MedBASE Software
Contents
1. in the top left corner of the Claim Select or press Escape to exit E Select Claim and Close Window Patient Name Accnt Health Service Date MedBASE Lite User s Manual Page 4 Clicking on the Submit button brings up the OHIP Submission screen as shown below This screen is used to both verify all unsubmitted claims for errors and or to create a machine readable file on diskette for submission to OHIP OHIP Submission DR JAMES ALLISON 0000 224840 00 Submit Date dd mm yy verity Bim Cancer The current date will appear as the default in the Submit Date field To change this date simply enter a different date This date will entered on the submission diskette This button is used to verify all unsubmitted OHIP Reciprocal and WCB claims for errors The errors checked for include Service code excluded from machine readable input Diagnosis code required for this service code Referring physician required for this service code Hospital number required Admission date required Service date is after submission date Service date is more than 6 months old Service date is after admission date Missing Health number for this patient Missing date of birth for this patient Reciprocal Claims require a specified province Reg for lt province gt must be __ digits Manual review required for this claim If errors are found an error report wind2. program and documentation An annual fee will be charged for this Ongoing Support as agreed upon at purchase Default of payment of annual support fee will result in suspension of all Ongoing Support This is the only agreement between you and MedBASE Software Inc It cannot and shall not be modified unless in writing and signed both by you and an authorized officer of MedBASE Software Inc You agree to be bound by this mutual agreement between you and MedBASE Software Inc
3. program and documentation Under copyright laws you agree not to transfer the program and documentation in any form to any party without prior written consent of MedBASE Software Inc Further you agree that copies of the program shall be made only for backup and archival purposes These archival copies must be retained in your possession Except as provided in this Agreement you may not transfer sub license lease or rent time share or lend the program and documentation your copies of such ot any of your rights under this License Agreement except by prior written consent from MedBASE Software Inc You may not alter decompile reverse engineer disassemble reverse translate or in any other way derive any source code from this program You may not remove or obscure MedBASE Software Inc s copyright notices in either hardcopy or machine readable portions of the program and documentation MedBASE Software Inc shall not be liable for any tort indirect special or consequential damages such as loss of profits or loss of goodwill that may result from improper use of this software The liabilities of MedBASE Software Inc shall be limited to a refund of the product s price The program supplied by MedBASE Software Inc may be installed and used on only one computer terminal MedBASE Software Inc agrees to provide Ongoing Support in the form of telephone assistance on site technical maintenance as required as well as updates to the
4. 2792 HORTON STANLEY JMJ Service Fee Service Diag Service Fee Service Diag Code Billed Date Code Code Billed Date Code io4 40 C EAEE 413 L__ L__JZ E E6024 85 00 _ E 06712792 3 I lf IO GZ JI masi miea C_ LJ E I IL II an OCZ I Li ae M E E e ee I O Manual Review Select Submit Reconcile Summary Quit Several buttons are present at the bottom of the screen and are accessed by clicking on them with the mouse Their functions are briefly described below This allows you to save the current card and bring up a new blank card If there are no service codes entered on the card the account will be deleted This brings up the Claim Select screen as shown below allowing you to select a previously saved but unsubmitted claim for editing Claim Select Search List by Unsubmitted Claims Only Surname First Name 10 Digit Health OR Awaiting search criteria Account Cancel Type in the Account the 10 Digit Health or all or part of the Surname First Name to select a patient If Return is hit without entering any search criteria then the full list of unsubmitted claims will be displayed in a browse window see below If more than one claim matches the search criteria then a partial list of claims will appear in the browse window Select the claim you wish to edit and close the window by clicking the mouse
5. MedBASE Lite User s Manual Page 1 Introduction MedBASE Lite is a simple yet versatile billing system designed for the Apple Macintosh and IBM compatible PC s The MedBASE Lite program is designed for the physician who is accustomed to billing via OHIP card and through a simple and intuitive OHIP card like interface the user is able to take full advantage of the attributes of computerized billing MedBASE Lite is similar to the full featured MedBASE program with respect to claim entry error checking computerized billing and reconciliation The Lite version does not offer certain advanced features such as multiple provider capabilities magnetic card reader data entry sophisticated database functions appointment scheduling or accounting functions but should these features prove desirable to the user then an upgrade path to the full featured MedBASE program is available MedBASE Lite makes full use of many of the intuitive tools characteristic of mouse based systems with the aim of providing a user friendly environment for the operator A minimum of operator training is necessary for using the program and the layout is designed to maximize efficiency and minimize operator error This manual is intended for those using the Macintosh MedBASE Lite application The manual assumes that you are familiar with basic Macintosh operation and are acquainted with the use of the mouse and menu driven commands For new users unfamiliar with this enviro
