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ChiroMagic Reference Manual

1. Referring provider LUPIN Payer s Hame ID and Address Primary Subscriber s Name Last First Middle Suffix amp Address KEYSTONE MERCY HEALTH dddda G evrop PANCAKE DE PHILADELPHIA pap LONDON KY 40742 50199361 Birth Date 978 1981 Ll Orig Reference ns Prior Auth Pan Member ID Patient Subscriber Signature Authorization Group Mame amp Mum Signed HCFA 1500 form block 13 on file wt PatientSubseriber Release of Information Yes Provider has a Signed Statement Permitting Release of Medical Billing Data Related to a Claim llness Last Worked o Return to Work P Last Seen Similar Symptom Admission 12 14 2005 Discharge 12 14 2005 Diagnosis Codes Gi 1 64511 2 P D a a a a a a a Service Dates Procedure Codes Diagnosis Units Fam Wuefa o0s fo saoo oem E ee SE Le et i Referring Prov BEACH SANCY Ld Provider LUPIN AS33533 Proprietary Information 18 Institutional Edit Screen UB Claim Editor Patient MOON C NIGHT Payer UNITED HEALTHCARE INC P 8 726 Help Provider FMC CAMPUS 2817 J Overrides On Charges 943 20 My Claim ID 4444 AliMed Claim ID 71635074 Instance ID 79302403 save amp Resubmit gt Original Reference Number Ld My Claim ID Claim Detail View Provider Signature on File Accept Assignment ae a Patient Information Hame Last First Middle Suftix and Address of Patient Birth Date 10 20 1955 service Lines View NIGHT
2. Show Carrier Info Also by default the below criteria are grayed out displaying the check boxes i Show Guarant to the left so you can choose to display the information or not E Show Paid amp Adj Show Diagnosis Show Carrier Info If the Show Carrier Info box is checked the DOS Summary Format insurance carrier information will be displayed on the Account Ledger Report for the patient Show Guarantor If the patient has a guarantor entered in the database and this box is checked the guarantor will show a m on the ledger Show Guarantor E Show Paid amp Adj If this box is checked the payments and Show Paid amp Adj a adjustments will show up on the account ledger l Show Diagnosis Show Diagnosis If this box is checked the diagnosis codes DOS Summary Format will show up on the account ledger DOS Summary Format If this box is checked the charges will be displayed without detail and in Date of Service summary format Additional criteria that can be selected for the Account Ledger are listed Fig Criteria below Keep in mind that multiple criteria can be chosen when printing oe we an Account Ledger Charge Date m Financial Class This allows the account ledger to be run for a specific financial class PRI Carrier This allows the account ledger to be generated for a specific primary carrier for one patient or all patients who have Published 1 6 2009 Page 233 of 248 Reference Manual q a
3. check is being posted Remember the whole check does not have tobe san 7 applied at one time _ T ses ae Once the whole check is entered and all payments have been applied against the charges the check has to be applied by clicking Apply Check E Published 1 6 2009 Page 200 of 248 Reference Manual Utilities Menu This menu is available for the following tools R Utilities Reset Order to Selected Charge Order This will Sewn ea ae allow you to reset the order in which the names are Zero all displayed in the grid If the charges were selected in Atopopulate all amounts based upon Carrier EOB Settings the order in which they appear on the EOB and they 22 ttm need to be placed back in DOS order click this button Zero All When posting the EOB if the carrier paid nothing click the Zero All button and it will place 0 00 amounts in all fields This can also be used if something was posted in error and it needs to be reset Auto populate all amounts based upon Carrier EOB Settings If this button is checked then the payment fields will be populated based upon the EOB Settings Show Interest Column Check this box if the carrier paid interest Note On the bottom of the screen the running totals section showing you Billed Allowed Paid Adj Balance Totals Billed FYOB O0 Allowed 535 00 Paid 60 00 Adj F000 Balance 127 00 Note Magic Wand The Magic Wand is next to every account
4. MEDICARE omer ss s Ss m r Medicare Carrier Type What type of carrier it is This is important because the settings can be copied from one carrier to another Pri Bill Type Select from the list how the primary claims for this carrier will be billed Sec Bill Type Select from the list how the secondary claims for this carrier will be billed Published 1 6 2009 Page 166 of 248 Reference Manual FeeSched Select from the list the Fee Schedule for this carrier PayerID The payer ID number for the carrier this can be found on the patient s insurance card or at www zirmed com CalimFilingCode CI for Commercial MB for Medicare MC for Medicaid BL for Blue Cross Blue Shield HCFA 4 digit year Select this check box if the insurance carrier requires the date to be displayed in a 4 digit year like 2008 EDI Setup Should read Default EDI Setup Master Carrier Select the master carrier from the drop down if master carriers have been created Ledger Tab The carrier ledger is just like the patient ledger It displays all of the same tabs Charges Checks Balance Totals and Aging Voided Charges Voided Checks and Claims This screen displays all of the information from the perspective of the carrier a Insurance Carriers MEDICARE 24D Mi x H Save E Save and Close QO Master Carriers E Information W Ledger MEDIC2 la ID No Setup MEDIC Biling Settings mEDIC2 EOB Setti
5. This is when you write off money with consent A patient coupon is an adjustment An insurance PPO plan where you have contracted for an amount for services is an adjustment What are Refunds Refunds are negative payments This is when you give money back to the Carrier or Patient What is a Write off Write offs are the removal of money that is owed to you but that you will not receive A bankruptcy a death or a patient who will not pay you are examples of write offs Published 1 6 2009 Page 41 of 248 Reference Manual Example PRIADJ This is an adjustment from the Primary Carrier This is a contractual adjustment Set it up like this Source Primary Type Adjustment SECPMT This is a payment from the secondary carrier Set it up like this Source Secondary Type Payment Published 1 6 2009 Page 42 of 248 Reference Manual Setting up a new Payment Method e Click Utilities a Utilities Calculator F6 Support Log Of P 3 m Setup G User Manager Inventory o Schedule Settings For Visit Types Schedule Settings for Providers fe Scheduler Open Today Tab Schedule Appts I Restart Account Assistant e Click System Setup ae Utilities Calculator Fo 5 ie System Setup pa Usd Manager gt Inventory A Uppork Log OF e Click the Payment Methods Tab e Click Add Method de Add Method n e Enter a Code Code MD
6. hold so it will not be billed PAREA Charge Review for patient s Pl charges Bill to Patient This immediately moves the charge to l gf Goto camer KAISER the patient balance and will no longer be waiting to be billed to an insurance carrier ah View in Carrier Ledger af View in Patient Ledger Enter blemo E View History Create Claim Creates the claim for this charge Charge Review for patient s case charges Will take you directly to the charge review for that particular patient giving you the ability to look at additional charges and other information Go to Carrier This will take you directly to the carrier for that patient View in Carrier Ledger This will take you directly to the carrier for the ledger Published 1 6 2009 Page 179 of 248 Reference Manual gt View in Patient Ledger This will take you directly to the patient s ledger Enter Memo This will allow you to enter a memo about the charge View History This will take you to the history of the charge when it was entered and by who Create Claims Once the charges have been approved it is time to create the claims Click on the Red HCFA and select Create Claims All the claims about to process will be shown Even Electronic EDI Claims will still view in HCFA form for your convenience Typ T Billing Functions i Create Claims The Create Claims process has to be done for all of the charges that are in the list
7. to the previous or next charge in the charges e Click CANCEL to cancel the adjustment i Mew Balance o 00 grid f Prey Charge x Cancel a Apply Mest Charge zp Write Off Balance The Write Off balance screen is just like the Adjustment Screen except that the default payment method is PATWO Claim Charge tem Enter in the write off amount 187734 305745 B44 2008 58941 Prev Payments Prev Adis Prey Vitite Otfs Current Balance e Enter in the method for the Write Off as00 oo 000 so00 e A reason MUST be supplied write ot 50 00 e Click APPLY at the bottom to apply the eee worat writeoft Reason Moved out of area e Click CANCEL to cancel the adjustment iii 4 Prey Charge ff Apply Mest Charge ip e Click Previous Charge or Next Charge to go to the previous or next charge in the charges grid This function is very helpful when cleaning up accounts that have balances that need to be written off Published 1 6 2009 Page 104 of 248 Reference Manual Void This function allows the user to void a charge Remember that charges can NO longer be deleted so the charge has to be voided To void a charge follow the instructions below e Click Void from the blue function flag Charge Functions for Charge HAH g5 Take Charge off Hold Edit Charge Unapoly Patient Payments i Unapoly Patient Adjustments e Refund e The computer will display a message that says Are you certain you want
8. For example SALES Local Sales Tax 5 675 From the Status Icon on the left column you can call up the Tax Rate Functions screen where you can edit the tax rate code or description at any time or you can delete the tax rate oy Close x Refresh Reports You will see a anda i Add Tax to the left of the tax rates TA Y x when you have items that gt tems Ea Categories Tee have a tax rate set When pal you click on the it will ople Tears ray expand the view allowing Description Edit Tax Rate z po you to see the items DSS SUPPLEMENT BOX assigned to the tax rate Pressing the will roll up the expansion Assign tax rates at either the Category screen to an entire category or the Items screen to a particular item Fee Schedules Tab This is where all of the fee schedules are created What is a fee schedule A fee schedule is defined as a list of charges agreed to by the clinic Fee schedules should be created for standard insurance Medicare and cash You may want to add an employee fee schedule for the sale of weight loss inventory items to the staff a Hit the Add Fee Schedule button to add a new New Fee Schedule schedule ig jo Description STANDARD PRICE Cancel 4 Save From this screen enter a code and description for the fee schedule For example EMP Employee Published 1 6 2009 Page 59 of 248 Reference Manual From the Status Icon o
9. PR bi ed ast Pre Bill Hold status Payments From Primary Biling Type c Rendering PX Primary 3 wj COn hold OH rimar nt Referring PX Char ge Dates Dates that sai Oott a sie ai ie HCFA a are attached to the charges Sane ls mo O r 8 Gury _ Charges Las B illed The last bill G Bill To Status Status Edits Charge Edits H Commit Changes date of the claims Hold Status All charges have a hold status If a pitas charge is on hold then it will not be billed Payments from Primary This identifier allows data to be queried by payments from the insurance carriers Billing Type Queries charges by billing type Case Type Queries charges by case types Patient Queries charges for a specific patient Carrier Type Queries charges for a specific carrier type Carrier Queries a specific carrier Treating Queries charges for a specific treating physician Rendering Queries charges for a specific rendering physician Published 1 6 2009 Page 190 of 248 Reference Manual a Referring Queries charges for a specific referring physician Using the Charge Review Understanding how the charge review works will give you unlimited power on looking up a viewing charges in the system For example the clinic has been billing Medicare for years and 3 months ago you discovered that there was a problem with the registration of the NPI number and Medicare Medicare now has t
10. Published 1 6 2009 Page 156 of 248 Reference Manual Function Buttons at the bottom of the Tender Screen It is important for you to know what the buttons represent on the bottom of the screen zm Reset x Cancel lt Back Erisnea Change Calculator Icon To the right of Change Due is the calculator icon Click the calculator icon and this allows you to calculate Ei z S Close New Credit j Change Due anything necessary If there was change due it will TC appear as a default in the display On top there are three options Close New Credit Change Due oa 7 J Close closes the calculator without taking action New Credit This takes whatever is in the display and puts into Apply to New Credit field as j i z Change Due This takes the calculation that was just i i n made and puts the result into change due The screen a IENE will NOT close until everything is in balance ca E Reset Button This completely resets the screen and takes all payments and dollar amounts back to 0 00 You can always click reset and zero out the window to start over Cancel Clicking cancel will cancel the whole charge Back The back button takes you back to the charge detail screen where charges can be edited added or deleted Finished This will finish the payment process and save the invoice into the system Published 1 6 2009 Page 157 of 248
11. WWHITESS55555 WHITE AMME vy DAANG Mational Rural Electric Coop 234 00 1 Accepted by ZirtMled Edit Mote More 04 26 07 Resub JOHNSOM JOHM MRECA 52132 CARTERGEEGGG CARTER BRITTANY L OF 0106 Bluegrass Family Health 954 00 1 Accepted by Zirhled Edit Mote More 04 2607 Resub JOHNSON JOHN 61124 JACK SONTEFO JACKSON JACK W DAAG yells Fargo Third Party 6568 00 1 Accepted by Zirtled Edit Mote More 04 26 07 Resub JOHNSON JOHN Administrators 87615 Search Claims You may fill in any box in the Search Claims area click on the Search button and it will display your search results Available search options in the Less View e Patient Name Patient name submitted with the claim e Trans Dates The date the claim last processed through ZirMed s system The default will be 6 months but use the dropdown to select 2 years NOTE This is different from a Date of Service e Include Hidden lf you would like to include your hidden claims in your search then click this box The box will populate a check mark indicating that hidden claims will be included in the search e Payer dropdown box allows the user to choose between the ZirMed Payer name or My Payer which is the name submitted with the claim You may take advantage of the User Preferences setting to have this default to either Your Payer Name e ZirMed Payer Name e Claim Number Patient control number submitted with the claim this is typically the patient account
12. Accounts Permissions Reset Passyyord karen craignivile ee Edit User A E trainin U H AMY BLACKBURN traininey anual beverly hila beverly 23 First name Matthey Coulston hiCoulston EEL Murie eraigmyle O permissions user amiesenn E Mail tra account irainingaccourt Optional if you enter one please make sure that it is valid Page of 1 0 Active Force user to Change Password F indicates the Domain Administrator Primary Account ZirMed Training Account S076 lwant this user to be able to add users delete users and change user information as well as have automatic access to all functions for all accounts within my domain Update User Proprietary Information 4 Permissions The Permissions screen is divided in two sections On the left is a list of accounts you can set permissions for a user to gain access to To assign permissions for a given account you must click the account name Once you have chosen an account the right section will show a list of functions that are available to be assigned to the user you are editing for that highlighted account If the user already has a function it will be checked The exception to this is a security manager that has been given Full Permissions The left side of the screen will show that they have rights to ALL accounts therefore you do not have to highlight an account f Fi Me d zirMed Training Account 5076 training account Log Off 1r Accou
13. Cancel Cancels all work on the charge that is being entered Delete Deleted the charge that was entered Save Saves the charge that was entered Remember that on each item there is a Bill to Insurance checkbox when checked the item will go onto a claim for the insurance carrier If not checked it is assumed to be paid by the patient Note Once an item has been added a Blue appears next to the item number Select this and ALL the Fee Schedule pricing is displayed allowing you to override the price with another fee schedule This is especially helpful for cash sales or staff sales There is a Tax column on the charge item grid Note that tax is NOT available on services billed to insurance At the bottom right of the grid the number of charges and the Grand Total are displayed Do NOT worry about the number of items being billed out The system will figure out what claims and invoices are needed based upon whether the patient has an insurance 3 Charges Grand Total 148 00 carrier and if the charges are services or products Published 1 6 2009 Page 152 of 248 Reference Manual Charge Entry Today s Payment Tender Screen This screen is where the payments are entered for today s charges You can also apply payments from a credit to today s charges here Notice how the screen is broken down into sections There is the Today s Charges section the Patient Payment Section and the Patient Credits secti
