PREPARED 2004 07 31 Prepare A R for All Patients Prepare A R for 1 Patient A R by Account Number A R by Patient Name A R by Account Type A R by Insurance A R by Therapist Expected
116. er procedure or click QUIT to return to the main TRANSACTION screen 1 PROCEDURE CODE TEX1 UNITS AMOUNT 1 00 45 00 97110 THERAPEUTIC EXERCISE NOTES Last Patient When the charge is accepted additional information about the visit is pulled up as shown below and can be modified as needed 42 4 Transactions X Office 1 Account Type BC aon Ins Unbilled Date Code TEx4 3 0 00 Ins Bal Ins Paid Pat Bal Pat Paid 10 12 2006 Current Ins Bill 30 60 Pat Bill 60 90 0 00 Office 1 10 12 2006 90 120 0 00 1 120 0 00 Place of Service 11 Auth Vis 20 Remaining 19 Type of Service 01 Auth Date Max Charges 0 00 1 719 41 PAIN IN JOINT SHOULDER 0 00 2 4 Bill to Patient Sjecond Insurance Only or Blank for All OFFICE This is the assigned office for the patient as entered in the Patient File If the patient was treated at a different office it can be designated here THERAPIST The treating therapist is automatically filled in from the assigned therapist which can be changed if someone else treated the patient This is used on the THERAPIST ACTIVITY REPORT and various lists to calculate charges generated by each therapist PLACE OF SERVICE is only used on insurance forms The default for this field is pulled from the Patient Data Entry Screen TYPE OF SERVICE TOS is also used only on insurance forms Most insurances don t require POS or TOS so you can probably skip
117. ese are all on demand reports which means they can be run as often as desired rather than on a preset schedule The selection of Management Reports is shown below with examples of various reports You don t need to run every report Decide which are most applicable to your office and print only those reports There are two reports you should run every month to verify that your Accounts Receivable are in balance These are the Accounts Receivable by Account Number and Collection Analysis Virtually all reports can be run for a specific OFFICE LOCATION or revenue center or for the entire practice as a whole Some reports ask if you want to include discharged patients Other reports ask if you want to include categories with no activity for the period such as referrals or account types with no activity With most reports you are asked the time frame to include on the report You will almost always use the current month however you may look at data from past months or totals for a quarter or even year to date PROVIDING THE DATA FROM THOSE PAST MONTHS HAS NOT BEEN REMOVED NOTE The totals shown on different reports for the same time period may not be equal PTOS provides a great deal of flexibility so that you can track statistics the way you want For example you aren t REQUIRED to enter a treating therapist when you post a payment If you don t however that payment won t be credited to a therapist on the THERAPIST ACTIVITY REPORT but
118. he main TRANSACTION screen shown on the next page The data displayed gives an up to the minute picture of the account It allows you to quickly spot an account with a high balance someone who has only a few visits remaining on their treatment plan or an account that has somehow not been billed on schedule You can also click the PREPARE A R NOW button to age the account up to the minute 39 i Transactions E e110 a 60501 E NAR Office H BC COLLEC Ins Unbilled 240 00 Last Code Date 10 13 2006 Charges 240 00 Last Tx Payments 15 00 Balance Adjusts 0 00 Ins Bal Ins Paid Pat Bal Pat Paid 10 12 2006 Current Ins Bill 30 60 0 00 Pat Bill 60 90 0 00 1st Visit 10 12 2006 90 120 0 00 vi 0 00 Auth 20 emai 19 Auth Date 12 06 Max Charges 0 00 Making sure that the patient doesn t exceed authorized treatment is important PTOS therefore checks the patient s AUTHORIZED VISITS and AUTHORIZATION DATE If the authorization date authorized visits or maximum charges have been exceeded the screen will highlight these fields in yellow The POSTING NOTE also appears in yellow below the patient s name FINANCIAL DATA FIELDS ACCOUNT TYPE The patient account type as explained under ENTER PATIENT DATA INS UNBILLED Charges which have not yet been billed TO AN INSURANCE CARRIER are shown here When an insurance claim is sent the amount billed is subtracted from UNBILLED CHARGES If the patient has no entry in th
119. herapist account type home and work phone and an EDIT column The edit shows an A if the patient is to be removed from PTOS when REMOVE OLD ACCOUNTS is run CITY Patients are sorted and subtotaled by the city in the patient s address 88 ZIP CODE Patients are sorted and subtotaled by the sip code in the patient s address BIRTHDATE You can list all patients sorted by birthdate or you can select a specific a specific birth month to list EMPLOYER Patients are sorted and subtotaled by employer EMPLOYER CITY Patients are sorted and subtotaled by the city in the employer s address OCCUPATION This sorts patients by their occupation COVER SHEET PRINTOUT This list provides a cover sheet which contains the data you ve entered on the Patient Data Screens This can be printed and placed in the patient s file PATIENTS BY SORT The SORT field in the Patient Data file can contain any miscellaneous information you wish to track for the account This list sorts and prints any accounts with an entry in the SORT field 8 OTHER LISTS As with PATIENT LISTS these are designed to provide information to the front and back office staff All lists are described below with examples of some printouts When OTHER LISTS is selected the menu below appears OTHER LISTS Transactions Procedure Codes ICD9 Codes Insurance Carriers Doctors or Attorneys Therapists Account Types City Codes Payment Adjustment Codes
120. hrough the many possible Outcome Report formats Experiment with different combinations until you find a mix of reports that are the most useful for your individual requirements MONTHLY COLLECTON REPORT Each month payments are received These are for charges that may be from two weeks ago or two months ago Knowing the age of charges that are being paid helps manage collection activity This report shows what payments were received in the various Accounts Receivable aging categories In order for the report to be accurate payments must be posted using the LINE ITEM or DATE RANGE format When you select this option the screen below appears ma 4 Monthly Collection Report n Opdat tracking datadi To initiate collection tracking for the first time you must start by selecting option 2 to Update Tracking Data This sets a baseline against which payments for the next period will be measured Once you run option 2 all new payments will be tracked in their appropriate aging categories At the end of the tracking period let s say one month later you can select option 1 to print the MONTHLY COLLECTION REPORT A report that looks like an Aged Accounts Receivable Report will be printed however the amounts shown under CURRENT 30 60 etc will be totals of payments that were received for charges in those periods After printing Monthly Collection Reports in any of the formats that you require again select option 2 to Update Tracking Data This
121. ient was treated BALANCE Probably the single most important piece of financial information This amount is updated immediately whenever you enter a charge payment or adjustment You can always find exactly what is owed INS BAL Since you ve entered the DEDUCTIBLE and PERCENT TO BILL PATIENT or CO PAY billing in the Patient File PTOS can calculate the patient and insurance portion of the balance This field shows the insurance portion of the total balance PAT BAL This is the patient s portion of the total balance NOTE If you answered yes to CALC OF EXPECTED AMT in the Patient File this amount will reflect the percent to bill patient multiplied against the EXPECTED AMOUNT of each charge CURRENT 30 60 60 90 90 120 120 These five fields show aging of patient balances and again allow you to quickly spot slow paying accounts REMAINING This shows how many visits remain on the treatment plan MAX CHARGES Maximum charges you designated in the patient account There are several tasks you can perform from the main transaction screen When you first pull up the screen the PATIENT ACCOUNT NUMBER box is active If you wish to pull up a different account you don t need to end and go back to the SEARCH screen but can just enter the correct account number here You can also use F2 or double click to find the right patient We ll cover the various options available from this screen starting with posting charges Once
122. ill from any patients who have not received a statement since that date will be selected INCLUDE PATIENTS WITH ZERO PATIENT BALANCE PTOS will not print a statement for a patient with a ZERO or credit balance unless you tell it to Checking this box allows statements to be generated even if nothing is owed by the patient Normally if the patient portion of the balance is zero you don t want to send a statement Sometimes you may want to send a statement either as a reference to the patient as to their account status or when REMOVING OLD ACCOUNTS When an account is closed you can REMOVE the patient which clears them off the active system Before REMOVING OLD ACCOUNTS you can change the ACCOUNT TYPE to ZZ then run statements for all ZZ patients to be placed in their chart OFFICE TO BILL If you ve separated your accounts into different offices you can run bills for a specific office BILL BY DATE RANGES INCLUDE ACTIVITY FROM TO If a patient has been treated over several months you may not want all activity listed only the last month or so You can select which dates to include on the statement by filling out this line For example FROM 2004 07 01 through 2004 08 31 will bill only July and August activity Leaving these two fields blank will cause all transactions to be listed not just those for the current month This provides the patient with a complete concise bill BILL ONLY IF THERE WERE CHARGES