6. Summary Quit Prov Enter the 2 letter abbreviation for the province to be billed as done with manual Reciprocal Medical billing Registration Enter up to 12 alpha numeric characters as required for the specific province will be verified prior to billing Patient Address Enter the street address city and province in the 3 field at the bottom of the screen Postal Code Enter the postal code format A9A 9A9 Reciprocal claims will be submitted and reconciled in an automated machine readable manner as with other OHIP claims To quit the program press on the Quit button or select Quit from the File Menu as shown below It is important to exit from the program before shutting the computer off HA Edit MedBASE LITE For technical advice and support call MedBASE Software Inc at Phone and FAX line 416 778 5852 Emergency Service 416 417 2743 MedBASE Lite User s Manual Page 8 MedBASE LICENSE AGREEMENT MedBASE Software Inc will assume that in purchasing this software package you have agreed to be bound by the terms of this license agreement If you do not accept the terms of this license agreement you may return the package to MedBASE Software Inc within 30 days of purchase for a full refund MedBASE Software Inc grants to you and you accept a Software License to use the program and documentation delivered with this Software License Agreement MedBASE Software Inc retains the copyright protection of the
7. generated report details all of the mandatory claim and patient data for each claim item as well as totals Claim Summary Provider DR JAMES ALLISON 0000 224840 00 Acct Range 1 to 222 Date Range dd mm yy 01701793 to 12 01 93 O Outstanding Claims only You can specify a Date Range Acct Range or limit the summary to Outstanding Claims only ie claims which have not yet been reconciled To print the summary click the Print button Click the Done button to exit MedBASE Lite User s Manual Page 7 Reciprocal Medical Billing If RMB is entered under the Payment field on the MedBASE Lite billing screen then a slightly altered Reciprocal Medical Billing screen will appear as shown below This screen is identical to the usual billing with the exception of 6 fields These are listed below SSS meaBArse Lite Provider o000 224840 00 Bc Referred by 201012 Service Fee DR JAMES ALLISON Service Diag Service Fee s service Diag Code Billed Date Code Code Billed Date Code io4 40 Ji eres J LALALA JL _J 63134 8 80 _ J0 21711792 28 lf IOC JI a ess G_ 2iiis2 aze_ SE E i JOG i J LOG I L ICA CO Ed C Patient Address 144 BURTON LANE VICTORIA BC Postal Code O Manual Review New Select Submit Reconcile
8. he top of the following page The screen resembles an OHIP billing card and is filled out exactly as one would for a regular OHIP card However for patients previously entered entry of the Health will bring up the other patient information automatically Account s are generated automatically by the program in a sequential fashion starting with Account 1 and provide a unique identifier for each claim Health and Referring Physician are automatically checked for validity at the time of entry to prevent operator error The Payment field must be marked as either HCP the default WCB or RMB to indicate either OHIP Workmens Compensation Board or Reciprocal Medical Billing claims respectively Entering RMB will bring up a slightly modified billing screen displayed on Page 7 similar to the manual Reciprocal billing card A Facility and an In Patient Admission date are required for hospital inpatients You will notice that after the Service Code and of services are entered the Fee Billed will be entered automatically You may overwrite this if you wish to edit the fee As on the manual OHIP card up to 10 claim items may be entered for each card MedBASE Lite User s Manual Page 3 MedBASE Lite Provider 0000 224840 00 DR JAMES ALLISON Health Date of Birth H 109792593 14705744 Her Referred by Facility In Patient Adm Surname First Name Coro 1302 571
9. hen appear asking whether you wish to print a Billing Summary Click Yes or No as desired Be sure to record the number of Claims and Records The OHIP Submission screen will then be exited It is advisable to check all submission diskettes to ensure that a submission file is present Duplicates from the MedBASE Submissions folder can be copied onto a new diskette if necessary Cancel Click on this button if you wish to exit and bypass the billing procedure This will be necessary when you wish to correct errors identified during verification before proceeding with billing The OHIP Submission screen will then be exited Reconcile The Reconcile button is used to reconcile previously billed claims from a OHIP Remittance Advice RA Diskette After selecting Reconcile a file selection window will appear Insert the OHIP RA diskette and select the RA file should begin with a P as per the new OHIP format Click Open to continue or Cancel to abort the reconciliation If you select a file which is not an OHIP remittance advice file an error message will appear If a proper file has been selected the file will be read the diskette ejected and the OHIP Reconciliation screen will appear as shown at the top of the next page MedBASE Lite User s Manual Page 6 OHIP Reconciliation OHIP Reconciliation in progress Accept underpayment if within 1 00 Accept overpayment if within 1 00_ Record