14. Charges Charge Balance CHIRO 2634 34 35 00 Patient Ledger Totals and Aging Tab Published 1 6 2009 Page 122 of 248 Reference Manual Voided Charges Tab This is a list of all the charges that have been voided Remember that charges CANNOT be deleted Once it is entered it has to be voided YOU CANNOT DELETE A CHARGE The user will see the voided date and who voided the charge RR1IOS5 75 KATHY MORALES Test 2 P Close A Save go Utilities y Patient Information E Case Information le Insurance IB Diagnosis Codes D Motes Se Ledger Jorn Weight Lass iby Close me Refresh Ledger Date Range osso to osm4s2008 Last 30 Days Case lt ALL gt Charges Payments Balance Totals and Aging Voided al Voided Payments Claims void Date YoidUser YoidReason Charge Balance Status O604 2008 01 00 PM syvilliarns Made entry mistake 305746 0604 2008 ces MA 64 01 64 01 pat Patient Ledger Voided Charges Tab Voided Payments Tab This is a listing of voided payments The user will see the voided date and the user who voided the charge PAYMENTS CANNOT BE DELETED Voiding does not alter charges or collections it merely shows a record of all mistakes and changes to the account RR103575 KATHY MORALES Test 2 E lose gave SA Utilities pe Patient Information E Case Information Ki Insurance E Diagnosis Codes EF Motes 2 Ledger Weight Loss 5 C
15. Contents CUNT OMGCIC Reference VICI sacrcesssisueustvcevesituasstestnterasetacaneantacevssiinaasoes satenaasteconsatarcacees tecseanesocuuea toes 9 T stalline CIUPOIVIGONG scryaieaeccnsecnstcs soeaddeotceviawusuuesscnseesaiecceoed densactisauseuayscudeusatcateoudcunseavicaveesarsussaatdensdon Il WINOWS AP E TIIE AE II IE II AA E 11 Windows Vista is psessasisiecesicetessasepissssievisesasesiesssisedetiasevessssiesisusaseuiesssisuteusasevussssdeubsusesesuessebsebeusosesuscssieeisesesesie 13 Seine up the Printeri eseszastsccasstensestodeaserscdavseveedancsasitewswaiclexsosuadaueevesdancsaustanseatclencsssadsusesveddensaictawsaaicleccssucdins 16 TM rOUDIESNOOUNS RDT aeae E E E A E 17 TrOUDlESHOOUME PUNO NG ossessi en a EA EAE SA 17 The customer printer does not appear in Account Assistant ccccccceeecccceececeeeceaeeesesseeeeeeceeeeeeeeeeaaaaassanseeeseeeeeess 17 KARS N ee E E a cmteuepevelasieeetiouens 18 Report prims strange CAE ACTING crresecceicuicic nnee ra re E r EE a e EEr aA Sa aE a aE 18 Report prints like MiICroNChE cose vesasonteesmaanenanessnetseduessuerecnaratameesitraiedseeeluduestcchadtnvaasoxentvenestaaseumevetnesenesecmhenesevelaaueetiauens 18 Save Paper Preview Defore PHNUING ssecesasernscncaseocesertneroucseuacesecenadeneeitanentye aea E E eir ERNE EE EE EE 19 Omek Ke Tene COMES o 21 Mandatory Scheduler Statis OCS ois sees wesicnsscocsencevssapenbessnscusventicedoesaeacavectseneesssstuinesticetwestecceausacauavesseu
16. From time to time you may find it necessary for specific claims to bypass the CCI and or LCD NCD edits and pass to the payer as you submit When this is the case you may add an exception so a claim will bypass the edits Once you have added an exception you may copy it at any time e From either Professional or Institutional claims tabs choose the Coding Tools tab then the Exceptions tab It is very important to remember that you must copy exceptions specific to either professional or institutional claims e Find the exception you wish to copy by utilizing the search bar to search for the specific exception you wish to copy e Once you have located the exception you wish to copy locate the action column of the display and click on the Copy link e The exception you wish to copy will display populated with the information from the exception you are copying from e You may change or edit any of the fields e Save You MUST click on save for your exception to be saved i Coding Compliance Exception Microsoft Internet Explorer Sele Copy Exception Clase Window Required fields are bolded ec Oven O nco Payer Hame or iD Medicare B Kentucky Adminastar SMKYO oo Specify Situation C All Situations Selecting this option vill allow claims for selected payer code pair and dates entered below to process without passing through CCl edits Procedure Code Col 1 97116 Procedure Code Col 97530 Modifier Service
17. See sample EOB on the next Page Proprietary Information 68 EXPLANATION OF BENEFITS EOB SAMPLE INSURANCE CO G alf j ir 1 w I fr fal m 1m J a i MN I L j i P a 1223458789 JOHN SAMPLE 09 11 04 DATES OF SERVICE OTHER MEDICARE MEDICARE 040216080915 07 30 2004 07 30 2004 JOHN Q PROVIDE OFFICE VISIT FOR E amp M ESTABLISHED 99 00 62 46 00 15 00 00 00 00 00 42 71 PRTIENT 15 MINUTES URINALYSIS WITHOUT MICROSCOPY AUTOMATED 12 00 2 84 00 290 00 Q 00 00 2 84 102 00 0 00 15 00 0 09 0 00 v 00 0 00 45 55 EXPLANATION OF CODE TOTAL AMOUNT PAYABLE TO PROVIDER S BY PLAN 45 55 RID PATIENT LIABLE FOR COPAY DEDUCTIBLE COINSURANCE TOTAL AMOUNT PAYABLE TO PROVIDER S GY MEDICARE 0 00 TOTAL AMOUNT PAYABLE TO PROVIDER S BY THIRD PARTY 0 00 TOTAL OF DEDUCTIBLE COPAY COINSURANCE 15 00 i WHICH IS PATIENT S MINIMUM RESPONSIBILITY OWED TO PROVIDER THIS IS NOT A BILL An EOB provides information about how claims bills for Definitions cont medical services are processed Keep this EOB for your records and if applicable Applied to Deductible If your Primary Ins coverage includes a deductible for this procedure use it to compare with actual provider bills and your annual deductible has not yet been met this is the portion of the bill you are responsible a for paying to the provider Definitions 19 help understand this Ee Copay or
18. installed on your computer so you can connect to ChiroMagic and utilize Phunkey Windows XP e Click on Start e Click on Programs e Click on Accessories e Click on Communications e Click on Remote Desktop Connection e Click on Options T Remote Desktop Connection a General Display Local Resources Programs Experience Logon settings al Type the name of the computer or choose a compu the drop down list Computer apps phunkey com Username hmartin Password Domain PHUNKEY C Save my password Connection settings Save current settings or open saved connection Published 1 6 2009 Page 11 of 248 Reference Manual Computer Name type apps phunkey com e User Name enter your user name will typically be first initial and last name like hmartin e Domain enter PHUNKEY There is no need to enter your password The computer will always ask for your password due to HIPPA compliancy e Once you have typed in all of the above information e Click the Save As button gave IM E Desktop E a E Fe i My Documents My Recent Documents Desktop My Documents Pr My Computer izg C My Network File name Jefaulk n Places Save as type Fiemote Desktop Files ADP Cancel A e Change the File Name at the bottom of the screen from Default rdp to ChiroMagic e Click on the desktop icon on the left hand side of the screen e Click Save e
19. Billmg Menu The Billing menu contains any data or function that is related to billing This 1s where Bulk Billing is done and this is also where the lists are maintained for billing Carriers This is where the insurance carriers are maintained and set up Guarantors This is where the guarantors are managed ME Bulk Billing This is where billing is processed Ailing Lae Calcula ME Carriers Statements This is where statements are created EA Guarantors Location Ledger This is a ledger card for the location EF Bulk Biling Reporting Ei Statements h Location Ledger Charge Review Utility that is given to all facilities to query and look fi Reporting i up data in mass E Carrier Payments This is where insurance carrier payments are CA Carrier Payments posted Unapplied Checks Unapplied Checks This is a list of unapplied checks that have been entered into the database Published 1 6 2009 Page 163 of 248 Reference Manual 3 Carriers Understanding and Setting up Carriers There are two different types of carriers in the system Master Carriers and Carriers Master Carriers have been designed so carriers can be grouped together This was mainly done so posting EOB s would be easier Understanding Master Carriers Master Carriers should be created if there are multiple carriers that are paid by the same carrier For example if there are 10 Blue Shields in the database because claims ha
20. Ctrl 7 Enter Memo Add a Claim Charge note that will be viewable in View History Ctrl 8 Resubmit this charge Allows you to put in a reason reset bill to back to Primary for example reset Hold and the big change Change BILLING Charge Functions ty Ctrl 1 ero Out Charge Eb Cti 2 Copy Previous 4uto populate from last 99203 entry Ctrl 2 h Ctl 3 Auto populate amount from Carrier EOB Settings A Ctrl 4 Auto distribube for entire visit ze Ctrl 5 Remove Charge F Ctr 6 Adjustment Note Ctrl 7 Enter blemo i Ctrl 8 Resubmit Ctrl 9 Claim Adjustment Reasons Edit Charge af View in Patient Ledger mp Go to camer ANBLES C Reset Charge E View History ie Highlight Ctrl 9 Claim Adjustment Reasons Allows the user to place in the adjudication note from the primary carrier stating why they were not paid Published 1 6 2009 Page 199 of 248 Reference Manual Edit Charge Ability to edit the charge View in Patient Ledger Takes you to ledger for that patient Go to Carrier Takes you directly to the carrier Reset Charge Resets the charge Void Charge Voids the charge View History Brings up the history for that charge Highlight Allows the user to highlight the charge in the list so if they need to access this screen again that can be done and the user will know where they left off Orange Flag Functions These functions are
21. Description Md 4 Order _ m Published 1 6 2009 Page 43 of 248 Reference Manual e Enter a description Lode M Description Money Order Source i Type Payment e Select a Source from the drop down menu Description Money Order e Select a Type from the drop down menu e Click Save io settings Is eae Types F Cancel A Save ok Adde Y Reference Manual Published 1 6 2009 Page 44 of 248 Patient Statuses Understanding and Setting up New Patient Statuses Patient Statuses are identifiers that can be attached to patients when they are no longer active If you use the patient statuses then you can run reports on those statuses The defaults are as follows S Short Term L Long Term T Transient D Deceased and O Other Additional Patient statuses can be added as needed To add a new patient status follow the directions below e Click Utilities Ukilities Calculator F6 Suppork Log Of ip 5 m Setup i User Manager gt Inventory st Schedule Settings For Visit Types e Schedule Settings for Providers H Scheduler Open Today Tab ie Schedule Appts le Restart Account Assistant e Click System Setup ae F Utilities Calculator F6 Support Log Or aa System Setup Fz Usi etanager Lp Inventory e Click the Patient Status Tab Published 1 6 2009 Page 45 of 248 Reference Manual SP Adg Patient St
22. HFCA form Mod View This button allows you to quickly see what modifiers are attached to the charge if you is using a small monitor TALE eo p e soj eof ojs f B sle e a e e o It is important to understand what the column headers mean when looking at the charge screen Ins Case Refer Rend Treat Units Item Description Unit Amt SubTotal Tax Total Modi Mod2 Mod3 Mod4 Pointer Diag Diag2 Diag3 Diag4 INS If this box is checked it means that the product or service is set to bill to insurance In the setup of services you defined the item as a service and marked if the item was billable to insurance Every item that is being entered into the database is either billed to insurance or billed to patient All products by default are NOT billed to insurance unless you denotes otherwise Remember when entering charges you can check the box if it is not already checked Case This is the case that the charges are attached to Refer This is the referring doctor who is attached to the charge Rend This is the rendering doctor who is attached to the charge Treat This is the treating doctor who is attached to the charge Units How many units are being billed for this charge Item Typically the CPT code unless this is a service then it could be called a shortcut code Description This is the description that prints on the HCFA form Unit Amt The amount that the facility charges p
23. This is a REQUIRED field Enter the email or enter NONE or REFUSED DOB Date of birth Type the date of birth in the following format mm dd yyyy no dashes Published 1 6 2009 Page 79 of 248 Reference Manual Gender Male or Female This is a REQUIRED field The arrow keys move the radio button between the two fields if you are using the keyboard for data entry Click the space bar to select male or female Referral Source This is a REQUIRED field None can be selected if they refuse to inform the clinic of how they heard about the clinic Remember that marketing plans and management planning are based on tracking the effectiveness of advertising It will take a staff member just as long to select NONE as it will to put in the correct Referral Source If a new referral code needs to be added click the Green to the right of the field and enter the new Code and Description Note This is an initial note that will be entered into the Notes tab of the Patient Information screen It will automatically be set to Active and also as a Scheduler Pop up When going to the Today s tab after scheduling an appointment the Yellow Sticky note will appear with the note that was entered Referring Patient If the new patient has a referral source of an existing patient enter the patient who referred the patient here Referral Source will be PATIENT and the Referring Patient is the referring patient s account number Search f
24. Troubleshooting RDP If you cannot connect to RDP then try this e Confirm you have Internet access e Confirm the computer name e Apps phunkey com e Confirm your user name and password If you believe that you are typing the correct information then test this by logging into CHIROMAGIC with the training user name and password o User Name train10 o Password magic123 e If you can access the training database then confirm the spelling and the case sensitivity of the password e If you are getting a licensing protocol error then please contact support for further instructions support phunkey com Troubleshooting Printing If you have installed the PrintIT Client and you still cannot print then try this The customer printer does not appear in Account Assistant This situation is usually is caused by one of the following e The client printer begins with the word Auto o If the word Auto appears at the beginning of the printer name in the local Printer folder simply edit the name and delete the word Auto e The computer has not been rebooted since the installation of Print IT o Close all open programs and restart the computer If Print IT Client has not been installed on the local workstation or the Print IT Client needs to be reinstalled e Verify that Print IT is installed by checking for the Print IT Client applet in the control panel on the computer If it appears then the client software should
25. You can also search by the F Patient Search patient s first name by entering a space and then the Acct or LastName FirstName first name or a portion of the first name Click OK or narhol OCS hit enter on the keyboard m The computer will query the database and display the results in a window If there is only one patient in the database that meets the search criteria you will be taken directly to that patient s account If there is more than one patient with that name you are looking for it will be displayed in a gird The green arrow allows you to select the patient and click ok If the line is yellow and the arrow to the left is green and click ok to select this patient iw Patient Search Acct or LastName Firssttere mar hol F gt ppe y SM3 5 HOLLY MARTI 10032008 03301974 Pl 6r 0969 5431 Published 1 6 2009 Page 141 of 248 Reference Manual Magic Wand The Magic Wand gives you rapid access to any functions for a particular patient The Magic Wand represents the same functions throughout the software Wherever a Magic Wand is displayed you have access to the functionality for that particular patient Schedule Appts This allows you to schedule appointments for the patient Print Future Appts This allows you to print future SN3 HOLLY MARTIN Sandusky9 appointments for the patient Patient Functions a Schedule Appts H Print Future Appts Enter Charges Charge Revi
26. added to the Providers Screen you will need to update the Providers screen then return to name matching Below the Payers List section is the Matched Names section To view this section place a check in the box labeled Show Matched Names As indicated by the red warning message this section should be hidden when you are performing Match to Payer lf you need to un match and re match a provider that had been incorrectly matched 1 Click Un Match next to the matched name 2 To Re Match a name place a checkmark in the Include Names That No Longer Have Held Inquiries box above the Un matched Inquiring Providers section and repeat the steps to name match P ary A 0 A ZirMed Your Connection to Simpler Solutions Claims raining Guide Last Revised on 11 1 2007 10 30 AM Table of Contents DOMAIN ADMINISTRATORS amp SECURITY cccccsscsssssssececsesesecsesscsescsesetsesscststeesseeeeees 3 SE sce eaeetec tyne tated E danced A E 4 WELCOME u ceccsccccsccscsecsesecsesecsesecsesecsesecsesucassessssussssesassussssessssesasavsssansassecasaesasarsacacsecaess 7 CLAIMS FILE CREATION sseccsecescacoscentccneescereoeetotvuscetecctonedesdesicurtivancesiedebestetiiesresnior 9 VKO S 10 EE S A E acterized tetas tase E E teseniloececens 13 COMMON REJECTIONS amp RESOLUTIONS cccsssssssessesecsesesecsesecsesetsesetstsetsesetseees 22 NAME MATCHING ccccscssssescsessesesscsesecsesessesessecsssusecssessusessusesausecausesaus