123. in a given month an additional charge will be posted to the account BACKUP PTOS DATA This option copies PTOS data to a separate folder on your computer THIS DOES NOT TAKE THE PLACE OF BACKING UP YOUR PTOS DATA ON ZIP DISKS OR OTHER MEDIA AND TAKING IT OFFSITE FOR ADDED SAFETY LOGIN AS A DIFFERENT USER This lets you change the system date or your password level without having to exit and restart PTOS RESET FILES You should never turn off your computer while it is running a task If you do you may damage data files If data becomes scrambled due to abnormal ends or hardware malfunctions RESET FILES can frequently recover files into usable condition YOU SHOULD RUN RESET FILES ONCE PER WEEK just as a maintenance procedure to reorganize into their most efficient format CLOSE ALL FILES This MUST be selected by workstations on a network when RESET FILES or PREPARE ACCOUNTS RECEIVABLE are run It closes data files so that EXCLUSIVE operations can be run DELETE INDEXES AND RESET This is a more advanced version of RESET FILES that will further defragment data It can be run if the system slows down do to heavy use or if there has been a hardware malfunction 97 10 SPECIAL TASKS These are special functions which contribute to the flexibility of the system When you select this task the following menu appears SPECIAL TASKS MENU nd Letters heduling Remoy Renumb Import Insurance Payment Data SEND LETTERS
124. ing accounts This is an outline of how PTOS will be used Keeping this flow in mind as you learn about PTOS will help bring the entire picture together COMPUTER SETUP PTOS is a VISUAL FOX PRO application program designed to run under Windows 95 or higher on IBM compatible PCs MEMORY We recommend a minimum of 64 megabytes of memory 128 megabytes is better and 256 megabytes is optimal DISPLAY PTOS for Windows requires a monitor with a resolution of 800 by 600 or higher PRINTERS Selecting a printer is critical for achieving the best results We recommend LASER printers All PTOS output is formatted for 12 characters per inch printing and alignment must be set carefully especially for insurance claims Other requirements are that the printer be set for 11 inch paper 6 lines per inch printing Different printers accomplish setting these parameters in different ways There are hundreds of printers on the market We simply can t keep up with all the changing commands for manipulating printers and we do not provide printer drivers It is the responsibility of the person who sold you the printer to show you how to set it up LOCAL AREA NETWORKS If you will be running PTOS on a network there are several considerations to keep in mind First you MUST have a Network version of PTOS With the Network version of PTOS you receive an addendum that details the setup and operational considerations to follow PTOS requires FULL RIGHTS t
125. is option PTOS will then ask if you want to generate labels for a specific account type location or office You can also print for only patients with a FIRST VISIT date on or after a date you enter and you 100 can select active discharged or all patients You can print the labels in patient number name or zip code order and you can tell PTOS how many labels to print for each patient LABELS FOR DOCTORS OR ATTORNEYS If you want to generate labels for referring doctors or attorneys load labels into your printer and select this option PTOS will then ask whether to print for doctors or attorneys You can also enter a specialty to print the labels for or you can leave blank for all The labels can be printed in name or zip code order and you can specify how many labels to print for each doctor or attorney LABELS FOR INSURANCE CARRIERS This lets you generate labels for one or a group of insurance carriers LABELS FOR PAYORS If you want to generate labels for payors load labels into your printer and select this option PTOS will then ask if you want to generate labels for a specific account type location or office You can also print for only patients with a FIRST VISIT date on or after a date you enter and you can select active discharged or all patients You can print the labels in patient number payor name or zip code order and you can tell PTOS how many labels to print for each payor ARCHIVED PATIENTS This option lets
126. ists If you need to reprint a missing report select this option and enter the number of the report to be reprinted APPEALED OR DENIED CHARGES Charges that you have marked as appealed or denied can be listed through this option PROCEDURE LISTS When you need to generate reference lists of procedure codes or procedure detail codes there are several options The following menu appears when this option is chosen 4 Procedure Codes List Aue A EEA codes And Descriptions i Only Descriptions Containing First option lists only the Procedure Code and Statement Description Line as a quick reference Second option shows all fields of procedure information just as you see it on the ENTER PROCEDURE CODES screen Third option lists the procedure code and the last date it was used This is helpful when purging old unused procedure codes ICD9 CODES With this option you are able to print a list of all diagnosis codes You can list only codes with a specific diagnosis such as any codes containing LUMBAR or you can generate a list of all codes as a reference You can also select if you want the list sorted by ICD9 CODE DESCRIPTIVE DIAGNOSIS or INJURY AREA INSURANCE CARRIERS When this task is selected you are asked whether you wish to print the list in order of INSURANCE CODE or INSURANCE NAME As with other lists you can print only carriers with a specific NAME or for all codes A description Blue for example would call up Bl
127. ivable Report can be run so the overdue balances are aged exactly to the day You may want to add a finance charge to lien cases or cash accounts but not charge interest to Medicare or Worker s Comp patients When you select this task the following menu appears 96 ADD FINANCE CHARGES ENTER ACCOUNT TYPES TO CHARGE ENTER DESCRIPTION FINANCE CHARGE ENTER PERCENT TO CHARGE ENTER A MINIMUM FINANCE CHARGE AMOUNT CHARGE ACCOUNTS OVER 3 0 6 0 9 0 OR 1 20 OVERDUE CHARGE A LL OR D ISCHARGE PATIENTS ONLY PTOS asks for the account types you want charged as well as a description In some states you can t charge a Finance Charge but you could charge a Rebilling Fee So PTOS lets you put in the description you want The standard finance charge is 1 5 but you can modify the percent as needed If you want a minimum charge such as 5 00 that can be entered and you can select the definition of an overdue account The default is billing the charge to an account 90 days past due but you can change this to over 30 60 or 120 days You can also indicate to only charge a finance charge to patients who have been discharged Finance charges are entered as DEBITS by PTOS This means they will appear as a charge on patient statements and in financial calculations but will not be billed on insurance claims Only add interest charges to an account type once a month If you run this task for the same account type more than once
128. just type PA in this field and PAYOR name and address will be copied You can also double click or press F2 for a list ADDRESS Employer address line 1 CITY STATE ZIP Of employer address ADMIT COND Upon admission the patient can be evaluated in up to six categories such as functional level pain strength or others you designate These numerical values are on a scale of 0 to 10 and entered in each of the 6 ADMIT CONDITION categories You can use a percentage such as 70 or 45 percent instead of a level if you wish Before establishing the criteria you use in the ADMIT COND and DISCRG COND fields you should read the OUTCOME REPORT options in the MANAGEMENT REPORTS section 31 DISC COND On discharge the patient is evaluated on the same six categories as ADMIT COND Several OUTCOME REPORTS can then be run in MANAGEMENT REPORTS NOTE IT IS CRITICAL THAT CATEGORIES BE CONSISTENT IF STRENGTH IS THE FIRST CATEGORY ALWAYS ENTER THE VALUE FOR STRENGTH IN THE FIRST POSITION IF SOMETIMES YOU ENTER THE STRENGTH VALUE FIRST AND SOMETIMES YOU ENTER FUNCTIONAL LEVEL FIRST THE OUTCOME REPORT WILL BE MEANINGLESS ATTORNEY This can be used to track referring attorneys If the attorney is entered in Update Referral Codes enter the code in this field or use F2 to select the appropriate name NOTES LINE 1 and 2 are displayed on this screen To access additional notes click the NOTES button at the bottom of each PATI
129. l up the resulting file i e REP1 TXT to view or edit with a word processing program DIRECT PRINTER TO Lett ACCOUNTS RECEIVABLE PARAMETERS You are able to set several parameters for calculating accounts receivable Normally accounts are updated when transactions are entered and completely re aged when PREPARE ACCOUNTS RECEIVABLE is run in MANAGEMENT REPORTS If you wish any patient who had activity during the day can have their account completely re aged when the DAILY TRANSACTION REPORT is printed The PTOS standard is to age accounts from the day a charge is posted If you wish you can change the setting so that aging will not start until the INSURANCE CARRIER is billed You can tell the system to print the A R on the DAILY TRANSACTION REPORT Then each time the report is run PTOS will recalculate A R show the old A R not including activity on the report the net change on the report and the new A R If there is a difference indicating a discrepancy in the data then the difference will also print You can also close an accounting period No transactions prior to the closing date can be added modified or deleted 22 ACCOUNTS RECEIVABLE PARAMETERS CALCULATE ACCOUNTS RECEIVABLE 1 WHEN PREPARE AJR IS RUN IN MANAGEMENT REPORTS 2 WHEN DAILY TASKS IS RUN AGE BY Posting OR Bpilling Date PRINT AJR ON DAILY TRANSACTION REPORT Y N TO CLOSE AN ACCOUNTING PERIOD ENTER THE CLOSING DATE NO TRANSACTIONS PRIOR TO THIS
130. le of 600 by 800 resolution Printer capable of 12 CPI printing INSTALLATION INSTRUCTIONS SINGLE USER PTOS for Windows can be loaded into any folder on your computer We recommend loading it into a folder named VPTOS on the C drive This is the default in SETUP 1 Place the CD in your drive Depending on your configuration the CD may install automatically If not click START on your desktop then click RUN Run SETUP from your CD drive If your CD drive is G for example you will type G SETUP in the OPEN box 2 Follow the prompts through the several SETUP screens until you are prompted for the FOLDER in which to install PTOS The default is C VPTOS You can however change both the drive and the folder for installation We recommend keeping everything in C VPTOS unless you really have a reason to change it Finally click on INSTALL ALL FILES INSTALLATION INSTRUCTIONS NETWORK Network installation is similar to single user installation with a couple of additions You will have two program CD s one labeled SERVER and the other CLIENT The SERVER CD should be loaded on the network server in the same manner described above for a single user installation In most cases the drive letter will be F If installing PTOS on your network server from a work station be sure to use the server drive letter The CLIENT CD should be loaded on each of the workstations The default installation folder for client