10. nment we recommend reviewing the Macintosh User s Manual Proper operation of the program requires that MedBASE Lite be properly installed as described below The application is compatible with Systems 6 0 or 7 0 Because of the potential memory demands of a large database system we recommend at least 2 MBytes of RAM with System 6 0 and preferably 4 MBytes of RAM with System 7 0 A hard disk with a capacity of at least 20 MBytes is recommended MedBASE is compatible with all Macintosh computers from the older Mac Plus and SE to the newer PowerBook and Mac Quadra systems Getting Started Installing the Program To install MedBASE Lite insert the diskette entitled MedBASE Lite Program into the floppy disk drive This disk contains a file of the M compressed code of the MedBASE Lite application and related files When MedBASE Lite comp the MedBASE Lite comp icon is double clicked a dialogue box appears as shown below prompting you to select a destination for the decompressed files Click on the Drive button in System 7 0 click the Desktop button and select the Hard Disk to save the decompressed files to the hard disk Click Extract to decompress the MedBASE files When gt 2 ect Destination Folders AA poo decompression is complete a new folder Ym iard Disk Cier entitled MedBASE Lite Billing Folder wil 7 _ reeur Cime be present on the hard disk and will contain O System Folder the MedBASE Lite ap
11. ow will appear as shown at the top of the next page Click on Print to print a report of these errors If errors are found they should be corrected before proceeding with the submission Click Done to return to the OHIP Submission screen MedBASE Lite User s Manual Page 5 DR JAMES ALLISON Provider 0000 224640 00 Yerification Complete 6 errors found Service Date Error 18704791 Service date more than 6 months old 19 04 92 Diagnosis code required 25 04 92 Service date after admission date 04 05 92 Referring physician required 09711792 Service date after admission date 09 04 92 Missing OHIP amp Health number Print Done NOTE Only one error is reported for any claim item It is advisable to reverify the submission prior to proceeding with billing to ensure that a second unrecognized error was not present Click on the Bill button when you are satisfied that the OHIP submission is error free All unsubmitted OHIP Reciprocal and WCB claims will be processed OHIP claims without a valid Health will not be submitted After processing is complete a machine readable ASCII file will be created and a file save window will appear with a prompt to insert the OHIP submission diskette Insert the diskette and click Save The file will be saved on the diskette and a duplicate copy will also be saved in the MedBASE Submissions folder on the hard disk The diskette will be ejected and a prompt will t
12. plication as well as the _Cancel_ MedBASE Databases and Submissions folders Your MedBASE Lite program is Entract now installed MedBASE Lite User s Manual Page 2 Starting the Program MedBASE Lite is accessed by simply double clicking on the MedBASE Mi Lite icon When the program is accessed for the first time the user will be asked to enter the Provider Information as shown below Be careful to enter page ase Lite the correct information as you only get one chance to register Provider Information Enier Provider Information Name DR JAMES ALLISON Group No 0000 Billing No 224840 Specialty No 00 District Code N Pay Type Pay Provider Pay Subscriber To register simply enter the Provider Name format DR JOHN SMITH the Group No 0000 for a solo provider or the 4 digit OHIP registered group number the Billing No 6 digit physician number and Specialty Code 00 for general practitioners or the 2 digit OHIP specialty code The District Code is a letter which signifies the OHIP office to which you submit your computerized billings N for Toronto Make sure that the dot beside Paytype is next to Pay Provider by clicking it with your mouse then click the Done button to exit Entering Claim Information When the program is started and the provider information has been entered the MedBASE Lite billing screen will appear as shown at t
13. s Reconciled Discrepancies Prev Processed Not Found As a default the claim item will be reconciled if the fee paid is within 1 00 of the fee billed Otherwise the claim item will be marked as a discrepancy The underpayment and overpayment limits may be edited as desired Click the Continue button to proceed with the reconciliation The OHIP Reconciliation screen will show the progress of the reconciliation both in the form of a status bar and in the table indicating the total of records reconciled of discrepancies not found ie on the RA diskette but not in the database and previously processed When the reconciliation is completed a prompt will appear asking whether you wish to print the Reconciliation Summary reports These reports include 1 Reconciliation Totals and List of Discrepancies 2 Summary of Claim Items Not Found if applicable 3 Message from the Ministry of Health if present on RA diskette Click Yes or No as desired Click Done to exit the OHIP Reconciliation screen Summar Clicking on the Summary button brings up the Claim Summary screen as shown below This function is useful for printing a summary of claims in a given date range or account range The date range can be used for detailed daily weekly or monthly claim summaries The account range is useful for verifying entered data against original data keeping track of the accounts entered in a given time period The
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