27. box near the Save amp Resubmit is the same thing as the Overrides On box that is on the Edit screen Editing My Claim ID CRUISES46464 4irMed ID 46473075 Rejection Message Time amp Date a a oR CIGNA HEALTHCARE 98999 LRENDERING MAME MATCHING REQUIRED 10 46 00 AM Save and Resubmit Poo BILLING NAME MATCHING REQUIRED on 12292005 ZIRMED data upon resubmit 1 MEDICARE MEDICAID CHAMPUS GROUP OTHER 1a INSURED S 1 0 NUMBER dd4qagaag 2 PATIENT S NAME Last First MI 3 PATIENT S BIRTH DATE SEX 4 INSURED S NAME Last First MI TUMMY TOMMY 710990 MOF TUM TOMMY 5 PATIENT S ADDRESS Addri Addr2 7 INSURED S ADDRESS AddrifAddr2 123 YOU AND ME WAY E E RELATIONSHIP TO INSURED 123 YOU AND ME WAY M CTY STATE 8 PATIENT STATUS CIT STATE single Married Q Other ZIP CODE TELEPHONE ZIF CODE TELEPHONE Employed Student full Student part 9 OTHER INSURED S NAME Last First MI 11 INSURED S POLICY GROUP FECA C E 4 OTHER INSURED S POLICY GROUP fa EMPLOYMENT a INSURED S DATE OF BIRTH SEX Oves no 08 10 969 MOF b OTHER INSURED BIRTH DT SEX b AUTO ACCIDENT STATE b EMPLOYER S NAME OR SCHOOL NAME MOFO Oves no a isd c EMPLOYER S NAME OR SCHOOL NAME c OTHER ACCIDENT c INSURANCE PLAN OR PROGRAM NAME E Oves no d INS PLAN PAYER NAME ID 2Y 10d RESERVED FOR LOCAL USE d IS THERE ANOTHER BENEFIT PLAN ee a a 12 PAT
28. f T M ZirMe d Training Account 5076 training account Log OF 1r Ci Account Prof Claims Inst Claims Remis Eligibility Print Services Patient Statements 7 Pay Welcome Account Profile users Reports Downloads Manage Users User ID or Hame fe Search oat II Help ContactUs Customer Support Center Survey Mew User Page of 4 Go General Accounts Permissions Reset Password karen craigniyle training account trainingaccount Edit User First name karen Ima Sick July15 aam Optional if you enter one please make sure that itis valid Active Force user to Change Password Primary Account ZirMed Training Account S076 lwant this User to be able to add users delete users and change user information as well as have automatic access to all functions for all accounts within my domain Update User Delete User indicates the Domain Administrator Proprietary Information 3 USERS Go to Account Users screen The Users screen is where you will manage all of your users You can add users reset permissions update and inactivate any user from this screen The first thing you will see when you come to the Users screen is a list of all of your users on the left This list can be filtered using the search box at the top Click on the name of the user you want to work with and you will see their General Information along with a row of tabs With those tabs you can edit the users e General Information Fi
29. of claims currently rejected Since it reflects the current status of a claim resubmitted claims show only one time There may be discrepancies between the total number of claims from this report and the total number of claims from the Claims Activity Report for the same period This is because the Claims Summary Report total reflects the number of claims whereas the Claims Activity Report total reflects the number of times a claim is submitted and resubmitted NOTE Only original submissions will appear on this report Claims Summary Report by Batch Name Date Range 1012007 12 31 2007 Batch Hame a 6 2007 humana 5 0 6 71 2007 2006 BATCH 2 humana claims demo 3 demo 2 demo Received OF 41 2007 0604 2007 0604 2007 0425 2007 0425 2007 O52 242007 Ose 42007 Os 42007 Totals Claims Total Claims Charges 60 00 1 550 00 0 00 6 464 00 1 977 00 1 977 00 6 464 00 9 463 80 26 395 80 Claims T oO A oOo A oO A A This report should be printed monthly to show your totals for the month Proprietary Information Rejected Claims Charges 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 38 Claims Number Cross Reference some Payers remittances show only the ZirMed transaction ID Prefix along with all or a portion of the patient s account number This report will allow you to match the ZirMed transaction ID to your internally assigned patient claim number so the
30. payments can be applied to the correct patients accounts Each time a claim is submitted to ZirMed for processing a unique identifier is assigned to the transaction This identifier should be used to identify claims in order to properly post payment and adjustments to the patient s account within your Practice Management System This report can be created for all Payers within a given date range or by selecting a single Payer from the lookup menu it can be Payer specific The New Instance ID will be the number appended to the beginning of your Patient Account Number Only print this as needed 2irMed Training Account 5076 E Log Off i d ZirMed Account Prof Claims Inst Claims Remit Eligibility Print Services Patient Statements lt Pay Leads Admin F Poy Help Contact Us Customer Support Center Survey Claims Batches Mame Matching Providers Reports Enrollment Payers Coding Tools Settings claims Cross Reference Report Date Range Filter This Month From os 01 2007 Payer BC BS of Kentucky ZBKYO a Last Month To 08 31 2007 Custom Proprietary Information 39 Rejected Claims for any Batch Name This report gives you a listing of current rejected claims and lists the rejections by payer You will see the patient information specific to each claim and most importantly this report is printable Print this as needed Rejected Claims for Any Batch Close Window O Group By Payer O G
31. the child is the patient and the parent is the guarantor It can also be used for an attorney To set up a new guarantor click on the Magnifying Glass and click New Guarantor at the top of the list Has Legal Representative If the patient has legal representation for this case then check the box Active Checkbox This is where you set the case to active or inactive If the case is closed uncheck the active box Charges can only be entered on cases that are active Published 1 6 2009 Page 88 of 248 Reference Manual Insurance Section This is where all insurance carriers for that patient are displayed This is where to indicate what insurance carrier to bill each case Insurance Ppp If the carrier is in the list as the primary carrier Teri Sec then select the check box under primary If the ANTHEM BLUE cROSSBL e patient has a secondary carrier for the case M _ KASER PERMANENTE check the box that says secondary The insurance carrier must be active to set it as the primary or secondary carrier Notice the Blue Book to the right of the carrier name Anytime a blue book is shown you can click on the it and it will take you to the details for that carrier Chiropractic Section This is where all of the chiropractic information is stored for a case oe 4 Chiropractic Nature of Condition This is j Nature of acute Condition where to enter the nature of Condition Acute Conditi
32. then you MUST RESUBMIT PAPERWORK TO MEDICARE If you have been assigned a Type II NPI number but Medicare still has you listed as a Sole Proprietor then Medicare will require you to submit your claims with just a Type I NPI number You cannot submit claims to with your Type IJ NPI number until Medicare changes your structure to a corporation Medicare will NOT notify you that you have been changed from a sole proprietor to a corporation so you have to stay in contact with them to confirm that they have made the change If you are not sure what numbers Medicare needs you to use contact Medicare and ask them if they want your Type I and Type II NPI numbers If they tell you that they only want Type I NPI numbers then you have to bill your claims using ONLY your Type I NPI number If you have a group legacy number and a PIN legacy number then claims will have to be submitted with both NPI numbers If you only have a PIN legacy number then you will have to submit with just the Type I NPI Number Everything approved and still not getting paid by Medicare These are the most common things that happen when not getting checks from Medicare These are the Medicare DO S If you do not do them the claims will be rejected and you will NOT get paid by Medicare e All claims must have an onset date on the claim o To enter the onset date Open the AA go to the insurance tab and enter the onset date The onset date is the date of current injury or illn
33. 1124060047 1124060047 Bulk Billing History Tab The most recent claim batches will be on top The Date User who processed the batch Entity billed Type EDI fa sAn fe Type and Total of the Claim Batch PT Histo Functions e Select any of the batches c a gt ReSendEDI File i e Click on the History Batch Function icon and you have the MAjossoro0s opportunity to Re Send the EDI file Published 1 6 2009 Page 183 of 248 Reference Manual History Detail Below you will see the Batch History Detail Click on the Red Flag for the Claim History Functions You have the opportunity to view any of the claims al ama anina pa CHRO PRI 21 MICHAELDIX 1477738367 201361054 201361054 1174686570 i 3 T BENSON CHRO PR 5 MICHAELDIX 1477738367 201361054 201361054 1174686570 A g View Claim R GOETZKE CHRO PRI 1 MICHAELDIx 1477738367 201361054 350003626 1174686570 Claim History Functions al 6145 WD100482 PATRICK HERRON CHIRO PR 2o MICHAELDIY 1477738367 201361054 3 128K 6D 1174686570 6147 WWD100448 LORI SAND CHIRC PRO 21 MICHAELDIM 1477736367 201361054 201361054 1174656570 6145 WD100494 BRANT KOLB CHIRO PR 2o MICHAELDIY 1477738367 201361054 128K BDI 1174686570 6149 WD100498 RICHARD DESSEL CHIRO PR S MICHAELDIY 1477738367 201361054 201361054 1174686570 6150 WD100533 CAROLYN LINGENFELTER CHIRO PR 2o MICHAELDIY 1477738367 201361054 128K BDI 1174686570 6153 858 ALLISON KUSILEK CHIRO PR 2o M
34. 114 of 248 Reference Manual Yellow Function Flag Insurance Payment The functions that are available from the yellow function flag are different then than the functions that Payment Functions e Edit Payment This allows the user to edit basic information on the insurance check go Edit Payment x Void Ins Payment e Void Ins Payment Allows the user to void the insurance payment kA Go to Insurance Check e Go To Insurance Check This takes the user to the original insurance check Edit Payment A Payment from an insurance carrier can be edited to some degree The things that can be edited are the Method of the payment and also the notes None of the other information is editable on an insurance check To edit an insurance check follow the instructions below e Click Edit Payment from the yellow function flag Payment Functions Edit Payment of Edit Payment 225 for SN3 HOLLY MARTIN M 4 Save E Save and Close EJ Cancel g Payment Date 1029 72004 i Unapply Payment Method ec 4 Void Payment Amount 10 00 e Change the method Applied 10 00 Remaining 0 00 Ret Mo e Click Save T K 1029 2008 Copay Mote fe e Type ina note Created by traing on 1029 2008 fa 10 30 AM Published 1 6 2009 Page 115 of 248 Reference Manual gt Un Apply Payment e Click the Un apply Payment button from the green function flag Payment Functions
35. 20 00 0 00 o 00 sooo fe Ae E T 00 ono onc0 ramse ornoa HYOROTHERAPYRERCUSS OOOO oo om oo o e F F F i F Po Po Po Fa el el ey fei Po Po ey fe 2 Z Po O6042008 CASH cash O6042008 ST ADSI PATIENT STATEMENT PAYMENT z OB042008 99070 MA WATER PILLOVY 64 01 E A 880 Ova 00 tO 4 7800 om 180 00 7 _ 000 so e n e ao e 65 00 20 63 4 lt l 129 01 rj 414 04 Li 35 00 1 The Balance tab goes by date It does NOT have a date range or the ability to separate cases When the charge is listed and it says balance at the right even if the charge balance is 0 00 the balance was still the charge When you get to the offsetting payment the balance will lower The final square in the lower right is the final running balance This is the total that you will see in the Totals Tab It lists EVERY transaction payment or charge or adjustment or write off that has ever affected the account o It shows you a running balance at all times o All payments are have a red background o All charges white Published 1 6 2009 Page 120 of 248 Reference Manual From each payment or charge click the Function icon and you have all functions available from the charges or the payments screen ra Bat TT r n t i a Pt PT IEM 7 FP Pavia 1 l Pvikt4l Pabosinzionne gag WT 3 4 AREAS Pe losoeoo0s ADJ ADIUS Charge Functions E
36. 8 o Case Description isDefault P EH Bye WEIGHT LOSS 5 Simply enter a numeric part of a page isbot diagnosis code or any part of the description and click enter or click the Magnifying Glass and it will pull up any possible matches Select the code and it will appear in the Diagnosis Code box Default Diagnosis Codes If you want the diagnosis codes to appear checked in the Charge Entry Wizard click on the Default checkbox If the box is not checked the diagnosis code will still appear be in the CEW but it will not be automatically checked Published 1 6 2009 Page 93 of 248 Reference Manual e woe vuon ins O Chiropractic Vv Green Arrows Notice the Green Arrows to the left of the diagnosis code number This allows you to re order the diagnosis codes In some states this is important for insurance carriers such as Medicare a jeke TIT EE HNL z l Diagnosis Function Box Click on the Diagnosis Code function box to the left of the Case Code This will allows the codes to be copied to another case or reset the diagnosis codes to blank This makes adding new case diagnosis codes very fast Ep Copy Pl diags to WL e Clear diags for Pl To expand the codes for the next case click on the to the left of the Case Type code Published 1 6 2009 Page 94 of 248 Reference Manual Notes Tab The notes tab allows you to create as ma
37. Aalance Tatal Aalance Avail Cire How Do I Refund a Credit e Click Refund Credit from the green function flag Payment Functions Apply Credit Refund Credit ee Unapoly Payment 4 Void Payment e Type in the amount that will be refunded ee Patient Ledger E4 Fatient HOLLY MARTIN Amount Method REFPAT Reason x Cancel a Apply e Select the Method from the drop down e Type in the reason a reason MUST be supplied e Click Apply Published 1 6 2009 Page 111 of 248 Reference Manual gt How Do I Un apply a Payment e Click the Unapply Payment button from the green function flag Payment Functions Apply Credit Refund Credit Fd Edit Payment CT Unapply Payment x Void Payment Patient Ledger x e The computer will then ask Are you certain you want to unapply Payment X YZ from all charges e Click Yes e The payment then becomes unapplied and now the payment amount becomes an available credit being displayed in the grid with the yellow box in the Avail Credit column AN re you certain you want ta unapply Payment 265 From all charges Fa tt Ma a Bm n a Ma Ha Tm a an Maa LO iee ee ee a Y rT sin Ma olen DD a Ma a Maat A 2 a D 1111 2008 2159 51 000 34235235235 P2008 05 04 PM How Do I Void a Payment Click the void payment button from the green function flag Payment Functions 3 ra Edit Payment a Unapply Fayment e The computer
38. Apply Credit Refund Credit Fd Edit Payment ee Unapply Fayment x Void Payment Patient Ledger x e The computer will then ask Are you certain you want to un apply Payment X YZ from all charges e Click Yes A re you certain you want ta unapply Payment 265 From all charges e The payment then becomes unapplied and now the payment amount becomes an available credit being displayed in the grid with the yellow box in the Avail Credit column Void Payment e Click Void INS payment from the yellow function flag Payment Functions ra Edit Payment ee Void Ins Payment e The computer will ask This payment was applied from an insurance check This portion of the insurance check will have to be re applied through the check register Are you sure this is what you want to do oid an Insurance Payment Ed A This payment was applied From an insurance check This portion of the insurance check will have to be re applied through the check register Are you sure this is what you want to do e Click Yes e Type inareason A Reason MUST be supplied Published 1 6 2009 Page 116 of 248 Reference Manual e Click Ok e Once the payment has been unapplied the user needs to go into the unapplied checks and reapply that portion of the insurance payment Applied Payment Function Flags Once a payment has been applied to a charge there are applied payment function flags that become available underneath the p
39. Box 14 ogee e008 r Levels of Subluxation Detaut FProwidersF acility Initial Date of Jos220008 a eein r Referring HOLLY H MARTIN ax Treatment m Date of Acute Josr22 2008 Billing Rendering HOLLY H MARTIN xX aiie iicn Treating HOLL H MARTIN OK Last X Ray Date Josr22 2008 RA Lookup Facility in MOTION CHIROPRACTIC Ee mae BA Lookup Accident Information Guarantor Employment Related Boxi0a PX Accident Type auto accident Has Legal C State Representative Signature x Delete This Case Ens Copy to a New Case Source Both for block 12 and 13 On File Date Jose2re008 lt Means that the field is a default field auto populated based upon the case type setup in the system Refer to the system setup section for further instructions on defaults for case types Description This is the case description Chiropractic Weight Loss or customize with Truck Accident Boating Accident Football Injury Work Collision Case Type This is for the type of case CHIRO WL WC PI or an additional case type that has been added under the Account Assistant Utilities System Setup Case Type Tab Bill Type This is how the bills will be generated for this particular case This defaults from the case type setup but can be overwritten at the case level if need be The following choices are available Published 1 6 2009 Page 87 of 248 Reference Manual HCFA Means all charges for this case