131. lect to run this list by a specific Location Office or Account Type Next you are asked to choose a SORT category Primary Diagnosis or Injury Area are the most common but you can also sort and compare outcomes based on the insurance carrier account type or any of the several other sort groupings Sorting by insurance carrier for example may show differences in outcome based on the number of visits the carrier will authorize A third major category is GROUP BY The Outcome Reports are multi dimensional Not only do they show outcomes by diagnosis or injury area they compare how those outcomes vary by other factors such as how soon the patient was treated after their injury 80 ENTER GROUPS GROUP DAYS BETWEEN INJURY AND FIRST VISIT ARE 1 LESS THAN GREATER THAN GROUP 1 AND LESS THAN GREATER THAN GROUP 2 AND LESS THAN GREATER THAN GROUP 3 AND LESS THAN GREATER THAN GROUP 4 ak WwW PY There are five date range groupings that can be specified In the above case you may enter 15 as the first group 30 in the second 45 in the third and 60 in the fourth This means you want to see the outcome compared based on how soon you saw the patient after they were injured A sample is shown in the report below Instead of grouping by INJURY TO FIRST VISIT you may want to see how outcome varies based on the duration of treatment so choose 1ST VISIT TO DISCHARGE An ENTER GROUPS screen similar to the one above would ap
132. manent as opposed to changing them for just one run just answer YES to MAKE OPTION CHANGES PERMANENT OTHER PATIENT BILLING OPTIONS PATIENT BILLING BY OVERDUE AMOUNT Patient billing by overdue amount lets you send statements to delinquent accounts Select whether you want over 60 90 or 120 day accounts and if you only wish to include those who have made no payments since a date you specify NOTE if you select billing those over 60 days only accounts whose OLDEST balance is 60 days will be billed Anyone with a balance over 90 or 120 will NOT be billed This allows you to group billing and dunning notices to accounts that are a little past due 60 days more delinquent 90 days and very much past due 120 days PATIENT BILLING BY PATIENT NUMBER The final option for patient billing is by patient number This allows you to generate a statement for up to SIX patients at a time Enter the patient numbers to bill and their names are pulled up as a reference You can also use the HELP key if you don t know the patient s number This statement option can be useful for printing statements to patients who have just been discharged 63 5 INSURANCE BILLING Insurance Billing Patient Billing elect Form Layout v Laser HCFA 1500 Bill to P Bill by Patient Range Patient from to Bill by Account Type ill for Set Printer Line Formats 2 3 C ed Treating Output 5 t Amount Ranges Bill Yyhi BLATE Amoun
133. n be printed in BOX 84 by selecting Y es PRINT A3 ON THE UB92 This value code prints in box 39 40 or 41 of the UB92 and is required by some but not all intermediaries Enter Y es to print A3 PATIENT NOTES SCREEN 4 Notes 060501 DAVIS GIANNA R yr verification patient has Delete Delete All Un delete all ASCENDING DESCENDING Displays notes in date order NEW NOTE Type any notes pertaining to your patient account such as insurance benefits and or telephone calls made or received by the insurance carrier patient or attorney regarding your patient s account You must press the enter key so that your note will be saved 38 SHOW DELETED Will display deleted notes PRINT Allows you to print patient notes to paper DELETE Click on highlight the note you wish to delete and press the delete button DELETE ALL Allows for all notes to be deleted UN DELETE ALL This option will bring back into notes screen all deleted notes CLOSE Ends the note session ADDITIONAL PATIENT SCREEN INFORMATION LOCKED UNLOCKED ALL PATIENT SCREENS show LOCKED or UNLOCKED at the top of the screen If you are running on a network and pull up an account it is UNLOCKED If you start making modifications to the patient s data PTOS automatically locks the patient record Other users can view the patient account but they cannot modify it until you close the record thereby unlocking it DELETING AN ACCOUNT If you wa
134. ng digit years in all date boxes ELECTRONIC CLAIMS If you have purchased the PTOS ECS interface option checking this box will send billing output to the ECS transfer file for transmission to your ECS intermediary SET PRINTER LINE FORMATS As every printer is somewhat unique you may need to click on this selection to adjust where boxes print on your version of the insurance form 64 BILL BY PATIENT RANGE If you want to bill a specific patient number range you can enter the range here BILL ACCOUNT TYPES You can select only certain account types to bill Up to six account types can be billed in a session As with patient statements if you only enter the first character of the account type all account types with that first character will be billed If you want all Medicare whether they are MM MP or any other M account simply type M This means bill any patients whose first character in account type is M BILL FOR ASSIGNED OR TREATING THERAPIST TO BILL This option will allow you to bill by the assigned therapist or the treating therapist and the ability to bill by an individual therapist LOCATION TO BILL If you only want patients from a specific location those whose account numbers begin with a specific character enter the location OFFICE TO BILL If you ve separated your accounts into different offices you can run insurance claims for a specific office OUTPUT SORTED BY You can sor
135. ng of amounts owed is VERY accurate It also means that you cannot re run Accounts Receivable for a prior time period because any Line Item or Date Range payments or adjustments that were posted since the old report was originally run will now be included against the charges they were posted to probably showing the total A R to be lower than when it was originally run When Preparing A R PTOS asks you to ENTER STARTING DATE FOR REPORTS and ENTER ENDING DATE FOR REPORTS When you Prepare Aged Accounts the information used in many other Management Reports is also calculated The STARTING and ENDING dates refer to the date range you want reports compiled for PTOS will default to preparing for the current month i e STARTING 2004 07 01 ENDING 2004 07 31 but you could change the dates to STARTING 2004 01 01 ENDING 2004 03 31 to get reports for the first quarter or any other time frame you wish to view NOTE When PREPARING ACCOUNTS RECEIVABLE much of the data used in other Management Reports is calculated The CHARGES PAYMENTS ADJUSTMENTS and VISITS that appear on many other reports are based on the dates you select when A R is prepared It s essential to fill in the STARTING and ENDING dates for the period you want to use for ALL reports When some of the reports are run PTOS again asks for the date range This is used to calculate numbers such as NEW ONGOING DISCHARGED and TREATED patients For your reports to be accurat
136. nt to remove a patient account from the system first delete any transactions you ve entered for the patient then PRINT NEW AND DELETED TRANSACTIONS from the DAILY TASKS option Finally erase the patient s first and last name from the Patient Data Screen PTOS will then consider this an invalid account and remove it when RESET FILES is run RENUMBERING AN ACCCOUNT If you wish to change a patient account number select RENUMBER PATIENT ACCOUNT from the SPECIAL TASKS menu This could be necessary if the revenue center to which the patient is assigned has changed The patient s account number and all transactions related to the patient will be renumbered Once patients have been entered you can start posting charges and payments so that PTOS can do your billing and create statistical reports The first transaction for your existing patients when you convert to PTOS will be entering their current balance Entering beginning balances and all transaction posting is explained in the following section 3 TRANSACTIONS Transactions are entries that affect the balance of an account They include charges payments and adjustments Before transactions can be posted the patient account must exist in PTOS Selecting TRANSACTIONS from the MENU BAR pulls up the same SEARCH screen as ENTER PATIENT DATA described previously You can use the same techniques to find the patient RIGHT CLICKING on the proper patient or clicking the TRANS button pulls up t
137. o the VPTOS folder and all of its sub folders and files In addition all workstations must have FULL RIGHTS to their local TEMP folder and its files You can direct printing to any printer on the network by selecting PRINTER DIRECTION from CHANGE PARAMETERS in SYSTEM TASKS Printing can also be redirected at the time sending output to a printer is selected If you use print spooling it is up to your hardware consultant to set the spooler correctly If this is not set correctly documents can be lost OPERATIONAL CONSIDERATIONS The Network version of PTOS allows a high degree of freedom when using various data entry and reporting routines As with any multi station data entry system however certain precautions should be taken into consideration These considerations can be summed up in one statement No data can be entered that will affect the results of another operation taking place at that same time Specific considerations are listed below RESET FILES When one workstation is resetting files all other workstations must first select the CLOSE ALL FILES task from the SYSTEMS TASKS menu bar Once reset has completed they can click on OK to reopen files and continue using PTOS IMPORTANT INFORMATION There are basics which apply throughout PTOS which you should take note of THESE ARE ALL IMPORTANT AND MUST BE FOLLOWED FORMAT FOR DATES There are four different formats you can select to enter dates These are explained in the