40. CHIROPRACTIC 123 MAIN ST an zE 12345670910 b btn 11225344 NPI This is the NPI number for the facility The information that prints in Box 32 Provider No This will be the legacy ID number for the provider if a legacy id number is required Tax ID This is the tax id number for the facility Published 1 6 2009 Page 35 of 248 Reference Manual 3 QUAL This is the qualifier needed for electronic billing It should always read 77 Setting up a Facility Box 32 on a HCFA form where services were rendered It is important to properly set up your facility because this 1s the information that prints in box 32 of a HCFA form This is also known as the location where services were rendered If this information is not correct then you will not get paid by the insurance carriers To set up a facility follow the instructions below e Click Utilities at the top of the screen a a eee E a oO i yts Biling ar e fe User Manager f Scheduler e Click on the Facilities Tab MAT RELY ALU oes CA e Click the Add Facility button Li i ee ES Settings dh Add Facility e Select the Entity that the facility is attached to from the drop down list x Cancel H Save P Add Facility x lt Delete Facility i YX iy z Code _INMOTIONCH IN MOTION CHIROFB CTIC e Enter a Code for the facility this is an identifier that you will see when a
41. COPS aina A A E 233 APPONI MEN S oeseri rea TEE N CE EAEE AENEA AEE EEE Ar AEAEE NEE R 235 TA TRC OU orr E E E E E EAE EE E 238 Cen UPON oa EE E EE EEEE 241 How DoT POCumeniS airearen E E E E E E E EEE 242 Published 1 6 2009 Page 6 of 248 Reference Manual Billing Trouble Shooting Guide wccsoecccsavsrecstuseveicardeadessuccteeceusteaerivaserdcatderdacsvscescneuscvsenuvsseedestbeaanessest 243 NPI N omDET Sieisen aE S Oa a 243 Type IL NPI N mDerS iss coccssecsswersscsncessacenssdaccascsasacvavesssteacasencsnstdaceueasausasseadsesodicessenctdecesaasssacescdescosaseasascouce 243 Type TNEI NUMP Sorinnes eN N r EEEE iaeiaiai 243 BELING DAILY sossiicsrd iiien oaar e er are o rA N A AERONA a E ENEA VENEA NTRA Nra e 245 How do I know what claims can be billed electronically nnnnnnnenneeessssssseseeeeneeseessssssssssssssseereeesessssssessssseeeereeee 245 Problem Resolution Guide for Medicare cccccccceecceeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeseeeeseeeeeeeeeegagags 245 Everything approved and still not getting paid by Medicare cccccccccccceccccceeeeaeeeseeeeeeecceeceeeeeeeeeeeasaaaaaeesees 246 Quickly Adding the Three Do s for Medicare and Re billing ce cececesssseeeeeeeeeeeeeeeeaaaaaeeseeeeececceeeeeeeeeeeeeeaaas 247 Published 1 6 2009 Page 7 of 248 Reference Manual Published 1 6 2009 Page 8 of 248 Reference Manual ChiroMagic Reference Manual Dear Fri
42. CPT code will be displayed instead of the item code When copying charges if Charge Modifier differs trom patient s Fee Schedule use Fee Schedule modifier iAbkways iMever Ask After entering charges for a patient Display Claim Authorizations If this box is checked the Show Patient Receipt claim authorizations will be displayed when entering charges for a patient This will display a countdown of how many visits the patient has left Open search for Patients from Current DOS Open search for any Patient Close the Charge Entry screen Do nothing Allow blank Referring Physician If this box is checked then you are not required to enter a referring physician when putting charges into the system Automatically enter PAY OR DENY in 30 DAYS in Box 19 for all charges If this box is checked the text PAY OR DENY in 30 DAYS will automatically be placed in box 19 for all charges When copying charges if charge modifier differs from patient s Fee Schedule use Fee Schedule modifier If this box is checked when copying a charge if the modifier is different on the charge that you are copying than the patient s fee schedule it will pull from the fee schedule and not the most recent charge Phunkey recommends that you select Ask and then the system will prompt and warn you when entering charges if the modifier is different than the fee schedule Published 1 6 2009 Page 24 of 248 Refere
43. Charge Log Published 1 6 2009 Page 102 of 248 Reference Manual Diagnosis Tab This is the tab that allows the user to manipulate the diagnosis codes that are attached to the charge The order green filler and checks allow users to change the diagnosis information that is being billed on the charge Charge Information Diagnosis Charge Log Pf oi escriptiom Xes a eee Charge Log Tab This is the tab that allows users to confirm what actions have been made on a charge Sometimes a charge will be billed out and an EOB will arrive and information on a charge could have changed This is where the user can look and see what has happened on the charge Published 1 6 2009 Page 103 of 248 Reference Manual gt Enter Patient Adjustment Enter patient adjustment function is only be available on a charge that has a balance If the charge balance is 0 00 then the function to enter an adjustment will not be there To enter a patient adjustment f Adjustment for Charge 281 Ed Patient Dos e Enter in the Adjustment Amount HOLLY MARTIN e Enter in the method for the adjustment Claim Charge DOS e A reason MUST be supplied 183 1113 2008 Prev Payments Prev Adis Prey VWiite Offs Current Balance e Click APPLY at the bottom to apply the room ooo oog 73 00 adjustment Adjustment 0 00 Method PRAD e Click Previous Charge or Next Charge to 0 Reason
44. Close all of the screens and you should see a ChiroMagic Icon on your desktop Double click and you will be able to access ChiroMagic NOTE If you do NOT have Remote Desktop Connection in your Windows Menu then you have a different operating system and need to contact support If you have VISTA please see following page for instructions For support support phunkey com Published 1 6 2009 Page 12 of 248 Reference Manual Windows Vista You MUST have high speed Internet Connectivity to utilize ChiroMagic Instructions for Installing Remote Desktop Protocol RDP on your Computer Please make sure that you follow the instructions below to get RDP installed on your computer so you can connect to ChiroMagic Make sure that you have all Windows critical updates installed on your machine e Click on Start e Click on Programs e Click on Accessories e Click on Communications e Click on Remote Desktop Connection e Click on Options General Display Local Resources Programs Experience Logon settings A Type the name of the computer or choose a computer from the drop down list Computer apos phunkey cam User name hmartin Password seesese008 Domain PHUNKEY Save my password Connection settings Save cuiment settings or open saved connection Published 1 6 2009 Page 13 of 248 Reference Manual e Computer Name type apps phunkey com e User Name enter your user nam
45. Date From To Frequently Asked Questions What is the benefit of copying For example you have a CCI exception for Medicare and you want the exact same exception for Medicaid The copy function is any quick way to accomplish this Proprietary Information 49 because all you do is click on copy from your original Medicare exception change the payer from Medicare to Medicaid and click on Save Your original Medicare exception remains intact and you have easily created an exception for Medicaid without having to reenter the information Searching Exceptions Once you have added exceptions you may need to perform a search so that you may either view or take some other action on the exception such as editing copying or removing The search feature allows you to be as specific or as broad as you need The following are the various filter search options Coding Compliance Exceptions Entries on this screen will be excluded from Coding Compliance validations Payer Medicare A Kentucky Adminastar S Service Date 02 01 2007 Type All Procedure Code 99213 i Dx Code 1900 lt Modifier New Excepti e Payer If you know the payer name or ID enter it in the field or if you do not you may click on the eyeglasses to activate a search to find the correct payer o Search model Name Contains e Service Date If you would like to search for an exception for a specific Service date then enter the date in thi
46. E Amount ChargeDate Allows you to select a date range for the i ies z Wo Last Payment Date m charges Item If this box is checked a list of items will be displayed that have tax applied to them and allow you to select one or multiple items TaxCode Allows you to select from the list of tax codes that are in the system Amount Allows you to select an amount range LastPaymentDate This is the payment date range e ClickRun RunReport Report The results for the report will be displayed in a grid Notice how you have access to the Magic Wand and also the Blue Flag which will take you directly to that charge for the patient Tax Report 2 records Drag a column header here to group by that column Acctha LastName FirstName TENT Ea tem Tax Code Amount Last eA Date MARTIN HOLLY t BALL SALESTAX 1 05 0940 2008 ry E MARTIN ULY 15 3740043 SALES TAK 007 09M 0 2008 Published 1 6 2009 Page 239 of 248 Reference Manual Once the data is on the screen you have the ability to print from this screen or email the spreadsheet If you click email spread sheet the data will come to your inbox in a spreadsheet giving you the ability to manipulate the data Notice at the top of the screen the box that says Drag a column header here to group by that column If you want the report sorted by item or charge date or any of the columns that are on the grid all you have to do is drag the colu
47. Encounter Forms Encounter Forms FS e The Encounter Forms option screen will appear amp Encounter Forms Fa 5 Close E7 Schedule top Settings Appointment Date y Options l Sort Alphabeticall EE September 2008 D V Specify a Time Range Sun Mon Tue Wed Thu Fri Sat A 1 2 3 4 5 6 From 08 30 AM To 06 00 PM 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 28 29 30 1 2 3 4 5 Fd o g 10 11 _ Today 9 27 2008 Search for Patient All Forms Enter search text as Acct or Vv Only print encounter forms that LastName FirstName have not been printed yet P View All Forms for the Selected Date Confirm the Settings for the Encounter Forms prior to printing them for the first time Once the settings have been defined for the clinic they will save and you will not have to set them again unless they need to be changed Published 1 6 2009 Page 218 of 248 Reference Manual Show Future Appointments If this box is checked then the patient s future appointments will print on the Encounter Form Encounter Form Settings Ol H Sae cancel Show Past Visits If this box is checked then the patient s past doo a y W Show Past visits visits will print on the Encounter Form Fire iene W Show Patient Special Instructions Show Page I Patient Diags If this box 1s checked then the Show Patient Memo Show Ca
48. GY 3 03242008 Number of Visits The number of visits are displayed in a numeric editor This allows you to spin the visits up and down This is a user based setting is set up in system setup Last Visit By DOS This is the default for the charges that are displayed in the grid This displays the charges in Date of Service order Last Visits by DOS Entered This displays the charges in the grid in date entered order rather than DOS order Print If a charge is highlighted in the grid the print function allows you to print a patient receipt for that particular Date of Service or print a Patient Invoice for that particular Date of Service The column headers listed on the past visits are important to understand KEC E gt Case The case that the charges were entered for DOS The date of service for the charge Treat The treating doctor attached to the charge Rend The rendering doctor attached to the charge Codes The CPT codes and units that were entered for that visit Published 1 6 2009 Page 146 of 248 Reference Manual Entered The date the charge was entered into the system The function keys at the bottom of the CEW give you the ability to copy charges and create new charges Er Copy Selected Odd Mew Charge Entry Detail Screen This screen is where all of the products and services are entered for a patient s case This is where you enters the charges into the computer
49. Guarantors Understanding and Setting up Guarantors Guarantors are defined as people or companies that are financially responsible for patient s finances For example there might be a patient who has been in an auto accident and the facility mails all correspondence to the Attorney s office rather than the patient This would be a prime example of how a guarantor would be used Guarantors are stored in their own table so if there are many patients who deal with Martin and Martin Associates they only have to be entered into the database one time Company The name of the Company FirstName First Name of contact Guarantors Iof x LastName Last Name of contact BA close dP Add Guarantor Delete Guarantor Attn Send to attention of x WT x Company Martin and Martin Associates Address Address of company company sf Fsteme Holly LastName Martin Address2 Suite number or Apt se ania eee number Address 12365 Main Street City City of company ogee City Happy ville State State of company State ca Zip 123456 Zip Zip of compan pP p p y Phone fone Phone Phone number of company Fax attjat1 3111 Contact Nicole Hughes Fax Fax number of company Soa Memo Sample Guarantor Contact Contact at company Memo Internal note about the guarantor Published 1 6 2009 Page 175 of 248 Reference Manual Adding a New Guarantor e Click Billing p i j Sia Billin
50. Home Health http www cms hhs gov providers hha Hospitals http www cms hhs gov providers hospital asp MLN Matters http www cms hhs gov medlearn matters Medical Learning http www cms hhs gov medlearn Network Medical Suppliers http www cms hhs gov suppliers Medicare Providers http www cms hhs gov providers Open Door Forums http www cms hhs gov opendoor Physician Fee Schedule http www cms hhs gov physicians mpfsapp Look Up Tool Physicians Home Page http www cms hhs gov physicians Provider Updates http www cms hhs gov providerupdate Providers National http www cms hhs gov physicians cciedits Correct Coding initiative NHIC CME amp DME http www medicarenhic com dme dme_forms shtml information Proprietary Information 79 0 67irMed CONTACT INFORMATION Mailing Address ZirMed Inc 626 West Main Street 6 floor Louisville KY 40202 Telephone Numbers Toll Free 877 494 7633 Main 502 473 7709 Fax 502 473 8602 After Implementation Your Implementation Specialist will handle you account until the training and monitoring process has been completed After monitoring for support call 1 877 494 7633 option 5 Electronic Mail Support support zirmed com Enrollment enrollment ZirMed com Sales sales zirmed com NPI Information NPlinfo ZirMed com Proprietary Information 80 Accounts Receivable Understanding What A R and Collections Should Be What should
51. If there is one HCFA and one EDI then the Create Claims process has to be done twice As soon as Create Claims has been clicked a message will pop up that reads Bulk Billing x AN Check Deficiencies must be run before claims can be created Do vou want to run Check Deficiencies at this tine Click yes and the deficiencies process will run If there are any charges that need to be looked at the grid line will turn pink like below Correct the problem and then create the claims The deficiencies report can be emailed or printed for you to work from Once all of the deficiencies have been corrected click the Create Claims button again and the charges are all moved to the claims tab 5 CHIRO FRI BCBS OBOS2008 LUTHER snone 98940 1 45 00 45 00 45 00 0 00 2r 14 Published 1 6 2009 Page 180 of 248 Reference Manual Claims Tab Once the claims have been created the charges then get placed on the claims tab The Claims tab will show all of the Batches waiting for processing It is important to understand the headers on this tab fp Charges fp Claims le History Bach tele user erty Type eo Tyo Gaim Gout Ta aio gt Ea Batch This is the batch number for the claims that are being created Date This is the date the claims were created and not submitted User User who created the claims Entity The entity that the claims were created for Type The type of billing method fo
52. MOON Co o Sex Patient s address line 333 Glow ROAD SSN 00 two a einer iD 2222222 COLUMBUS OH 55555 Client Number Insurance Policy Number Property and Casualty Claim Number Country Code Statement Covers Period 3 13 2006 3 17 2006 Medical Record Number ne Principal Diagnosis Code 5856 g Facility Type Claim Frequency Code Principal Procedure Type Code a dns Principal Procedure Date LC ed Admitting Diagnosis Type amp Code Oooo ME o o Patient Status _ Injury Code a Covered Days ___ Co Insurance Days Lifetine Reserve Days DE Mon Covered Days Payer Estimated Amount Due Patient Estimated Amount Due as Patient Paid Amount Billing Mote Date Hour Type Code Source Code Discharge Hour Condition Codes 1 2 1 gt Claim Information Lill Treatment Codes Other Diagnosis Codes 1 26521 Z Other Procedures O W T Type Code f Date a gcur ence r Code Date Coe a E Code Date From To AL _ I _ The Institutional Claims Edit screen has different form locators than the Professional Edit screen The Institutional Edit contains the information that would be used on UB claims Proprietary Information 19 Professional Old Edit Screen The Old Edit Screen is in the form of a CMS 1500 Click on the field you need to change enter the required information then click the Save and Resubmit Note The Reapply Provider Screen Data upon resubmit
53. Mew Form O4f25200F 01 22 32 Ph 126464426 126464425 Qld Form Mews Form Date Time Source User Message 04252007 01 08 23 PM ZIRMED CLAIM LOADED FOR PROCESSING O4f252007 01 22 32 PM ZIRMED Rejected CLAIM REJECTED BY FIRST EDITS BILLING MAME MATCHING REQUIRED O42B200F 0427 23 PM training account Claim Resubmitted trom Mame Matching O426200F Ob27 32 PM ZIRMED Rejected CLAIM REJECTED BY SECOND EDITS BILLING PROVIDER ADDRESS LIME IS REQUIRED TO BE PRESENT 201 044 NM301 BILLING PROVIDER CITY Is REQUIRED TO BE PRESENT 2401 044 M401 BILLING PROVIDER STATE Is REQUIRED TO BE PRESENT 20104 4 M402 BILLING PROVIDER ZIP IS REQUIRED TO BE PRESENT 207044 M403 Edit Allows for editing a claim with the HIPAA compliant editor See sample below Note This allows you to enter notes specific to a claim Notes are displayed in the Claim status history window and the last note is displayed on the claims screen along with the date and user that created the note Click note type your message and press Add Note If you would like to Hide the claim at the same time you Add Note simply check the Also hide claim s when adding note before clicking the Add Note button More Additional action items are available in this drop down as follows Proprietary Information 16 Hide Allows for hiding a claim Why would you hide a claim Once a claim is sent to ZirMed it cannot be deleted If you receive a rejected claim from a payer because
54. Name PayerlD Apps Req NPI Notes ACM UHC Kentucky UHCKI WHC F h Y Notes BCBS of Kentucky ZBK 0 OOBE0 FIER M Y Notes Medicaid Kentucky SKK YO KY MEDICAID FIER Cr Y totes Medicare B Kentucky Adminastar SMK Y0 00660 FR Y Y Notes Displaying 1 4 of 4 Payers Fage af 1 So Proprietary Information 43 CODING TOOLS Go to Professional or Institutional Claims Coding Tools tab CCI LCD NCD EDITS OVERVIEW ZirMed INC and CodeCorrect have teamed up to provide CCI and LCD NCD edits to our customers In addition to providing CCI and LCD NCD edits for your claims the following is a highlight of the new features e Add your own exceptions to the edits e Edit your own exceptions to the edits e Seta specific date range for your exception e For each claim that does not pass a CCI and or LCD NCD edit o View complete Column One or Column Two listing o Obtain Medicare reimbursement lab fee schedule global days assistant surgeon information plus much more o Links to LCD and NCD policies for your review o Links to MedLearn Articles CMS Claim Processing Manual CMS National Coverage Decisions Federal Register and much more o CPT HCPCS crosswalks gt ae in question o Modifier information for the in question You will also be able to access ZirMed INC Procedure Code Search and the ICD 9 Search from the Coding Tools tab A billing report is also available for your convenience EXCEPTIONS Adding Exceptions From time to time you may
55. O NED CCI Exception Coding Compliance Exception Microsoft Internet Explorer fe fe x Add Exception Clase Window Required fields are bolded cc OLED O NCD payertameor dE Specify Situation All Situations Selecting this option vill alow claims for selected payer code pair and dates entered below to process without passing through CCl edits Procedure Code Col 1 Procedure Code Col 2 Modifier Service Date From To Save Cancel Proprietary Information 45 The type of exception will be defaulted to CCI as that is the type you have chosen You may change types to LCD or NCD at this point if you find you had chosen the incorrect type See section below LCD NCD Exception for a description of the LCD and NCD Add Exception screen Payer Name or ID A payer name or payer ID must be entered as it is a required field If you Know the payer name or ID enter it in the field or if you do not you may click on the eyeglasses to activate a search to find the correct payer o Search model Name Contains Specify Situation The add exception screen will always default to Specify Situation If you choose Specify Situation then only the claims meeting the criteria you enter here will bypass CCI edits All Situations If you choose All Situations then the payer name becomes the only required field as this option means that all claims for the selected payer will not pass through the CCI edits
56. Only use this if your PM System does not have the ability to exclude a particular payer s inquiries from going to ZirMed Below the Payers List section is the Matched Names section To view this section place a check in the box labeled Show Matched Names As indicated by the red warning message this section should be hidden when you are performing Match to Payer lf you need to un match and re match a payer that had been incorrectly matched 1 Click Un Match next to the Payer 2 To Re Match a payer place a checkmark in the Include Names That No Longer Have Held Inquiries box above the Un matched Payers section and repeat the steps to name match fA 7ZirMed Eligibility Provider Name Matching Provider Name Matching Inquiring These screens are used to associate the names provided by your Practice Management PM System with the information contained within ZirMed s providers screen To access Provider Name Matching go to Eligibility Name Matching tab and click on the appropriate tab Normally you will match the inquiring provider name one time You will be required to complete provider name matching anytime you send a name that has not previously been sent The name may be the same however any deviation from the spelling or punctuation will cause the inquiry to be held for name matching The Name Matching screen is divided into three sections 1 On the left is the Providers Search List section It is here tha
57. Penalty Amount you are responsible for paying to the provider Penalties may occur Provider Charge Amount provider physician hospital etc bills for service when certain services are not authorized e g surgery out of the network Amount Denied Amount Primary Ins did not pay May be due to our provider Coinsurance Percentage of Amount Allowed that you are responsible for paying to the provider contract your benefits coverage lack of authorization or missing information for this procedure as determined by your coverage EX Codes Code assigned to the action taken on each service e g a denial Other Insurance Amount another insurance company is responsible for paying e g workers Details provided in the Explanation of Code box above compensation or motor vehicle insurance Amount Allowed Amount eligible for payment consideration under our provider Amount Paid Amount Primary Ins paid toward each service contract or payment guidelines May be counted toward your deductible applicable Refer to the Important Information section on reverse side for additional information Sample EOB Proprietary Information 69 GLOSSARY OF TERMS Administrative Simplification Compliance Act Signed into law on December 27 2001 as Public Law 107 105 this Act provides a one year extension to HIPAA covered entities except small health plans which already have until October 16 2003 to meet HIPAA electronic and code set transaction r
58. Procedure Code Col 1 Enter the Column one procedure code you want to bypass CCI edits Required field Procedure Code Col 2 Enter the Column two procedure code you want to bypass CCI edits Required Filed Modifier If you would like a modifier to be considered in this exception then enter the modifier in this field service Date From and To If you would like for your exception to be in effect for a specified time or time frame then enter the date s you would like to limit the exception to Service dates are limited to one year prior and one year past the current days date Save You MUST click on save for your exception to be saved Proprietary Information 46 LCD or NCD Exception 3d Coding Compliance Exception Microsoft Internet Explorer aAA Add Exception Close Window Required fields are bolded Occ LCD O NCD Payer Hame or ID ar specify Situation C All Situations Selecting this option vill alow claims for selected payer code pair and dates entered below to process without passing through LOD edits Procedure Code 2nd Procedure if required Dx Coide image 2nd Daptede drrequired 4 Modifier Service Date Fram To o Save Cancel The type of exception will be defaulted to either LCD or NCD dependant on the type you have chosen You may change types to CCI or LCD NCD at this point if you find you had chosen the incorrect type See section above CCI Exception for a description
59. SCHLOTMAN Fe CALLAHAN BP CALLAHAN ye PALERMO Je PALERMO First Name DONKIN Signed In HOLLY Signed In WALLIS M Cancelled HOLLY Signed In ANTOINETTE Rescheduled AMBER No Show JORDAN Pending AMBER No Show GREG Pending GREG Pending EUGENIA Pending LILY Pending EUGENIA Pending TOMMY Pending TOMMY Pending MICHAEL Pending MICHAEL Pending Once the data is on the screen you have the ability to print from this screen or email the spreadsheet If you click email spread sheet the data will come to your inbox in a spreadsheet giving you the ability to manipulate the data Notice at the top of the screen the box that says Drag a column header here to group by that column If you want the report sorted by visit type or provider or any of the columns that are on the grid all you have to do is drag the column to the top of the screen into that box Published 1 6 2009 Appointments 17 records Visit Type Visit Type OFFICE VISIT 10 items Appt Date Time Provider 10 01 2008 09 40 AM 10 01 2008 10 00 AM HHM 10 01 2008 10 00 AM HHM 10 01 2008 11 00 AM HHM 10 01 2008 11 10 AM HHM 10 01 2008 01 35 PM HHM 10401 2008 01 45 PM HHM 10 01 2008 02 00 PM HHM 10 01 2008 02 20 PM HHM 10 01 2008 03 10 PM HHM Visit Type NEW PATIENT 1 item Provider HHM Appt Date Time 10 01 2008 08 00 AM Visit Type SPINAL DECOMP 3 items Provider STAFF Appt Date Time 10 01 2008
60. Scheduler E Open Today Tab Schedule Appts iO Restart Account Assistant e Click on System Setup ae A Utilities Calculator F6 Support Log Of 22 System Setup pa Us anager gt Inventory e Click the Financial Classes Tab Published 1 6 2009 Page 30 of 248 Reference Manual Se Reterral sources ge iS Financial Classes le ss m 5 e Click Add Financial Class la SS LLIN LS as ST VILE ap Add a Class Code e Enter a code Description e Enter a description e Click Save oo settings gt R Types X Cancel A Save dP Adde Y Published 1 6 2009 Page 31 of 248 CASH Cash Patient Reference Manual 9 Entities Understanding and Setting up an Entity This is where your corporate information is setup The information entered here has to match the information that is associated with the clinic s tax id number If this information does not match claims will be rejected and you will not get paid Company The name of the entity that prints on the HCFA form in box 33 LastName The last name of the doctor who is associated with the entity FirstName The first name i of the doctor who 1S associated il Save and Close ie Other System Setup Lists with the entity fe Patient Status lt Referral Source Groups Referral Sources e Marketing Categories E EDI Settings tE Settings 5 Service Types EE Case Types S Financial Classes D
61. Special Date 2 In the setup of the Encounter Forms this is a date field that can be custom programmed by the staff For example if a patient purchases orthotics and the doctor wants to know when orthotics were purchased use the custom date field e Co Pay This is the co pay amount for a patient This amount should never be 0 00 The Co Pay field is used to quickly designate the amount of co pay that the patient owes This is a flat fee or percentage However always use Co Pay codes if it is not anormal amount Here is a list of quick codes that ChiroMagic suggests using 100 Cash Patient 99 Personal Injury 98 Work Comp 97 Trade Out VIP 96 Cash doctor who pre pays bulk Note This way when working from the Encounter Forms staff members can quickly know what to collect from the patient This will significantly speed up the check out process and increase the customer satisfaction level and experience It will also increase your collections at the front desk Most importantly there should NEVER be 0 00 in the Co Pay field e Primary Insurance This is the insurance information that is on file for the patient s default case Always cross reference this information with the patient and confirm that this information is accurate Also if Medicare is the primary carrier confirm the Three Do s for Medicare e Group Name None e Onset Date e Initial Treatment Date e Future Appointments Th
62. and reduce costs in the following manner Providers experience greater control over administrative processes This increases cash flow staff productivity and revenue per patient visit Payers team with ZirMed in order to increase the percentage of claims submitted electronically Through extensive edits and adherence to detail we strive to have 100 pass through rates Practice management software vendors partner with ZirMed because we enhance the capabilities of their offerings With ZirMed the partnership is based on innovative technology solutions and dedication to customer service Let ZirMed take the complexity out of the administration of healthcare allowing you to focus on the provisioning of healthcare Z Zir Med Finding The Cure For Healthcare Administration Costs sesse s Published 1 6 2009 Page 204 of 248 Reference Manual fA 7ZirMed Eligibility Payer Name Matching These screens are used to associate the names provided by your Practice Management PM System with a standard Payer Identification code Payer ID that will be uniformly recognized by the ZirMed system To access Payer Name Matching go to the Eligibility Name Matching tab Normally you will match the Payer name with an ID only one time All subsequent submissions will automatically go to the correctly matched Payer Unless the spelling of the name generated by your PM System changes you will not need to do this again The N
63. and the new diagnosis code will be in the list for you to point to or use the green filler box Charges Screen This is where all of the charges that have been entered for a patient are listed The charges screen shows the charges in the order in which they were entered for the patient Once a charge has been entered into the database and saved it will be displayed on the charge list Charges Date of Service 10 06 2008 Add AN Edt Z lt p Cmyview 6 Modview SY Ins Case Refer Rend Treat Units Item Description Unit Amt SubTotal Tax Total Modi Mod2 Mod3 Mod4 Pointer Diagi Diag2 Diag3 Diag4 HHM HHM 1 98941 ADJUSTMENT THREE TO FOUR REGIONS 65 00 65 00 0 00 65 00 59 123 72252 72271 7391 Date of Service This is the date of service for the charges that have been entered the system will automatically default to today s date when entering in a charge If you change the date of service to yesterday the system will remember that for all of the charges being entered into the system If the Account Assistant is closed and reopened then the system will go back to defaulting to today s date Add This button is used to add an additional charge to the visit Published 1 6 2009 Page 149 of 248 Reference Manual Edit This button allows you to edit the charge that is highlighted in the list Clm View This button allows the charges to be displayed exactly how they will print on the
64. be used as a shortcut for all new visit types e Click on Add New Visit Code SP Add New visit Code e Enter code example OV e Enter Description example OFFICE VISIT e Select color example Blue e Click on the Other tab at the top middle right side of the screen ee Update Provider isit Type sy Apply DEFAULT Settings Grid Start Time e Click Apply Default Settings this will copy the hours to the new visit e Click in the minute s box and set the minutes length of the visit e Go to the hourly start time and select the check boxes to the times that you want to start the visit e Check the allow box next to the providers who will be doing the visit e Click SAVE Published 1 6 2009 Page 70 of 248 Reference Manual Utilities Schedule Settings for Providers Be sure to set the providers up properly in the schedule Doctors have schedules outside of the office and the system can also accommodate them Provider Scheduler Settings will be created for all doctors and staff members who see patients Notice how the screen is divided into sections Providers section Options Time Blocks and Exceptions ist Provider Scheduler Settings E Close H Save dop Other Providers E Show All Providers o STAFF AYAILABLE STAFF Options Active for Scheduling I Override Color D Black Time Blocks From Jos 00 Ahl To osoa Ph Clear All IY blo IY Tu i ve iY Th i Fr s
65. between aom M008 to ao 2008 Today hi E E Patient MO AcctNo E Wo LastName E MW FirstName E W Charge E W ChargeDate E W tem E W Tax Code E W Amoun E W Last Payment Date M By default the field for Last Payment Date will be checked and the default value for the criteria will be today You can overwrite this date with a custom date or one of the preset dates from the drop down Notice how the criteria are listed and how there are two check boxes flanking the field in the middle If the Show box is checked that means that the field will be displayed on the report If you do not want the field to be displayed on the report uncheck the Show box The other box is the criteria box If that box is checked you will be given the criteria on the right hand side to choose from Published 1 6 2009 Page 238 of 248 Reference Manual Patient If the patient criteria box is checked it gives you the ability to select one patient from the database AcctNo If this box is checked you can select a range of account numbers to print the report for Patient E ae Aceto E LastName If this box is checked you have the ability to print LastName E a last name range f FirstName E FirstName If this box is checked you have the ability to FVO Charge E print a first name range H ChargeDate E Charge If this box is checked you have the ability to print a tem m charge number range W Tax Code