138. on PTOS first asks if you want attorneys or doctors and if you want only those with a certain specialty If you want all doctors or all attorneys to receive the letter just leave specialty blank You can also indicate whether to generate the letters in name or zip code order The following fields are then copied to PTOSLETR TXT 1 Last Name 2 First Name 3 Title 4 Address Line 1 5 Address Line 2 6 Address Line 3 BIRTHDATE If you want to send birthday notes to patients select this option PTOS then asks for the birth month to find If you want all patients born in June just type 06 The same fields are copied as described in sending letters by DIAGNOSIS above NEW PATIENTS This option lets you send letters to all that were first seen within a date range that you select One use would be to send welcome letters to all patients who started week The same fields are copied as described in sending letters by DIAGNOSIS above and can be generated in patient number name or zip code order NOTE Each of the following label options allow you to select standard 3 5 inch by 15 16 inch one across labels or standard 1 inch by 2 5 8 inch three across labels You can also enter a range of Zip Codes to include If needed you can adjust label alignment for your printer in SET PRINTER LINE FORMATS in CHANGE PARAMETERS LABELS FOR PATIENTS If you want to generate labels for patients load labels into your printer and select th
139. or their account Credit balances could result from overpayments posting an entry to the wrong account or adjusting off an amount that shouldn t be adjusted off PRE BILLING EDIT There is certain key information that is needed on most insurance claims By running the Pre Billing Edit list several key fields are checked Any patients with insurance who are missing the Referring Doctor or the doctor s UPIN number Diagnosis Patient Sex Primary Insurance ID or Birthdate are listed The Pre Billing Edit report now has the option to exclude patient accounts with a zero balance CO PAY ACCOUNTS This lists all patients where CO PAY has been marked YES in the patient account PATIENTS AT CHARGE LIMIT If you entered a Charge Limit for a patient you can print this list to show who is at or near their limit When the list is run you are asked for a dollar amount and anyone with a Charge Limit entered and who is within this range will be printed BALANCE CALCULATED ON EXPECTED AMOUNT On the second Patient Data screen you re able to indicate any accounts whose balance should be calculated on the Expected amount of charges rather than the amount actually billed This option allows you to list all such accounts DEMOGRAPHIC LISTS NAME This can be used as a reference of patient information and as a cross reference for finding the account number of a specific patient Patients are listed in alphabetical order with their assigned t
140. ormats Summary Detailed Co pay Payment Patient Balance Computation Sample Statements Billing by Overdue Amount Billing by Patient Number SECTION 5 INSURANCE BILLING Billing Parameters Electronic Claims Set Printer Line Format Setting Standard Options SECTION 6 MANAGEMENT REPORTS Column Headings Aged Accounts Receivable Preparing Aged Accounts Aged Accounts Print Options Summary by Account Type Insurance or Therapist Expected A R Extended A R Display A R A R With Estimated Responsibility Collection Analysis Delinquency Report Referral Report Out of Balance Accounts Account Type Summary Therapist Activity Procedure Summary Billing Efficiency Insurance Tracer Diagnosis Report Outcome Reports Monthly Collections Collection Efficiency Medicare Log SECTION 7 PATIENT LISTS Treatment Lists Financial Lists Demographic Lists SECTION 8 OTHER LISTS Transaction Lists All Transactions All Charges Unbilled Charges Unpaid Charges Payments Adjustments Charges Payments by Primary Insurance Transactions Without Valid Account Reprint a Daily Transaction Report Appealed or Denied Charges Procedure Lists ICD9 Codes Insurance Carriers Doctors or Attorneys Therapists Account Types City Codes Payment Adjustment Codes Employer Codes SECTION 9 SYSTEM TASKS Daily Tasks Print New amp Deleted Transactions Daily Transaction Report View Transactions on Screen Print Bank Deposit Slip Ad
141. osis should not be visible through a window envelope By moving where the PAYOR data starts printing you can control what is visible in a window envelope CLEAR TRAINING DATA When you first learn PTOS you can enter dummy patients transactions and other data Then before using PTOS for real work select this task to clear that dummy data You can clear some codes while keeping others by checking which files to clear Before clearing data always back up your data first DISPLAY CHANGE PATH TO DATA FILES This is a selection that you shouldn t need to change once PTOS is initially installed It tells your system where to look for PTOS data PRINT REPORTS IN BOLD If your printer output appears too light check this option to get darker print SHOW CALENDAR When entering dates in PTOS a calendar can automatically pop up It can be turned off here VALIDATE DATABASE DURING RESET Validate Database During Reset This should normally be left on and allows more extensive file checking when RESET FILES is run THE NEXT STEP Once all codes are entered you are ready to start putting your patients into the system You ll want to enter all patients who are currently being treated and also discharged patients who still have an open balance ENTER OR CHANGE PATIENT DATA which we ll cover next Posting the current balance for all patients is discussed in a later section ENTER OR ADJUST TRANSACTIONS 25 2 PATIENT DATA This task
142. p for example MP could be Medicare with additional private insurance MM could be Medicare with Medicaid This gives you detailed activity breakdown in various reports and greater billing control When you enter an account type code PTOS checks to see if it s in the account type file If it is all corresponding patient s data fields are filled out appropriately When you post transactions the patient s account type is tracked If you later change the account type in the patient file you may want to change the account type in all transactions posted for the patient as well This can be done in the RENUMBER ACCOUNTS task under SPECIAL TASKS PATIENT SEX M for male or F for female DR RETURN Before a patient returns to the referring physician you may need to prepare a progress report Entering the scheduled date of return to physician will enable a list to be printed which aids the therapist in scheduling reports and treatment progress If the patient has additional treatments a new return date may be entered Also can be used in tracking when a patient needs a new RX or plan of care DATE INJURED Date of injury or onset of illness this field will print in box 14 of the HCFA form and or box 32 of the UB92 form FIRST VISIT First date patient was treated This is how VPTOS tracks new patients in your system BIRTHDATE Patient s date of birth DISCRG DATE When a patient is discharged enter the date To track dropo
143. pay amount The POST field is where you enter the amount being paid against the charge The second line shows the amount of the charge AM the expected amount EX any credits CR insurance payments IP or patient payments PP which have already been posted The third line of the charge description shows what you should be paid by the primary insurance When you created the INSURANCE CODE you specified a percent that the carrier normally pays when they are the primary insurance In the example on the next page it was 75 PTOS then calculates that percent of the amount charged and displays it under charge AM The percent of expected amount is displayed under EXPECTED EX The amount being paid should equal one of these numbers Also shown is the remaining balance 47 Enter the amount being paid against the charge or you can press lt enter gt to skip past the charge As you enter an amount on the line the total posted appears at the bottom left of the screen next to POSTED THIS PATIENT and POSTED THIS CHECK NOTE PTOS will automatically carry the check information if you wish to continue posting the same check to a different account When you reach the bottom of the screen you can press N ext screen to see more transactions or P revious to move backwards NOTE When you skip to the next screen the POST amounts for each line are transferred to the IP insurance paid field and the POST field is reset to zero on each individu
144. pear only you would enter five date ranges that represent the duration of treatment Any of the seven possible GROUPINGS can be selected and their corresponding date range groups entered In the sample report admit and discharge levels are being compared only in two categories You don t need to enter levels and compare all six categories You may only be interested in one or two comparisons such as overall functional level in category one and pain in category two PTOS permits you the flexibility of specifying what each category represents and how many categories you wish to compare DIAGNOSIS OUTCOME REPORT FOR 04 10 01 04 10 31 PRINTED 04 10 31 AVERAGE CHANGE BY CATEGORY AVERAGE TOTAL INJURY 1ST VISIT 1 2 3 4 5 6 CHARGE VIS DAYS PATS 354 00 LESS THAN 15 DAYS 6 2 4 8 0 0 0 0 0 0 0 0 964 12 1 32 0 3 L5 S29 5 0 4 1 0 0 0 0 0 0 0 0 L097 14 2 33 2 3 30 44 5 2 4 0 0 0 0 0 0 0 0 0 1498 16 2 35 4 6 45 59 Sak 3 7 0 0 0 0 0 0 0 0 1134 16 8 37 0 4 MORE THAN 59 4 2 B52 0 0 0 0 0 0 0 0 1239 17 9 41 2 2 GROUP AVERAGE Bike 3 7 0 0 0 0 0 0 0 0 1298 15 8 39 4 18 717 81 LESS THAN 15 DAYS 5 9 5 4 0 0 0 0 0 0 0 0 503 5 1 37 8 4 L5 29 5 6 5 0 0 0 0 0 0 0 0 0 553 baa 3 9L 4 30 44 4 5 4 4 0 0 0 0 0 0 0 0 652 6 8 42 2 3 45 59 4 0 4 2 0 0 0 0 0 0 0 0 765 7 3 46 3 6 MORE THAN 59 4 2 3 8 0 0 0 0 0 0 0 0 910 8 1 51 0 4 One format that some practices choose for category 6 is the result of a patien
145. ption in PTOS ENTER DAILY TRANSACTIONS Post new charges payments and adjustments PRINT BANK DEPOSIT SLIP If you use PTOS to generate your bank deposit slip PRINT DAILY TRANSACTION REPORT This is your key audit list of what was posted BACKUP FILES Backing up data files is EXTREMELY IMPORTANT Back up files DAILY WEELY ROUTINES E PRINT PATIENT AND INSURANCE BILLS These can be printed more or less frequently than once a week as desired m RESET FILES This reorganizes data files into their most efficient layout MONTHLY ROUTINES m PREPARE AND PRINT AGED ACCOUNTS RECEIVABLE This tracks the efficiency of billing and collections and is key in verifying that accounts are in balance E PRINT PATIENT NUMBER LIST This is also used in account balancing m PRINT COLLECTION ANALYSIS REPORT Along with aged A R and the Patient Number List this is used in balancing account totals m PRINT ANY OTHER DESIRED MANAGEMENT REPORTS There are some but probably not all reports that you want to see on a monthly basis E PRINT ANY OTHER DESIRED LISTS As referring doctor account type or other codes are added to your system print updated reference lists Em REMOVE OLD ACCOUNTS FROM THE SYSTEM When a patient is no longer active they can be permanently removed Once removed their data can no longer be accessed m PRINT NEW PATIENT NUMBER LIST If accounts have been REMOVED print a new copy of the list to use in balanc