66. carriers do not accept new doctors and that requires some work and lobbying on your behalf to get them to accept you Published 1 6 2009 Page 206 of 248 Reference Manual You are not billing DAILY If you bill once a week then it s just another week in the cash flow hiccup Get it billed get paid or get it fixed FAST You are not checking ZirMed DAILY 2 BIGGEST REASON You MUST check ZirMed Web Site EVERY DAY and fix rejections and problems and resubmit claims By the time you realize you have a problem you re in a cash flow crash Turn and Burn ANY PROBLEM Claims ANY Rejections and ANY EOB s with errors review them fix them and resubmit them the SAME DAY This is an extremely critical point in the process This changes a CRASH into a SPEED BUMP You are not entering your payments DAILY This means entering your Payments AND processing your EOBs If you do not know who has paid then you do NOT KNOW who OWES YOU MONEY This is critical You are not reviewing your reports in a timely manner Review the Snapshot ReportWEEKLY Review the Carrier Non Payment Report WEEKLY Review the Carrier and Patient A R reports MONTHLY ZirMed PAYS ON AVERAGE in 14 Days If you have Primary Claims on the Unpaid Carrier Report over 30 days old they should not be there unless they are PI or WC You are not managing your practice Remember to inspect what you expect That is a primary rule of management You have the re
67. claim Medicare Intermediary A private company that has a contract with Medicare to pay Part A and some Part B bills Medicare Contractor A Medicare Part A Fiscal Intermediary institutional a Medicare Part B Carrier professional or a Medicare Durable Medical Equipment Regional Carrier DMERC Proprietary Information 70 REQUIRED FIELDS FOR SECONDARY CLAIMS NSF amp ANSI Claim level DA1 DA1 DA1 DA1 DA1 DA1 DA1 DA1 NSF 9 0 10 0 11 0 12 0 13 0 14 0 15 0 36 0 Line Level FBO FAO FBO FAO FAO FAO 7 0 35 0 8 0 27 0 28 0 51 0 Pos 114 120 Pos 121 127 Pos 128 134 Pos 135 141 Pos 142 148 Pos 149 155 Pos 156 156 Pos 294 302 Pos 54 60 Pos 179 185 Pos 61 67 Pos 126 132 Pos 133 139 Pos 239 245 Proprietary Information Description ANSI Disallowed Cost 2320 CAS03 Contractual Obligation Disallowed Other Amt 2320 CAS03 Other Adjustment Allowed Amount 2320 CAS03 Deductible Amount 2320 CAS03 Coinsurance Amount 2320 CAS03 Primary Paid Amount 2320 CAS03 Zero payment Indicator Not mapped Interest Paid Not mapped Deductible Amount 2430 CAS03 Paid Amount 2430 CASO03 Coinsurance Amount 2430 CAS03 Contractual Obligation 2430 CAS03 Other adjustment 2430 CAS03 Approved Amount 2430 AMT02 71 SECONDARY CLAIMS FAQs 1 What is a secondary claim Many times a patient will have more than one insurance payer A patient can be covered under one payer through their own e
68. claims Payers Matched To Paper fo 4ETNA US HEALTHCARE fo HEALTHLINK System Payer Name Payer ID Delivery A A amp BENEFIT PLAN ADMINISTRATORS 93044 Electronic O 446 American Administrative Group Formerly loon Benetit T9185 Electronic Proprietary Information 27 PROVIDERS Go to Professional or Institutional Claims Providers screen The Providers screen is used to establish overrides for the data generated by your Practice Management PM System If your PM system is capable of supplying the data elements required to submit claims it is not necessary to use this feature ZirMed strongly suggests you rely on your PM System to provide this information whenever possible Since the data entered via the Provider screen will override the data uploaded from your PM System it is imperative that you carefully consider the downstream effect it will have When using this feature you need only supply those fields that need to be amended by the override Some examples of when you would use Provider overrides are e lf your PM System cannot provide the data elements required to produce a valid claim e g older systems that are not UB92 or HIPAA compliant e lf the Providers name needs to be in a different format for a given Payer or Intermediary e If your PM System cannot send the correct Medicare assigned billing provider number on Medicare claims Provider types supported by this function are e Billing Pay to R
69. cnn actresses Bartels esos wssfeS haat obec EEEn iani 7 QUICK REFERENCE TO CMS WEBSITES cccscecesseseesececsesecsesecseseesesetstsetsesetseeees 79 CONTACT INFORMATION ccccccscsscsesessescscsecscsscscsscsesscessrcsesussesreacsestsssatseeeseeeaveees 80 Proprietary Information 2 DOMAIN ADMINISTRATORS amp SECURITY Go to Account Users screen Security Administration System ZirMed s Security Administration System allows each organization to very specifically define the areas of the ZirMed system that each user is able to access To accomplish this one user for your organization is assigned to be the Domain Administrator for your organization Domain Administrators DA The Domain Administrator should do the following Add New Users to the system Set Permissions Indicate what each user is able to do within the system Reset passwords for users who have forgotten their password Inactivate users from the system Unlock users After 3 consecutive failed logins the system will lock a user Manage Domain Security Settings Password Rotation e Anyone who uses the site MUST be setup as a user with their OWN username and password this is for your security and ours e Only the Domain Administrator can add new users reset passwords and change permissions UNLESS someone else has been assigned full rights to do so We recommend that someone else be setup as a security manager as well for emergencies if the DA is out
70. e Click Rung RunRepot Report The results for the report will then be displayed in a grid Notice how you have access to the Magic Wand giving you the ability to access the patient s account directly from this screen Published 1 6 2009 Page 236 of 248 Reference Manual Ej Appointments Report S Close E7 Email Spreadsheet D Print Appointments 17 records Appt Date Time 10 01 2008 08 00 4M 10 01 2008 09 40 AM 10 01 2008 10 00 AM 10 01 2008 10 00 AM 10 01 2008 10 00 AM 40 01 2008 11 00 AM 10 01 2008 11 00 AM 10 01 2008 11 10 AM 10 01 2008 01 35 PM 10 01 2008 01 45 PM 10 01 2008 01 45 PM 10 01 2008 02 00 PM 40 01 2008 02 00 PM 10 01 2008 02 20 PM 10 01 2008 02 30 PM 10 01 2008 03 10 PM 10 01 2008 03 30 PM Visit Type NEW PATIENT OFFICE VISIT OFFICE VISIT 30 MINUTE MASSAGE OFFICE VISIT SPINAL DECOMP OFFICE VISIT OFFICE VISIT OFFICE VISIT SPINAL DECOMP OFFICE VISIT OFFICE VISIT SPINAL DECOMP OFFICE ISIT 30 MINUTE MASSAGE OFFICE ISIT 30 MINUTE MASSAGE Drag a column header here to group by that column Provider HHM HHM STAFF HHM STAFF HHM HHM HHM STAFF HHM HHM STAFF HHM STAFF HHM STAFF HS10201 SNS SNOO005 SNS H510200 SNOO002 SN SNOO0002 SNOO0008 SNOO008 SNOO003 SN4 SNOO0003 SNOo001 SNoo001 SNOOOO0 SNOOO0 Last Name Fe MARTIN Be ADAMS gt MARTIN NOBLE r LOVE Fe WILLIAMS r LOVE e DICKSON Fe DICKSON F SCHLOTMAN gt MARTIN F
71. e Click on Utilities e Click on System Setup Click the Entities tab System Setup ET Save and Close ie other System Setup Lists fe Patient Status le Referral Source Groups lt gt Referral Sources e Marketing Categories ED Settings da Add Entity ae Delete Entity a ID Numbers e Click Add Entity System Setup Al Save and Close amp Other System Setup Lists Patient Status Referral Source Groups lt gt Reterral Sources Ee Marketing Categories Ez EDI Settings ESA Settings 5 Service Types ia case Types Financial Classes E Entities Ea Facilities Providers js Pe ae Addentity FE Delete Entity ID Numbers e Enter all of the company information i as code company F Remember this is the information that is attached to your tax id number If you enter a company name that is not associated with your Tax ID number all of your claims will be rejected by the insurance carriers and you will NOT be paid e Enter your NPI number If you do not enter your NPI number all of your claims will be rejected and you will NOT be paid e Click Save 3E settings Is E Types X Cancel A Save dP Adde Y Published 1 6 2009 Page 33 of 248 Code Company LastName FirstName MI Suffix Address Address2 City State Zip Phone Fax Tax ID TaxonomyCode NPI Contact Email Entity Type JINMOTIONCH IN MOTION CHIROPRACTIC 000000 HUNTER HOLLY 123STREET ti
72. find it necessary for specific claims to bypass the CCI and or LCD NCD edits and pass to the payer as you submit When this is the case you may add an exception so a claim will bypass the edits To add an exception follow these steps e Itis very important to remember that you must enter exceptions specific to either professional or institutional claims e Located in the bottom right hand side of the search bar is a link titled New Exception Click on this link e You will receive a box that will ask you to choose the type of exception you wish to add You will need to choose o CCl o LCD o NCD And click Next to continue e The screens will vary depending on the type of exception you choose to enter Proprietary Information 44 047 M 3 zirMed Training Account 5076 training account Log Off rE 1r ed Account Prof Claims Inst Claims Remis Eligibility Print Services Patient Statements 2 Fay F Poy Hal ontact Us Customer Support Center Survey Coding Tools Settings Claims Batches Mame Matching Providers Reports Enrollment Payers alll Ge Procedure Code Search ICD 9 Search Reports Coding Compliance Exceptions Entries on this screen vill be excluded from Coding Compliance validations payer 0 Service Date Type Procedure Code Dx Code Modifier New Exception A Coding Compliance Exception Microsoft Intern Eg Add Exception Close Window Select type of exception needed cc OLep
73. frequently with the particular CPT HCPCS code you are researching Document Both the 1995 and 1997 E amp M Documentation Guidelines this icon only displays for E amp M codes 1 Defaults to the 1995 E amp M Documentation Guidelines but the user can view the 1997 E amp M Documentation Guidelines by clicking on the Click here to view 1997 guidelines Knowledge Man Clicking on Knowledge Man will access all documents listing the specific code within the text of each document Display will list the database name and articles found within that database The document name is a link that when clicked will display the entire article M Displays a list of modifiers that may be appropriate for use with a specified code R Displays a list of revenue codes as suggestions to accept with given CPT HCPCS codes Notepad This allows a user to view important information related to the code in an area readily accessible and visible to all For example if a code always requires a preauthorization making a note of the requirement in the note section would be appropriate Once a note has been typed into the notepad and Submit clicked a red checkmark will appear on the notepad icon the next time a user from the facility accesses this code Gear This is a crosswalk to the ICD 9 CM procedure codes Clicking on the ICD9 code will bring up code specific information for that ICD 9 CM procedure code Clicking
74. from Primary Check No Primary Payment This will only give us a list of charges that have NO primary payment e Billing Type Select All Check boxes e Case Type All Case Types e Carrier Select Medicare from the list e Click Run Query On the bottom of the screen the list of data will appear Charge BillTo Status Hold Date Acct FirstName LastName Case BillTyoe PriCarr Sec Carr Last Billed Total Paid Ach WriteQtf Balance h Ti PAT pri Wo 0947 2008 HS10200 y ANTOINETTE NOBLE CHRO EDI MEDIC lt NONE gt OS962008 130 00 0 00 0 00 0 00 130 00 Notice the function flag From here you can edit the charge individually or the whole result set can be updated Published 1 6 2009 Page 192 of 248 Reference Manual To update all of the charges in the list click the button that says Charge Edits This screen will appear Set Rendering Provider Sets the rendering provider on all charges in the grid Set Referring Provider Sets the referring provider on all charges in the grid Set Treating Provider Sets the treating provider on all charges in the grid Edit Diagnosis Codes Can edit diagnosis codes on all charges in the grid Set MODI Can set modifier on all charges in grid Set MOD2 Can set modifier 2 on all charges in grid Set MODS Can set modifier 3 on all charges in grid Set MOD4 Can set modifier 4 on all charges in grid Set Local Use Box 19 Can update box 19 fo
75. green means the doctor should look at the note and yellow means front desk should look at the note Published 1 6 2009 Page 216 of 248 Reference Manual Remember if no cell number 09 29 2008 9 40 2 OV HHM 10 00 a MA30 STAFF f0 the patient enter 000 000 Fr 0000 this way staff does not HOLLY H MARTIN 111 114 1111 3319 LAMP POST LAHE ask them on every visit what 03071974 the cell phone number is pai orga abet 672 929 5231 Home Cel o ea e VENI iced Gam thea pien a E have an insurance ope CO T number Primary Insurance KAISER PERN ENTE LO tir Patient should have at least 12 future appointments booked Patient Diagnosis Codes ast Visits CPT Code u Rend Mod Diagnosis Codes 09 2408 NICOLE HHM GY 72252 72271 7391 T7140 CHAM O70 CHEM E PIDPATF DAD 0S URPTE FDD o PTDPRIP T 0 PTDVISIT 6 fREDBAL Published 1 6 2009 Page 217 of 248 Reference Manual Printing Daily Encounter Forms Encounter forms are a communication tool that travels with the patient throughout the clinic The Encounter Form will inform all staff members in the clinic what is going on with the patient Everything that you need to know about a patient is located on the Encounter Form To print Encounter Forms follow the instructions below e Click on the Reports tab H JF Reports Biling Utilities Ca E Forms Fo Ez Report e Click on
76. have entered your claims you will then have to go into your billing menu to create a file of claims Follow directions given to you by your Vendor or your ZirMed Data Analyst 3 You will need to make note of the location where your file is saved This was determined at the time of the test file extraction NOTE Please refer to your specific Practice Management Instructions and any instructions that you received during the File Extraction test file from your Data Analyst Please use the following to record your file name and location where the file is saved for future reference Path The drive and folder that the file is saved in Filename Proprietary Information BATCHES Log in to www zirmed com Go to Professional or Institutional Claims Batches screen To Upload a batch 1 From the Upload a New Claims Batch section position the cursor at the Batch Name prompt and enter a unique identifier for this group of claims Hint Using the current date followed by a short description of the type of claims within the batch e g MCAID BC can make the researching later easier If you have opted to use the default filename that name will automatically appear here after you select the file step 3 2 Click on Browse button 3 A box displaying the name of the files in your Practice Management System will appear Determine where your file is saved and double click on the filename 4 The selected filename will displ
77. here Remember there is a Number of patient diagnosis codes E zz separate set of diagnosis codes for EVERY case Patients Scheduling Auto select Mon Fri when scheduling If this box 1s checked when the scheduler window opens the Monday thru Friday boxes will be selected This tells the software to automatically check for appointment m P ae S JUS ewelezie epai eet NT availability Monday thru Friday If the box is not checked then you need to manually select the day of the week for scheduling an appointment Scheduling i Auto select Mon Fri when scheduling Auto select Show first available appt each hour when scheduling If this box is checked when you open the scheduler window the system will automatically select the filter to show the first available appointment each hour If appointments are scheduled every 5 minutes it will show 12 appointments per hour This feature keeps the appointment list concise This feature is very useful when you are scheduling a patient s appointments for the next two weeks Environment Environment Load Today Tab when program opens When the Account Load Today Tab when program opens Assistant is opened it will automatically load the Today Tab By default this box will be checked for all users so if the billing department does not want the Today Tab to be displayed uncheck this box The staff can then open the Today Tab as needed by clicking Utilities and then the Open Today
78. injury WC workers comp For example if you have spinal decompression in your clinic and would like to track how much money you bring in for decompression then you would create a case type for decompression This will then track all of the data in the chiropractic service type but give you the ability to break down the chiropractic services by cases It is important to remember when setting up the case types that every patient in the system must have at least one case type Each case type can have its own set of default values To set up Case Types follow the instructions below e Click on Utilities Utilities Calculator F6 Support Log Of P er Setup ez User Manager Inventory 5 Schedule Settings For Visit Types Schedule Settings for Providers Scheduler E Open Today Tab Schedule Appts 1 Restart Account Assistant e Click on System Setup Published 1 6 2009 Page 27 of 248 Reference Manual Utilities Calculator F6 Support Log of AP System Setup Bushy gt Inventory anager e Click the Case Types Tab 2r par o Service Types GRP Case Types Financi Type 3e Delete Case Ty Description ee e Click Add Case Type me po tE Settings E Ser db Add Case Type Coady gt Desc Fill out the detailed information under the case type Below you will find a description of what each of the fields represent Service Type This is