146. r 30 60 or 90 days before you really insist on payment INCLUDE BILLED LINES The HAS BEEN BILLED entries showing when the patient or insurance were billed can be included on the statement SEND TO Normally the statement is addressed to the payor In some cases you may wish to send a statement to the patient as well An example would be billing an attorney as Payor and sending a second statement to the patient as a reference You can also indicate that the statement should be addressed to either the primary or secondary insurance carrier if you wish to bill them using the statement format rather than an insurance claim INCLUDE BALANCE FORWARD If the patient has been treated over several months and you are not printing the old charges PTOS will normally bring the old balance forward and print it at the top of the statement The Detailed statement example includes the BALANCE FORWARD while it has been suppressed on the Summary statement INCLUDE PATIENT HAS BEEN BILLED When the patient is billed PTOS asks if you wish to include a Patient has been billed statement in the patient account This is a DEBIT transaction for the patient automatically created by PTOS in a format which states who was billed the amount billed and the dates of service billed for example John Jones billed 565 50 for 12 01 thru 06 30 4 This will appear on the patient statement and any transaction lists and is VERY useful as a billing referenc
147. r reauthorization AUTHORIZED VISITS If the patient s insurance authorizes a set number of visits that number should be entered here If they later authorize more visits ADD that number in You can then track the total number of visits that were authorized REMAINING VISITS If the insurance authorizes or you want to assign a specific number of treatments that number can be entered here PTOS will then track how many visits remain as the patient is treated The number can be reset if more visits are authorized This is different from AUTHORIZED VISITS in that it shows how many visits REMAIN on the plan of treatment while AUTHORIZED VISITS shows the total that were authorized PRIVACY NOTIFICATION DATE The date you give the patient a copy of your privacy policies should be entered here for HIPAA compliance tracking HIPAA AUTHORIZATION DATE If the patient authorizes use of their private health information PHI the expiration date of that authorization should be entered here DEFAULT POS PLACE OF SERVICE codes are assigned by insurance carriers If you wish to print POS in box 24B of the HCFA 1500 enter a default POS here It will be pulled into transaction entry and can be changed if the patient was treated at a different facility 36 PATIENT DATA SCREEN 5 HCFA i PATIENT DATA SCREEN 5 HCFA NAME DA Locked x R ACCOUNT TYPE BC Additional HCFA 1500 Boxes BOX 1 1 7 Primary Ins 5 BOX 1 1 7 Secondary Ins
148. r when you posted the charges This is very useful in projecting your true cash flow When these reports are run any payments received are subtracted from the amount you indicated as expected the remainder being what you still expect to receive PREPARE AND PRINT EXTENDED A R This generates a special accounts receivable report The standard A R reports age accounts out to 120 days You may also have VERY old accounts such as liens which may go back years The Extended A R report allows a detailed breakdown of these accounts 72 Extended A C Recievable Reports Date Range 1 Enter Location For Report Blank For All Enter Office For Report Blank For All Enter A C Type Blank For All When this option is selected you are asked for the aging categories you want to see In the example below we ve requested 120 150 180 and 210 days This then finds all accounts with a balance over 120 days and groups the balance in amounts which are between 120 and 150 days 150 to 180 days 180 to 210 days and anything over 210 days Since you select the aging categories you can break down the report any way you want Since ANY time frames can be specified you may want to see very new accounts such as 0 to 15 days 15 30 days and so on You can also run the report for just one account type if you wish DISPLAY ACCOUNTS RECEIVABLE BALANCE This calculates and displays your up to the minute receivable totals It can be run if you want to see tot
149. range you ve selected You then enter the AMOUNT TO POST and PTOS applies it to open co pay amounts starting with the oldest open charge ADJUSTMENTS There are three types of adjustments PATIENT CREDITS INSURANCE WRITE OFFS AND DEBITS as described below PATIENT CREDITS A credit transaction reduces the balance owed by the patient Examples are a bad debt write off or a professional courtesy discount A credit is different from a payment in that no money is received To enter a credit click ADJUST on the main TRANSACTION screen PTOS then asks if you wish to use B alance forward L ine item or D ate range posting These function the same as described above for payments INSURANCE WRITE OFF This has the same affect as a patient credit in reducing the balance owed but it is applied to the insurance portion of the bill instead of the patient portion To enter an insurance write off use I You can then select Balance forward Line item or Date range posting which work the same way as patient credit posting DEBIT A debit entry increases the amount in the patient balance It is different from a charge in that it doesn t represent a treatment A finance charge for example is posted as a debit A DEBIT WILL APPEAR ON THE PATIENT STATEMENT BUT NOT ON THE INSURANCE CLAIM It is considered a charge payable by the patient not the insurance When posting a payment to a debit it should be posted as a Balance Forward patient payment You can
150. rdening center you wish to track separately If you already have a patient numbering system you can probably continue with it as long as you use the first digit as revenue center To start a new numbering system we suggest you use a six digit number beginning with the revenue center digit The first patient would be 100001 then 100002 etc The 250 patient you enter would be 100250 NOTE All account numbers should be the same length If you use a six digit number as recommended above all account numbers must be six digits Don t start with patient 1 then after nine patients start using 10 then later move to 100 as this will cause patient lists and reports to sort incorrectly To add an account click the ADD button PTOS pulls up a screen asking for the new account number If you want to see the last account number used click the FIND button If you are using several revenue centers you can enter which location you wish to see the last number for You can also specify which office if you have several offices Type the account number you wish to assign PTOS will verify the number has not already been used and bring up the patient data entry screen Patient Data is divided into five screens the first containing patient data the second containing referral information the third insurance information the fourth financial information and the fifth billing form customizing All fields are expl
151. ription line is the fee OLD AMT If you change fees PTOS will track and show the LAST previous charge THE STATEMENT DESCRIPTION IS PRINTED ON THE PATIENT STATEMENT CO PAY In most cases CO PAY will vary by account type It can therefore be established in the UPDATE ACCOUNT TYPES as described below or even modified for an individual patient You also have the option of entering CO PAY in the procedure code if it will not vary by account type When you enter data for a new patient you tell PTOS whether to use co pay billing This is explained later in the section on entering Patient Data TOS is the abbreviation for Type Of Service used in Box 24C of the HFCA 1500 COST If you wish to calculate the profitability of individual procedures you can enter an amount here that reflects the cost of delivering the treatment PTOS will track it on your PROCEDURE SUMMARY REPORT TIME Entering the time it takes to perform the procedure will allow total treatment time to be calculated on your PROCEDURE SUMMARY REPORT EXPECTED AMOUNT The amount billed is usually not what you really expect to receive for the visit By entering the expected amount here you can track the amounts you expect to receive from third party payors BILL TO PATIENT OR SECONDARY INSURANCE ONLY In most cases all charges are billed to all parties There may be certain charges that you don t want to bill to some insurance carriers Enter a P in this fiel
152. ry a different format PTOS will make all necessary adjustments NOTE ALL USERS MUST USE THE SAME FORMAT ONE USER CAN NOT SELECT FORMAT 1 WHILE SOMEONE ELSE USES FORMAT 2 NOTE This only affects data entry it does not change how dates print on reports lists or bills GENERAL LEDGER POSTING DATA If you are using the APS Accounting Module PTOS can automatically transfer your daily charges payments and adjustments into the General Ledger If you instruct PTOS to update General Ledger you are asked for the accounts debit and credit You then enter the ACCOUNTS RECEIVABLE Deferred Income Fees Collected and Cash in Bank accounts for posting Whenever the Daily Transaction Report is printed the totals for each day will be posted to the appropriate accounts SET SEARCH KEY PREFERENCE Search Key Preference When you want to search a list of codes or patient account numbers you can double click on the desired box or press the F2 key If you want to change to a different search key such as F3 or F4 it can be changed here 24 PRINTER LINE FORMATS An extensive list of modifications are available for printing You can modify where boxes print on insurance forms both vertically and horizontally You can also modify label and superbill formats On patient statements you can move the top of the statement and control how many lines of transactions print on each page to avoid wasted paper NOTE with HIPAA privacy standards the patient diagn
153. s The actual printing of the letters is accomplished through your word processing program by merging the document you typed with the PTOSLETR TXT file The specific instructions used to create the merged letter will be dictated by your word processing program 98 NOTE It is a common to have your word processing program loaded in a folder other than the folder where PTOS is located If this is the case there is one more step involved before the PTOS data can be merged with your letter After selecting SEND LETTERS which creates the PTOSLETR TXT file PTOSLETR TXT must be copied to the word processing subdirectory DELINQUENT ACCOUNTS Collection letters may be sent to overdue accounts by selecting option 1 PTOS will ask whether letters should be sent to patients with a balance over 30 60 90 or 120 days and with no payments since a date you specify You can also select a Account Type Location or Office Number PTOS also asks if you want the letters in patient name number or zip code order When you select DELINQUENT ACCOUNTS the following fields are copied to a file called PTOSLTETR TXT 1 Patient Last Name 5 Payor Address Line 2 2 Patient First Name 6 Payor Address Line 3 3 Payor Name 7 Balance Due 4 Payor Address Line 1 8 Amount Overdue SAMPLE OVERDUE ACCOUNTS LETTERS July 31 2005 3 4 5 6 We are very concerned about the status of the account for 2 1 Of the 7 owed 8 is more then 90 da
154. s All patients who have a deductible to be met can be listed or all patients who have had a Payment Plan amount entered in their Patient Data screen HIPAA DATES There are two HIPAA dates tracked by PTOS When this list option is selected you can choose whether to print HIPAA AUTHORIZATION dates or PRIVACY NOTIFICATION dates You can 86 enter a date and PTOS will list all patients whose HIPPA Authorization has or is about to expire or list all patients who have not received your privacy policies FINANCIAL LISTS NUMBER ORDER This list prints all patients and can be sorted by Patient Number or Last Name The total charges payments and adjustments for the account are included The last date an insurance claim or patient statement was sent is also shown This lets you easily spot a patient who has not been billed or someone with a large outstanding balance This is the third printout used along with Aged Accounts by Patient Number and the Collection Analysis Report to balance your system at month end The E in the far right column shows the EDIT code and is included on several financial lists PATIENT NUMBER LIST PRINTED 2004 07 31 O PATIENT CHARGES PAID ADJUST BALANCE INS BILL PAT BILL E 000895 Prido Felisa 652 00 259 20 0 00 392 80 04 06 31 000909 Delin Sally 792 00 0 00 0 00 792 00 04 07 12 000920 Morby Philip 804 00 0 00 0 00 804 00 04 06 31 000936 Hinsen Darlene 527 00 0 00 0 00 527 00 04 07 13 000028 Olives Hild
155. s is C CPTOS Once the initial installation of the workstation has taken place run the CPTOS program from the icon on the menu A Database Selector will ask you to enter the path to the data files on the server We strongly recommend creating a map to the server on each workstation NOTES FOR CONVERSION FROM PTOS 2000 E Inactive data will not be converted If you have inactive Patients and Transactions that you wish to save you should REINSTALL ALL INACTIVE accounts before converting mE ARCHIVE OLD ACCOUNTS has been changed to REMOVE OLD ACCOUNTS Once a patient has been discharged their bills paid and statistics run the account is permanently removed from the system as before There is no longer a backup of ARCHIVED data on diskette TABLE OF CONTENTS SECTION 1 INTRODUCTION Typical Activity Sequence Initial Setup Daily Routines Weekly Routines Monthly Routines COMPUTER SETUP Memory Printers Local Area Networks IMPORTANT INFORMATION Format for Dates Shortcut Keys Cancel Printing Stopping the System Messages List Boxes SYSTEM DESCRIPTION File Record Field LEARNING PTOS Seminars STARTING PTOS User ID Main Task Bar UPDATE CODES ICD9 Codes Insurance Carriers Referral Codes Procedure Codes Introduction Billing Code Translation Creating Procedure Codes Revising Procedures Copying Procedures Deleting Procedures Mileage Codes Therapist Codes Payment Adjustment Codes City Codes Account T
156. scription order EMPLOYERS This lists all employers in the system 9 SYSTEM TASKS System Tasks are housekeeping operations used to personalize PTOS for the individual practice and maintain and update system operations The System Tasks menu is shown below SYSTEM TASKS Daily Tasks Update Codes Change Parameters Add Finance Charges Backup PTOS Data Login as a Different User Reset Files Close All Files Delete Indexes and Reset DAILY TASKS After posting new transactions you ll need to run options from the DAILY TASKS menu When you select this option the menu shown below appears Although called DAILY tasks you don t have to run them once per day Sometimes you may enter several day s entries and then run 94 one DAILY TRANSACTION REPORT Other times if you enter a lot of transactions in one day you may want to run several lists during the day DAILY TASKS 1 View on Screen 2 Print Bank Deposit Slip 3 Print New and Deleted Transactions 3 PRINT NEW AND DELETED TRANSACTIONS We ll start with option 3 first because it s the most important When transactions are first posted PTOS marks them as new You can then print an audit list to verify accuracy Selecting option 3 Print New and Deleted Transactions from the DAILY TASKS menu will enable these new entries to be printed on the audit list which is called the DAILY TRANSACTION REPORT Once they have been printed they are
157. se sorting within each diagnosis by therapist account type primary insurance doctor or employer If you sort by employer the last column on the list will be employer If you sort by insurance the last column will be insurance code All other selections will print the referring doctor 85 INJURY AREA Listing by injury area is similar to diagnosis but is grouped by a broad category such as neck back arm instead of specific diagnosis The columns printed and secondary sort criteria are the same as the diagnosis list THERAPIST Patients are grouped by assigned therapist The therapist s code patient number and name are listed along with the patient s home and work phone account type and diagnosis and referring doctor employer or insurance depending on the sort criteria you select INJURY DATE This lists all patients whose injury date is in a date range you specify This can be sorted by account type therapist or doctor The printout includes therapist injury first and last visit dates and referring doctor FIRST VISIT This list is similar to INJURY DATE above except it looks at first visit date instead of injury date and prints TOTAL VISITS instead of INJURY DATE LAST VISIT This is the same as FIRST VISIT except it looks at last visit date REMAINING VISITS You can specify a REMAINING VISITS number All patients who have fewer than this number of visits remaining on their treatment plan will print Included are col
158. surance carrier code as described in the section BILLING CODE TRANSLATION The second digit of the code must use one of the numbers listed above such as 1 for PT visit kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk Notice that in our table of PROCEDURE CODES above there is an individual entry for Hot Packs This is for times you may have an unusual combination of treatment such as Hot Packs and Biofeedback which you haven t set up a combination PROCEDURE CODE for You can then post two individual codes HP1 and BF1 for example This is explained in detail in the section on Entering Transactions There is a Special type of PROCEDURE CODE called a Z code When you post transactions PTOS will count how many patients were treated This total is tracked in VISITS on the various productivity reports If you sell supply items such as weights or bandages you don t want to count them as visits When you post a transaction PTOS will ask if it should count it as a visit However if you have some codes that will NEVER count as visits the code should start with a Z This will automatically mark it as Count As Visit No when you post the entry To define a procedure select UPDATE PROCEDURE CODES Type the code you wish to assign The system checks to see if it has already been used If it has been created PTOS displays the procedure and it can be revise
159. sured is entered here and will print on the HCFA form If P is entered for INSURED NAME see below the patient s employer as well as birthdates sex and relationship code of 1 will automatically be pulled in PATIENT RELATION TO INSURED Relationship of patient insured party for the primary insurance 1 self 2 spouse 3 child 4 other For Box 59 of the UB92 form you can enter the codes shown on the following page and the corresponding UB92 code will print CODE PRINTS CODE PRINTS CODE PRINTS CODE PRINTS 1 9 01 09 E 19 J 24 O 41 A 10 F 20 K 29 P 43 B 15 G 21 L 32 Q 53 C 17 H 22 M 33 R G8 D 18 23 N 36 INSURED NAME name of subscriber for primary insurance This could be the patient the payor or another party such as employer If the patient is the subscriber type P in this box and subscriber name and address data will be copied If the subscriber is different from the patient but the same as the payor enter PA and payor name and address information will be copied If the employer is the insured party type EMP and the employer name and address are pulled in ADDRESS Line one of subscriber address CITY STATE ZIP Of primary insured s address ACCEPT ASSIGNMENT this can be Y yes N no or blank and determines how the assignment box of the HCFA 1500 is checked BIRTHDATE Primary insured s birth date SEX primary insured s sex 33 SECOND INSURANCE Enter any secondary insuran
160. t from Only Patients wh Send Billing to When you select INSURANCE BILLING there are several options you can choose The screen on the next page shows the criteria to create insurance forms PTOS provides for several standard forms The default form is the HCFA 1500 By selecting form Z the HCFA 1500 or V the HCFA 2007 will be formatted to print on MOST laser printers We also include both summary and line item versions of the UB92 as standard forms Depending on the state in which you are located there may be other billing forms Select the claim form to be used Then respond to any of the parameters that apply Sometimes a special form or unique modifications of the HCFA or UB92 are required We can customize most forms on a fee basis if we don t already have it in our forms library The fee is determined by the complexity of the form or modifications BILL TO The default is to bill the primary insurance You can also bill both primary and secondary at the same time or select secondary billing after the primary has paid If you select BOTH first ALL primary claims will print THEN claims for any secondary carriers will print If you enter name and address Information for a third insurance as the patient s PAYOR select X to bill the payor FORMAT OPTIONS On the right side on the INSURANCE BILLING screen are format options Y2K This applies to either the UB92 or HCFA 1500 Checking this box will enable the printi