79. it was a duplicate claim you can hide the duplicate To view a claim once it has been hidden simply change the Hidden status dropdown to Include Hidden or Hidden Only and press the search button to refresh the screen Hidden claims will show user who hide the claim and the date and time it was hidden To Hide a single claim Press the More link Press the Hide link The claim is immediately hidden To Hide multiple claims Check the box on the left side of the screen next to that claims submit date Click Hide link at the bottom of the screen Remember You can also use the NOTE link to hide the claim and type a note as to why it is being hidden Unhiding a Claim You can always un hide a claim by pressing the More link then selecting Un hide link or by checking the box es on the left side of the screen next to that claim s submit date and clicking the Un hide link at the bottom of screen 2 or 3 Allows you to create a secondary or tertiary claim See Secondary claims training guide for more details This is available for Professional claims only Old Edit Allows for editing a claim using an edit screen that mirrors a paper claim See sample below View Places the claim data in a PDF superimposed over the CMS 1500 08 05 form View using Old Form Places the claim data in a PDF superimposed over the CMS 1500 form See samples of Professional Edit Institutional Edit Professional Old Edit View and View usin
80. list of data that is needed for marketing purposes To access the marketing reports follow the directions below e Click on Reports e Click on Marketing e Click on Patient List Once the criteria screen is displayed the user can manipulate the data that is displayed on the report Below are examples of how a user would generate mailing labels for new patients as well as a finding out what the Return on Investment is for referrals How Do I generate a list for mailing labels for all new patients in the month of September Once the criterion is displayed e Check the box that says First Visit e Change the date range e Click Run Report ET Close aa Criteria Email Spreadsheet Ey Print Patient List 10 records Bee ac AEL We ae uu tor groue a we C o i LastName sili FirstName Aun hil alist Suffix Once the report is displayed es oe Email Blast g Phone Blast e Click Options at the top of the screen e Click Mailing List The system will cross reference for duplicate addresses once the mailing list options is checked Published 1 6 2009 Page 230 of 248 Reference Manual Collections Reports The collections reports are all located under the collections tab from the reports menu at the top of the screen This is where all of the A R Reports are created The A R can be displayed in many different formats eg IR by Carrier PH AIR by Case Type e A R By Carrier Allows the users to see
81. new versions of the software each year in February June and October If you have submitted a new feature request report criteria or additional field for the upcoming release and it has been requested by multiple parties we will endeavor to include it in the upcoming release at no additional charge If the feature update 1s for you specifically and is not of use to others then we will charge you a development fee based on our 125 per hour programming rate We will always let you know in advance if there will be a fee associated with the change If the feature 1s urgent and you need it before the next release we will do our best to accommodate the request and move it to a priority position in our development queue If you have any questions about the above support policies please do not hesitate to ask You can email carrie phunkey com How Do I Documents How do I documents are documents that the support department is constantly updating All questions that come in for support will eventually be answered through the document center How Do I Documents are written and updated daily and will be available on www ChiroMagic com The documents are another resource that can be used by the clinic to get answers to questions Attached are the documents that are currently available Check on www ChiroMagic com for updated documents Published 1 6 2009 Page 242 of 248 Reference Manual Billing Trouble Shooting Guide The entire insurance in
82. number found on your practice management system e Rejected Only To search for rejected claims only click this box Proprietary Information 13 e Rendering Provider professional claims or Attending Provider institutional claims Provider name submitted with the claim as the provider performing the service e Service Dates s On Professional Claims this is the From and To dates on the claim On Institutional Claims this is the Statement From and To dates on the claim f 7i M d ZirMed Training Account S076 karen craigmyle Log Cf 1r e Account Prof Claims Inst Claims Remis Eligibility Print Services Patient Statements Pay 4Pay Help Contact Us Customer Support Center Survey Claims Batches Mame Matching Providers Reports Enrollment Payers Coding Tools Settings Search Claims Rejected Claims Dashboard Old Claims Screen User Preferences Specify Claim Overrides Rejected Only above Displaying 1 30 of 64 Claims Claim Number Patient Name Service Trans Date Rendering Prowider Date s ZirMed Payer Charges Seq WWHITESS55555 VWHITE ANIME W 062606 National Rural Electric Coop 254 00 1 Accepted by Zirlled Edit Mote More 04 2607 Resub JOHNSON JOHN MRECA 52132 CARTERBEBGBE CARTER BRITTANY L OF 01406 Bluegrass Family Health 954 00 1 Accepted by Zirtled Edit Mote More 04 26 07 Resub JOHNSOM JOHN 61124 JACK SONFOFO JACKSON JACK W OB2606 Wels Fargo Third Party 6568 00 1 A
83. oer to a custom date by changing the dates in the boxes Ace Last 90 Days 104847 Last 1680 Days p44 Tooley Patient Name Enter a patient s name If posting an EOB for one ier eo eae patient the date criterion will apply to the patient who is being looked 8 up If no patient name is placed into the box then all patients who have charges that fall within the date frame and the carrier that was selected will appear in the grid below Month to Cate Published 1 6 2009 Page 197 of 248 Reference Manual Red Flag Functions These functions are available by clicking on the flag or hitting CTRL and 9 Find ALL carrier charges for the date range regardless of status If this box is checked it will display ALL charges for that carrier regardless of the status of FDA ALL Serer CHENES E E the charge If there is a charge that cannot be found in the original date range regardless of status search grid just check this box and the charge will be displayed e Click Run Query PA Run Query e Click the Check Mark Select Charges next to the charges that the payment will be applied Select Charges e Click select all if all of the charges in the grid should be selected Sole al Note Select the patients in the same order as the EOB This makes payment entry go faster Note From this screen click the next to any of the patients listed to see individual charges and invoices that are outstanding Also notice th
84. of the CCI Add Exception screen e Payer Name or ID A payer name or payer ID must entered as it is a required field If you Know the payer name of ID enter it in the field or if you do not you may click on the eyeglasses to activate a search to find the correct payer o Search model Name Contains e Specify Situation The add exception screen will always default to Specify Situation If you choose Specify Situation then only the claims meeting the criteria you enter here will bypass CCI edits e All Situations If you choose All Situations then the payer name becomes the only required field as this option means that all claims for the selected payer will not pass through the LCD or NCD edits e Procedure Code Enter procedure code you want to bypass LCD or NCD edits Required field e 2 Procedure Code if required Enter the second procedure code you want to bypass LCD or NCD if required e DX Code Enter the diagnosis code you want to bypass LCD or NCD edits Proprietary Information 47 e Modifier If you would like a modifier to be considered in this exception then enter the modifier in this field e Service Date From and To If you would like for your exception to be in effect for a specified time or time frame then enter the date s you would like to limit the exception to Service dates are limited to one year prior and one year past the current days date e Save You MUST click on save for your exception to be saved Editing
85. offs that have been applied to the charge n zi 10 20 2008 ice Se yy 0 AD JUSTMENT ONE TO TWO Tao Ta 10202008 PI 174 106 PAT sec o 97110 THERAPEUTIC EXERCISES Payment Method Amount Ref Mo Motes Date Applied un Pe 240 PRI 15 00 10 31 2008 03 16 PM fb 285 CK 38 00 34235235235 11411 2008 05 04 PM Published 1 6 2009 Page 100 of 248 Reference Manual Take Charge on off hold If this button is selected from the charge function menu then the charge that the user is working with be placed on or off of hold Edit Charge When the user clicks the edit charge button a charge detail screen appears From here the user can change some of the details for that charge In the top left corner all the charges that are on this invoice are displayed Remember an invoice is a collection of all the charges that were put in the CEW at the time of that visit The charge Billing Status is also located on this page for a charge This is where the user can see what primary and secondary carriers are attached to this charge and also see that last bill date of the charge The information that is being displayed in the Charge Billing Status is all detailed Be Invoice 106 for SN3 HOLLY MARTIN Sandusky9 H Save ET Save and Close Xx Cancel Patient Case Default for these Charges Charge tem CPT Code g8940 98940 ese ees ass ees Charge Billing Status On Hold fw Bill To Destination
86. on the Welcome screen or the Claims screen Expanded Rejection Analysis The Expanded Rejection Analysis report is a summary of all claims that have ever rejected regardless of their current status sorted by either the Message or by the Payer If a claim was rejected by ZirMed and you filter by Payer those claims will not display Using this report can help your practice identify and correct problem areas such as consistent data entry errors needed updates for your Practice Management System changes to ZirMed s system set up or individuals who may benefit from additional training The date range entered will select claims based on the date ZirMed first received the claims Under the Additional Criteria section you can further refine your search by entering certain keywords by specifying the minimum number of times a rejection occurred or by including excluding hidden claims Suggestion print this monthly Expanded Rejection Analysis By Message Date Range 01 01 2005 03 31 2006 Rejections Charges Rejection Message 26 10 072 00 RENDERING MAME MATCHING REGUIRED BILLING MAME MATCHING REGUIRED g 3 565 00 REFERRING MAME MATCHING REQUIRED g 3 356 00 PAYER MAME MATCHING REQUIRED RENDERING MAME MATCHING REQUIRED REFERRING MAME MATCHING REQUIRED E 3 272 00 CLAIM REJECTED BY SECOND EDITS BILLING PROVIDER ADDRESS LINE Is REQUIRED TO BE PRESENT 20104 4 N301 J BE PRESENT 201044 M402 BILLING PROVIDER ZIP IS REQ
87. on the additional gear icon in the top right hand corner will display a list of possible CPT codes for this ICD 9 code Clicking on the CPT code Proprietary Information 56 refers the user to a code specific information page contained in the CPT HCPCS database Clicking on the Knowledge Man icon in the top right hand corner will display any policies or bulletins that have been issued by the Fl Carrier set in Defaults The Subject line is a hyperlink into KnowledgeBase to research the entire document A for Anesthesia This link indicates possible surgical procedures corresponding to the anesthesia procedure and for surgical procedures requiring anesthesia the A icon indicates corresponding anesthesia procedure codes Clicking on the code refers you to the code specific information page contained in the CPT HCPCS database C PHCPCS ICD9 Crosswalk Displays CPT HCPCS and ICD9 codes that occur most often on the same claim in the CMS 2004 Standard Analytic File SAF outpatient data set The codes are listed in decreasing order of frequency PROCEDURE CODE SEARCH CPT 4 Go to Professional or Institutional Claims Coding Tools Procedure Code Search tab This is a Value Added Solution that you could choose to subscribe to For more information call us at 877 494 6633 It lists all of the Procedure Codes CPT 4 for the current and previous year You can designate which codes you would like to display by de
88. print in appointment time order However if they need to be printed in alphabetical order check the box that says Sort Alphabetically If the clinic has a large amount of appointments some staff HOTT members choose to print the Encounter Forms for the morning and then for the afternoon If this is the case check the box that says Specify a Time C specify a Time Range Range and place the From and To time in the boxes Published 1 6 2009 Page 219 of 248 Reference Manual e Click the button that says View Forms for date This will print all Encounter Forms for the date in that has been selected E3 YWiew Forms for 104 2008 Printing an Encounter Form for a Single Patient e Click on the Reports tab H Je S Reports Biling Ukilities Ca E Forms Fo Ef Report e Click on Encounter Forms Encounter Forms Fo The Encounter Forms option screen will appear B Encounter Forms xi P Close E7 Schedule g Settings Appointment Date Options I Sort Alphabetically EW october 2008 V Specify a Time Range Sun Mon Tue Wed Thu 28 29 30 From 08 30 AM To 06 00 PM 5 6 7 8 9 12 13 14 15 16 19 20 21 22 23 26 27 28 29 30 2 3 4 5 6 _ Today 10 1 2008 Specitic Patient Enter search text as Acct or LastName FirstName eN HOLLY MARTIN F gt Specific Patient All Patients Enter search text as Acct or Vv Only print encounter forms that La
89. re keying the claims Error During X12 batch processing is a file level error that prevents the file from even being uploaded A cause for this error would be a problem with the integrity of the file e g the file was missing the submitter id or data was missing that is required in the 837 Companion Guide f i d Demo Medical Practice 729 irMe Account Prof Claims nst Claims Femits Eligibility Print Services Patient Statements Pay Leads Admin OTs Help ContactUs Customer Support Center Survey Claim Batches Mame Matching Providers Reports Enrollment Payers Coding Tools settings Upload a New Claims Batch Batch Upload Status Production CT ome Search Batches Batch Mame fe Submission Date s 6 6 Months mea f 07 31 2007 Specify Batch Batchi sadnu 1 5 of 5 Batches Fage af 1 Submit Date Batch Hame Processed BatchiD Format User Submitted Processed Charges Rejected Discarded Status Or 24007 Demobatas ZirMed 22 5 004 00 0 0 Processing complete More 1654491 PRINT 1 D 0nap00r DemoDatat firkied o 22 4 173 00 B 0 Processing complete More 1654455 PRINT 1 C Oneh200 DemoDatas ZirWied m Error Duplicate batch detected More 1654457 D Batch Hidden by ZirMed Karen Craigmyle on 03 05 07 at 12 19 PM Note Clicking the Status will show you a description of the error Batch History Windows Internet Explorer Seles File Edit View Favorites Tools Help Batch
90. report displays non hidden currently rejected claims and allows you to select how you would like to have them grouped It can be accessed from links on the following screens e Account Welcome Rejected Claims Dashboard e Prof Claims Claims e Inst Claims Claims e Prof Claims Reports e Inst Claims Reports For Child Accounts When you first enter this screen the default Group By is Rejection Message and will include Name Matching Rejections This view will display your currently rejected claims sorted in descending order by the number of claims that rejected with the same rejection message You can change your primary Group By by selecting one of the following from the drop down box then clicking on the Go button e Batch Billing Provider Facility Payer Rejection Date Rejection Message Rejection Source Rendering Attending Provider For each line displayed in the lower section of the screen there will be additional links which can be used to help you work that group of claims Qty Clicking on the underlined number will take you to the Claims screen and display only that group of claims Drill Down This is a drop down box where you can select an additional breakout of that group of claims The drop down options here are the same as Proprietary Information 34 the Group By options above After selecting one of the options click on the Go link The screen will refresh and display only that group of claims broke