161. t most insurance output by account number patient name account type or insurance code PRINT MAILING LABELS If you check this box after all insurance claims have printed PTOS will stop and tell you to insert labels into the printer The system will then print one label for each carrier that was billed BILL BY DATE AMOUNT RANGES DATE FROM TO Normally PTOS will bill all charges which have not yet been billed to an insurance carrier except those that have been marked P only to be billed to the patient If you only want a specific date range you can enter it here AMOUNT FROM TO Each carrier has different Audit Levels For example a 300 claim may get only a quick look and approval by a claims clerk A claim of 600 may get a detailed review while the 1000 claim may go through several audit levels Each step means a delay in payment and an increasing likelihood that fees will be reduced or disallowed So you want to send in small claims frequently rather than large claims once a month At the same time you don t want to send in too small of a claim since it costs you time and money to produce mail and follow up on each claim you send By specifying amounts here you can set the size of claims you want PTOS finds patients who have unbilled charges in the amount range you enter We recommend running insurance claims weekly billing by unbilled charges over 250 This means a patient being seen frequently will be bille
162. t questionnaire Nothing is entered in category 6 under ADMIT COND After the patient is discharged they rate their satisfaction with therapy This score is entered in category 6 of DISCHARGE COND You now have a comparison of patient satisfaction which can be sorted by therapist account type or other criteria It can also be compared with your evaluation of the outcome in the other five categories Another recommendation is to use a category to indicate results of a follow up after 6 months or one year You can develop a scoring system to measure things like degree of to normal activity and out of work days due to a recurrence of the same problem If you can show a doctor insurance carrier or contract payor that your rehabilitation is significant in the long term 81 you have a solid marketing tool The numbers in each category show THE AVERAGE DIFFERENCE IN VALUE FROM ADMIT TO DISCHARGE In the above example you see that for patients whose primary diagnosis is 354 00 the GROUP AVERAGE INCREASE in functional level as this is what you assigned category one to mean is 5 5 You further see that if the patient is seen sooner for example with 15 days of injury you get a higher increase in functional level in this case 5 9 At the far right are average charges average visits and average duration of treatment in days for patients in the group Total patients in the group is also shown There is a tremendous amount of information available t
163. the UB92 PRINT A3 ON THE UB92 This value code prints in box 39 through 41 of the UB92 and is required by some but not all intermediaries You can control its printing by account type UPDATE EMPLOYER CODES Instead of typing the same employer name and address information over and over you can create a library of frequently used employers When you enter a four digit employer code the following screen allows employer data to be entered Update Employer Codes Zip 91356 20 CHANGE PARAMETERS Once code files are established you will tailor PTOS by setting System Parameters Select CHANGE PARAMETERS from the SYSTEM TASKS menu and the following appears CHANGE PARAMETERS Passwords and Security Levels Billing Code Translation Printer Direction Accounts Receivable Parameters Office Names Months for Year To Date Reports Date Format General Ledger Posting Data Set Search Key Preference Printer Line Formats Clear Training Data Display Change Path to data files Repair Line Items Print Reports in BOLD v Show Calendar v Validate Database During Reset INTERFACE PROGRAM OPTIONS If you use Spectrasoft software for scheduling or one of several popular documentation systems they can be interfaced directly to PTOS with this option You will only have this option if you have the PTOS interfaced version supplied by APS PASSWORDS AND SECURITY LEVELS Not everyone on the staff needs to have access to all PTOS options By
164. then calculated after each entry and aged amounts and balance due are shown at the bottom If deductible and or percent to bill patient amounts were specified in the Patient Data Screen or if co pay amounts have been posted against charges PTOS will calculate patient responsibility PTOS then subtracts patient payments and credits and will show the amount to be remitted as the AMOUNT DUE total NOTE IF YOU HAVE FILLED IN THE PAYMENT PLAN AMOUNT FIELD IN THE PATIENT FILE THAT IS THE AMOUNT WHICH WILL PRINT AS THE AMOUNT DUE IF NOT THEN THE PATIENT PORTION IS CALCULATED AS FOLLOWS 57 All debits are calculated as of the patient s portion this will include the Balance Forward debit when you initially install PTOS so the amount YOU consider to be the patient portion may not be what is shown There is no way PTOS can know what part of a Balance Forward DEBIT applies to the patient Charges are computed as follows First total charges are compared to the deductible If charges are less than the deductible the patient is billed for 100 of the charges If total charges exceed the deductible the patient portion is calculated as 100 of charges UP TO THE DEDUCTIBLE and the PERCENT you entered as the patient portion of the bill is multiplied against all charges in excess of the deductible If you have specified CALC OF EXPECTED AMOUNT on the Patient profile PTOS will multiply the PERCENT against the
165. type together such as all Blue Cross payments or all Courtesy Write offs 90 LORE RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRE G TRANSACTIONS FOR 04 11 01 FOR PATIENT 100000 THRU 122222 PRINTED 04 11 03 DATE PATIENT CODE DESCRIPTION AMOUNT PT AT V 04 11 0 OO1AR Alex Roberts 97128 Ultrasound 20 00 AR M Y 04 11 0 003PS Pam Simmons 97118 Electrical Stim 32 00 AR M Y 04 11 0 004KL Kent Langenforth 90020 Comprehensive Exam 122 50 AR B Y 04 11 01 100621 Alan Clark P LIN BC pd 366 00 for 10 03 10 01 04 K 04 11 0 00426 Alice Betnae S LIN Alice pd 360 00 for10 11 10 15 04 A 04 11 01 1004KL Kent Langenforth 97210 Therapeutic Ex 49 00 AR B N 04 11 0 OO4KL Kent Langenfrouth 99070 Cervical Collar 35 00 AR B N 04 11 0 013PT Pat Telen 97012 Traction Mech 40 00 AR W Y 04 11 0 016HP Harriet Powers 97118 Electrical Stim 32 00 AR M Y TOTALS FOR 04 11 01 330 50 CHARGES 5 VISITS PAID 726 00 PRR RRR RRR RRR RRR RRR ALL CHARGES This looks similar to the list above but only charges are included UNBILLED CHARGES When you select this option the following screen option will appear Tagi Unbilled Charges C Exclude Charges Marked To Bill To Patient Only Who To Bill is P Remember from ENTER OR ADJUST TRANSACTIONS that you can enter P in WHO TO BILL telling PTOS that this particular charge is to be billed only on the patient statement not on an insurance claim Checking Exclude Charges Marked To Be Bille
166. u ve specified are marked with an A 2 LIST ACCOUNTS TO REMOVE After marking accounts you can run a list of who will be removed for verification 3 REMOVE OLD ACCOUNTS All accounts you ve marked with an A will be PERMANENTLY removed 4 LIST REMOVED ACCOUNTS This will print a reference list of which accounts have been removed RENUMBER ACCOUNTS You may occasionally need to renumber a patient account or change an insurance carrier code You may also want to copy patient demographic data to a new account This task allows you to do so Choose the desired operation from the following menu RENUMBER PATIENT ACCOUNTS amp OTHER CODES 1 RENUMBER PATIENT ACCOUNT 2 COPY PATIENT ACCOUNT 3 RENUMBER INSURANCE CODE 4 COPY PATIENT ACCOUNT TYPE TO TRANSACTION ACCOUNT TYPE If you select option 1 you are asked for the current patient account number and the new number you want it changed to The patient account and all transactions for the patient are then renumbered Option 2 asks for the current account number and the new account number that you want the patient data copied to 106 If option 3 is selected you are prompted to enter the current insurance code and the desired code The code is then changed in the insurance file and ALL PATIENTS THAT HAVE THE CURRENT CODE ENTERED AS EITHER THEIR PRIMARY OR SECONDARY INSURANCE WILL HAVE IT REPLACED WITH THE NEW CODE When a transaction is posted the patient ac
167. ue Cross 93 Van Nuys Blue Cross of California Blue Nose Insurance and any other carriers with the word BLUE in their name You can also print a short list with only names and codes instead of all insurance carrier information Whenever new carriers are added or information about carriers changes this list can be printed All name and address data is shown for each insurance company It is also used as a reference to the operator when entering insurance codes in the Enter or Change Patient Data task DOCTORS AND ATTORNEYS You can list all doctors or attorneys in the Referral File sorted by Code Specialty Last Name or Print Name You can also ask for only doctors or attorneys with a specific name such as all Dr Smiths All fields in the Referral File are printed for reference THERAPISTS This list shows all therapists in the system sorted by either Name or Therapist Code ACCOUNT TYPES The Account Type list can sort by Account Type Code or Account Type Name You can print just a quick reference list containing just the code and name or a detailed list showing all fields for each account type CITY CODES This shows all City Codes you ve entered sorted by City Name City Code or Zip Code PAYMENT ADJUSTMENT CODES Similar to Procedure Codes Payment Adjustment Codes make posting payments and adjustments quicker and more consistent This listing shows the codes you ve created and can be printed in code or de
168. umns for therapist first visit last visit total visits account type authorization date authorized visits and remaining visits AUTHORIZATION DATE Any patients whose authorization date is within the date range you specify will print using the same format as REMAINING VISITS above DIACHARGE All patients who have been discharged and have not yet been archived or transferred to Inactive Accounts are listed Included is the assigned therapist discharge date and discharge information account type and referring doctor DROPOUT All patients who have dropped out and have not yet been REMOVED from the system are listed A dropout is designated by filling in the year and month the patient dropped out followed by 00 in the Discharge Date field of the Patient Data File For example 04 07 00 is a July 2004 dropout Included are the same columns of information printed on the DISCHARGE List above except first and last visit dates are substituted for discharge information NO ACTIVITY In a busy office a patient can sometimes fall through the cracks and become inactive without being noticed The sooner you identify someone who is missing treatments the better your chance of getting them back The list shows patients who have not been treated during a date range but have not been discharged or marked as dropouts PAYMENT PLAN DEDUCTIBLE When this option is selected you have the choice of printing either of two list
169. urance information is automatically filled into the patient file If you don t want to pull in any of the entries you see right click the mouse NOTE WHEN RIGHT CLICKING TO CLOSE A LIST BOX THE MOUSE POINTER MUST BE OVER THE DATA CONTAINED IN THE LIST BOX IT CAN NOT BE OVER A WHITE AREA IN THE BOX SYSTEM DESCRIPTION Most of the time you spend with PTOS will be entering and reviewing information in data files Here are three definitions to remember FILES are where your information is stored For example the Patient Data File contains all information about patients such as name address and balance due A RECORD is a collection of related words or data that make up one entry in the file A record in the patient data file contains all information about one patient A FIELD is a specific piece of data in a record First Name is a field in the patient data file LEARNING PTOS Read each section of the manual and perform tasks as you read about them Type in fictitious patient information and play with the data Don t be afraid to make mistakes everything you do during training can be deleted before you start using PTOS for real work PTOS has been developed for all sizes and types of therapy clinics Don t think that you must use every feature option list and report to get the most out of the program Read about all the features but don t feel that you must understand and start using every option to be efficient TEL
170. ut patients enter the year and month the patient dropped out followed by 00 e g 2004 07 00 NOTE Some reports need to calculate data about discharge patients And other lists can be printed only for active patients For these to be accurate AND TO REMOVE OLD ACCOUNTS you must fill out the DISCHARGE DATE field when the patient is discharged SORT DATA This can contain any unique information you wish to track for the patient population Under PATIENT LISTS a list of all patients can be run sorted by the entry in this field This would then group all patients by whatever you wish to track for an additional demographic report HOME PHONE Patient home phone WORK PHONE Patient work phone CELL PHONE Enter the patient s cell or other phone number EMAIL You can enter an email address for contact 30 INJURY AREA This is used for general description of injury area such as BACK KNEE or FOOT It allows a series of general injury type lists and reports rather than the groupings by specific diagnosis code If INJURY AREA is filled out in the ICD9 CODE file the INJURY AREA is automatically filled out when a primary diagnosis is entered ACCIDENT RELATED Indicates if the patient is being seen for an accident related condition A auto accident O other accident or leave blank This field will answer boxes 10B amp 10C PATIENT DATA SCREEN 2 DOC PATIENT DATA SCREEN 2 DOC Locked Patient 060501 Name
171. ype Codes Employer Codes CHANGE PARAMETERS Interface Program Options Passwords and Security Levels User ID Billing Code Translation Printer Direction Accounts Receivable Parameters PAGE NNNNN O O O WO OO Office Names Months for Year to Date Reports Date Format General Ledger Posting Set Search Key Preference Printer Line Formats Clear Training Data Display Change Path to Data Files Print Reports in Bold Show Calendar Validate Database During Reset SECTION 2 ENTER OR CHANGE PATIENT DATA Data Entry Screens Code Fields Field Descriptions Account Type Admit Discharge Financial Parameters Deductible Co pay etc HCFA 1500 Boxes UB92 Boxes Notes Deleting An Account Renumbering An Account SECTION 3 ENTER OR ADJUST TRANSACTIONS Posting Transactions Financial Data Fields Add Transactions Procedure Codes List Last Visit Extended Charges Quick Entry Mileage Codes Billing Code Translation Payments and Adjustments Line Item VS Date Range VS Balance Forward Insurance Payments Line Item Automatic Write Offs Date Range Crediting Insurance Payments to Deductible Patient Payments Co pay Patient Credits Insurance Write Offs Debits Finding A Transaction Rebilling A Charge Modifying A Transaction Deleting A Transaction Deleting Date Range amp Line Item List Transactions Enter Beginning Balances SECTION 4 PATIENT BILLING Billing by Last Date Account Type Setting Standard Options Statement F
172. ype of statement There are five formats available for patient statements Summary Detailed Co Pay Payment and Graphical The most common format is Summary and sample Summary and Detail statements are shown on the following pages All statement formats include DATE DESCRIPTION and CHARGES columns If Detail Statement is selected the description of a CHARGE transaction comes from the same lines of the PROCEDURE CODE used on the Insurance Claim This level of detail is rarely needed The remaining statement types use the Statement Description Line from the procedure code On a Payment statement payments are separated into Insurance Paid and Patient Paid columns This is simply an optional format to the Summary Statement if you wish to break out the source of payments A Co Pay statement is similar with a Co pay field added The Graphical option is our newest patient statement this option will include DATE CPT CODE DESCRIPTION CHARGES PATIENT AMOUNT PATIENT PAYMENTS CREDIT INSURANCE PAYMENT CREDIT and OPEN BALANCE and at the bottom of the statement has fields for the patient to fill in if paying by credit card Following the CHARGE column on the Detailed and Summary Statements are the PAYMENT and ADJUSTMENT columns If a Line Item or Date Range payment or adjustment was entered against a charge the amount paid or credited will print here next to the charge they were applied to The running balance is
173. ypes of payments By filling out DESCRIPTION to list on the first TRANSACTION LIST screen you can generate a list of all payments from a certain insurance carrier For example to list Blue Cross payments for July enter 05 07 01 through 05 07 31 as the dates to list from and through and Blue Cross as the description to list A sample list of PAYMENTS BY DATE is shown below The designation P LIN and S LIN indicate that these payments were posted as either Date range or Line item payments You can also be even more specific and enter a four digit INSURANCE CODE If you have several different Blue Cross plans and only want to list payments for one specific plan enter the INSURANCE CODE for that plan PAYMENTS FOR 04 11 01 DATE PATIENT CODE DESCRIPTION AMOUNT PT AT 04 11 01 100203 Art Liffe P LIN Benson pd 144 00 for 10 01 10 05 04 144 00 A MC 04 11 01 100507 Gary Winston P LIN Aetna pd 1154 00 for 10 01 10 09 04 1154 00 A M 04 11 01 100017 Bob Prescow P LIN Benson pd 640 70 for 10 01 10 09 04 640 70 A MC 04 11 01 100621 Alan Clark P LIN Alan pd 366 00 for 10 03 10 01 04 366 00 K M 04 11 01 100426 Alice Betnae S LIN Alice pd 360 00 for 10 11 10 15 04 360 00 A M 04 11 01 104032 Barry Cross P LIN Gen Ins pd 569 00 for 10 08 10 15 04 569 00 B PL 04 11 01 102240 Nancy Waxler P LIN Benson pd 168 00 for 10 06 10 09 04 168 00 A MC 04 11 01 100044 Ines Tisura P LIN Aetna pd 94 00 for 10 08 10 15 04 94 00 B Pl TOTAL PATIENT PAID 726
174. ys past due Frankly if you do not begin making payments immediately we will be forced to take appropriate action Sincerely Imma Hardnose DIAGNOSIS OR INJURY AREA To send letters to patients with a specific diagnosis or injury area select option 2 PTOS then asks for the diagnosis or injury area to locate PTOS will search the patient Data File and find anyone with the appropriate diagnosis You need only to specify part of the diagnosis For example entering BACK will result in any patient with the word BACK in their diagnosis being copied to the letter file This would include those with BACK STRAIN or LOW BACK STRAIN You can also select a specific Account Type Location or Office Number PTOS also asks if you want the letters generated in patient name number or zip code order When you select DIAGNOSIS these fields are copied to PTOSLETR TXT 1 Patient Last Name 2 Patient First Name 3 Address Line 1 4 Address Line 2 5 Address Line 3 99 SAMPLE DIAGNOSIS LETTER July 31 2005 2 1 3 4 5 Dear 2 We are inviting all of our patients with back problems in for a FREE seminar on August 10th If you re interested in attending please call for a reservation as space is limited Sincerely W E Kair DOCTORS OR ATTORNEYS You may want to send letters to all referring physicians or attorneys or to only those within a certain specialty such as all neurologists When you select this opti
175. zation Date 12 31 2006 Calculate Using Expected Amount Y N Authorzied Visits Co Pay Billing Y Remaining Visits Co PayAmount 15 00 Privacy Notification Date Charge Limit 0 00 HIPAA Authorization Date Posting Note COLLECT COPAY Default POS DEDUCTIBLE AMOUNT Many insurance plans include a deductible the patient must satisfy before the insurance pays benefits The insurance may then pay a percentage of charges over that amount Usually the patient has seen a physician and has already satisfied at least a part of that deductible If you know what remains of the original deductible enter it If you aren t sure 34 you don t need to fill it in When PTOS bills the patient it will bill the patient for all charges up to the deductible After the deductible is reached the system will bill the PERCENT TO BILL PATIENT below If the patient originally had a deductible of 250 and they ve already paid 100 to other providers enter 150 as their deductible You can choose to have the deductible calculate based on the actually charge amount or the expected amount See CALCULATE OF EXPECTED AMOUNT below PCT TO BILL PATIENT this is the percentage of charges in addition to the deductible that the patient will be billed If the insurance carrier pays 80 Enter 20 in this field and the patient will be billed for 20 percent of the charges Usually the patient is responsible for any amount not paid by their insurance

PTOS - 3.xx User`s Manual

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