91. s name The patient s name is entered in first middle and last name format AddressI This is the patient s address If the patient has a suite or an apartment number enter it in the address 2 field This will properly format it for mailing labels Address 2 This 1s for the apartment or suite number Demographics First Middle Last HOLLY H MARTIN Address 1 3519 LAMP POST LANE City State Zip eee This is the city City State Zip GAINESVILLE oa 30504 state and zip for P Home Phone 6751989 5234 viork 307 275 1 022 Cell f poa the patient Enter the zip code and DOB osson 974 SSM 111 141 1111 hale Female the city and state y j Employment NONE Marital Status NONE will automatically Status populate Home Phone This is the patient s home phone number Enter the phone number for the patient including the area code with no dashes Work This is the patient s work phone number Cell This is for the patient s cell phone number DOB This is the patient s date of birth Enter the patient s date of birth with no dashes or slashes in the format of mm dd yyyy SSN This is the patient s social security number This is required for most insurance carriers to properly submit the insurance claims Remember that patients are entering into a financial agreement with you so you should make sure that you receive their credit card number Pu
92. take the average Allowed Paid and Adjustment amount for all CPT codes in the database and add them to the list Default Pay If 22 is typed into that box and the arrow is clicked the computer will automatically set 22 in the percentage column for all records displayed in the list Adding an Insurance Carrier e Click on Billing at the top of the screen Sie Billing Utilities lt a hres e Click on Carriers SIS E Billing Utilities Calculat MS Carriers Ho Published 1 6 2009 Page 171 of 248 Reference Manual e Click Add Carrier 7 m Pree Cet r rere eer rrr eer err eerie eer de add Carrier x C e Check the Active Box e Enter a code for the carrier Make this part of the name for the carrier The code cannot exceed six characters e Enter the name and address information for the carrier This 1s the address where the claim will be mailed If you do not know the address contact the carrier e Select the Carrier Type from the drop down e Select the Billing Type from the drop down HCFA Paper Claim EDI Electronic Claim STMT Patient Statement e Select the Fee Schedule for the insurance carrier from the drop down e Enter the payer id for the carrier If Payer ID number is unknown then check the patient s ID card or reference www zirmed com gt Active Code Company Address Address2 City State Zip Phone Fax Contact CarrierType Pri Bill Type
93. the default service type for the case You must use the drop down to select the service type for the case that you are creating Service Type Chiropractic Code This is the Default Case Type Description NEW CASE TY FPE Auto create this case type for new patients Fee Schedule Financial Class Billing Type Facility Referring Provider Biling Rendering Provider Treating Provider Signature Source Accident Type Mature of Condition MoT SET Employment Related Box1da Has Legal Representative Code This is a short descriptor for a case type The following defaults have been provided CHIRO PI WC and WL Additional case types might be ACU for Acupuncture and SD for Spinal Decompression Description The default description for the case type Personal Injury could be an example of a description for a case type Published 1 6 2009 Page 28 of 248 Reference Manual Fee Schedule This is the default fee schedule for the case type If there is a PI fee schedule assign that to the Personal Injury case type Billing Type This is the most critical part of the case type What is the default Billing Type This is where you tell the system how the claims for this case are going to be created Electronic Claim is for ZirMed HCFA is for claims that need to be printed on CMS 1500 08 05 forms Workers Comp is for specialty workers compensation forms like those in N
94. the referral source then they do not know what marketing plans are working Last Patient Payment the last time a patient payment was entered Secondary Insurance The patient s secondary insurance information Patient Diagnosis Codes The diagnosis codes for the case Past Visits What was billed for the patient on their last three visits into the office CB Current Balance CURPTB Current Patient Balance YTDVISIT Total visits year to date YTDCH Total charges year to date YTDDED Total Deductible year to date CREDBAL Credit Balance Money that has not been applied to services Published 1 6 2009 Page 215 of 248 Reference Manual e YTDPATP Patient Payments year to date e YTDPRIP Year to date Primary Payments e YITDOTHP Year to date other payments e Today s Payment Payment that the patient made today e Special Instructions Any special instructions that you have entered for the patient e Patient Memo Any patient Memos that you have entered for the patient e Signature Line Place for the patient and the provider to sign if needed Below is a copy of an Encounter form Remember that Encounter Forms should be printed the day before the appointment Print all of the Encounter Forms for a day at one time The front desk should spend 10 minutes with a highlighter highlighting the things that everyone should pay attention to Some clinics use different color highlighters
95. to void charge XYZ AN 4re you certain you want to void Charge 204 e Click Yes e The computer will then display a message that says What is the reason for voiding this charge A reason has to be supplied Type in the reason and hit enter or click ok x What is the reason for voiding this charge Entered on incorrect account E creat The charge has now been voided and will be listed under the voided charges tab Published 1 6 2009 Page 105 of 248 Reference Manual Refund This function allows the user to refund the payment that is attached to the charge that is being worked with To refund follow the instructions below e Click Refund from the blue flag function menu Charge Functions for Charge 711 e Place Charge on Hold Create Claim Edit Charge ei Unapply Patient Payments e Type in the amount of the refund Sey x HOLLY MARTIN e Type in the method Amount e Type in the reason A reason MUST be poe supplied aaa e Click Apply X Cancel Ti Apply Go to Carrier This function will take the user directly to the insurance carrier for the patient that is being worked on Ifthe user needs to confirm an insurance carrier setting this is a very useful feature View in Carrier Ledger This function will take the user to the charge that is being worked with inside the insurance carrier ledger Enter Memo This function allows the user to type in a memo about the charge that is
96. will be billed to paper HCFA 1500 form Electronic Claim Means that all charges that are associated with this case will be billed electronically through ZirMed Patient Statement Means that all charges entered for this case will be billed on a patient statement New York Work Comp Special State WC form like NY Means that all charges for that patient will be billed on the special NY WC form Remember that the system is intelligent so the options that have been selected tell the system where to bill the charges Fee Schedule This is the fee schedule for the case This information is defaulted by the Case Type Setup If there is a WC fee schedule and a WC case the fee schedule should read WC Referring Provider This is the referring physician This will typically be a referring physician from an outside party Billing Rendering Provider This is the doctor who the charges will be attached to for billing purposes This is the doctor who has to sign the HCFA form Treating Provider This is the doctor who treated the patient That is used for production reports only and is not necessary for billing Facility This is the facility where the services were rendered This is the information that prints in Box 32 of the HCFA form Guarantor This is the name of the person who is responsible for the balance on the account if the patient is not responsible for themselves If there is a child who is under the age of 18
97. will then ask Are you certain you want to void payment XYZ from all charges Published 1 6 2009 Page 112 of 248 Reference Manual Yoid Payment AN Are you certain vou wank to void Payment 234 e Click yes Type in a reason a reason MUST be supplied What is the reason for voiding this payment Applied to wrong DOS F cancel e Click OK Published 1 6 2009 Page 113 of 248 Reference Manual How Do I edit a payment e Click Edit Payment from the green function flag Payment Functions Edit Payment Ei Unappl Payment 2e Void Payment Note Remember the only things that can be edited on a payment record are the payment date and the method The Ref No can also be updated Payments CANNOT be deleted Edit Payment 225 for SN3 HOLLY MARTIN 4 Save E Save and Close F Cancel als Es e Change the payment date e Change the Method Payment Date 1029 2008 ac e Type in a Ref No or edit the Ref No Method ec Amount 10 00 Applied 10 00 Remaining 0 00 Note The co pay note button if pushed will SS automatically place in the Note of Co pay and the date that you click the button Also notice on the bottom Me K ae how there is the note of who created the payment and gt Mot the date and time of the payment PN e Click Save or Save and Close Created by traing on 10 29 2008 fa 10 30 4M Published 1 6 2009 Page
98. www medicare bcbosmt com Regence BCBS of UT Utah Eff 12 01 2005 Intermediary changes to Noridian http Awww ut regence com physician Noridian Alaska American Samoa Arizona Colorado Guam Hawaii lowa Nevada North Dakota North Marianna Islands Oregon South Dakota Washington Wyoming http www noridianmedicare com National Heritage California Maine Massachusetts New Hampshire Vermont http www medicarenhic com Proprietary Information 74 First Coast Service Connecticut http www connecticutmedicare com Trailblazer Health Delaware District of Columbia Maryland Texas Virginia http www the medicare com Trailblazer Health Florida http www floridamedicare com Cahaba Georgia http Awww gamedicare com Mississippi htto www msmedicare com Cigna Idaho North Carolina Tennessee http www cignamedicare com Wisconsin Physician Services Illinois Michigan Minnesota Wisconsin http Awww wpsic com index shtml AdminaStar Indiana Kentucky http www adminastar com Empire New Jersey New York http Awww empiremedicare com All payer websites are subject to change Proprietary Information GHI Queens County Jurisdiction New York http Awww ghimedicare com Health Now Upstate NY only New York http www umd nycpic com HGS Administrators Pennsylvania http Awww hgsa com index shtml Triple S Puerto Ric
99. your A R be About three times monthly bank collections in a balanced office What is a balanced office A mix of Wellness PI WC Insurance and Cash too much imbalance creates too much A R What are the PROPER Collections Total Billing less YTD Adjustment to Gross found on the EZ Report Example You bill on average 80 000 a month with a YTD Adjustment to Gross of 40 That means on an average month you should be collecting around 48 000 80 000 80 000 40 That means that you should have an A R of no more than 150 000 in a balanced practice to feed 48 000 in collections Understanding Credits and Collections A Credit is when the patient pre pays for co pays or services For example the patient is coming in for the next two weeks five times a week and has a 40 co pay They pay the 400 up front so that they do not have to worry about it The 400 gets deposited that day and the patient has a CREDIT on the account The 400 goes into the BANK Collections total Bank Collections means WHAT WENT INTO THE BANK So all cash received that day insurance checks credit cards and pre payments all go into the bank That is Bank Collections Applied from Credit means that the services were USED that day but rather than paying cash services were applied from the Credit Balance That is Total Collections the total amount received that day NOT INCLUDING PREPAYMENTS and INCLUDING Applied from Credit If everythin
100. 0 2 p Account Number SN3 This is the patient s account number Name Holly Martin This is the patient s name Current Case This is the case that the charges will be applied to for the patient The default case is the case that will be displayed and can be changed by if necessary by selecting another case from the drop down Patient Balance This is the patient balance this does not include the charges that are pending payment from insurance Total Balance This 1s the total balance for the patient which is inclusive of insurance and patient balances Avail Credit This 1s available credit for the patient Pri Carrier This is the primary insurance carrier for the patient Pri Copay This is the primary Copay for the patient This is the number of future appointments the patient has scheduled L _ This is an identifier to let you know that the patient has a note that is marked as a pop up for the CEW if the mouse is dragged over the note the text for the note will appear Published 1 6 2009 Page 144 of 248 Reference Manual Authorizations The Authorization section allows you to define how many visits a patient is allowed in a specific time period or to denote how many total visits a patient is allowed to receive This feature 1s retroactive so if you set up the authorizations after charges have already been entered the system will then display the available authorizations based upon the infor
101. 008 10 49 AM Status changed from Pending to Signed In Provider Change the provider who is attached to the appointment Visit Type Change the visit type Date Change the date of the appointment Start Time Minutes Change the minutes on an appointment Note Make a note for the appointment Remember if you entered a new patient and entered a note then it will automatically appear here Log This 1s a log of all of the activity on this appointment Status Change the status of the appointment Once you have made the change to the appointment click the Save and Close button at the top of the screen If the patient has a note on the appointment the sticky note will appear meaning that there is a note attached to the appointment T scheduled appointments 6 patients v 0 ossoam Teewer crac ig snocoos_ yh Click on the sticky note and the note will appear on the screen Published 1 6 2009 Page 135 of 248 Reference Manual 1023 2007 demohs Likes massage before adjustment The Magic Wand is here so you can schedule future appointments enter charges or perform any function that needs to be performed by clicking on the Magic Wand Scheduling an Appointment for a Patient e Open the Account Assistant e Enter the patient s name martin holly in the patient search at the top of the screen and click enter e The Patient Functions box will appear e Click Schedule Appts e Enter the criteria that yo
102. 009 Page 198 of 248 Reference Manual Ctrl 3 Auto populate amounts from Carrier EOB Settings If you zeroed out all defaults this will repopulate just that visit or charge Ctrl 4 Auto distribute Enter paid allowed adjusted and it will AUTOMATICALLY calculate the rest DO NOT USE if you care about accuracy Ctrl 5 Remove Visit Remove the visit or charge from the selected charges Ctrl 6 Adjustment Note Add a note of why something was not paid Ctrl 7 Enter Memo Add a Claim Charge note that will be viewable in View History Ctrl 8 Resubmit this charge Allows you to put in a reason reset bill to back to Primary for example reset Hold and the big change Change BILLING METHOD for example can set secondary to paper Blue Flag Functions These functions are available by clicking the blue flag Ctrl 1 Zero out defaults If auto default populate was on will zero out Ctrl 2 Copy Previous from same CPT codes Takes the previous allowed paid adjusted Ctrl 3 Auto populate amounts from Carrier EOB Settings If you zeroed out all defaults this will repopulate just that visit or charge Ctrl 4 Auto distribute Put in paid allowed adjusted and it will AUTOMATICALLY calculate the rest DO NOT USE if you care about accuracy Ctrl 5 Remove Visit Remove the visit or charge from the selected charges Ctrl 6 Adjustment Note Add a note of why something was not paid
103. 012 MECHANICAL TRACTION 42 00 000 0 00 1 1 207 120 PI 10 29 2008 98940 ADJUSTMENT ONE TO TWO 45 00 0 00 0 00 charge in the grid E 208 120 PI 10 29 2008 97140 MANUAL THERAPY TECHNIQ 54 00 oo f 0 00 Note Once the Select button has been checked the apply payment button will automatically appear Once you have checked select in the box the balance on the charge will automatically become zero The computer will automatically post whatever amount is left in the credit and pay off the balance If the user does NOT want the full balance to be paid in full the user can then click the apply payment button and change the amount of the payment Charges oo gomil moes ose ae tn een Taare Sa 122 10802008 98940 ADJUSTMENT _ 122 10 30 2008 97140 MANUAL THERAPY TEGANE Sano o 00 en 261 147 Pho 1441 2008 97140 MANUAL THERAPY TECHNIG 54 00 o oo f rc 262 148 Pl 1112003 98943 EXTRASPIMAL 45 00 0 00 e Click Apply C Credit at the top of the screen q ppiying Credit from Payment 60 for SN3 HOLLY MARTIN Sand N Apply Credit X Cancel Credit Application HOLLY MARTIN Once the credit has been applied the charge will then be highlighted in the list in yellow and it denotes that the credit was just applied to that charge Published 1 6 2009 Page 110 of 248 Reference Manual e Click the Apply Payment button yE Patient Payment for SMS H0OLLY MARTIN BT Clo E B 4oply Payment Patient SM3 HOLLY MARTIN Patient
104. 1 Published 1 6 2009 Page 98 of 248 Reference Manual Charge Function Icon The power of the charges tab is in the Charge Function icon Like the Magic Wand the Charge Function icon will show only those processes that are available to that charge at that moment The charge functions that are available for the charge that is being displayed are based on the charge that is being viewed For example when viewing a charge that has been billed and paid by an insurance carrier will have different options available then a charge that has not been billed to a carrier Here are the options that are available for a charge that has not yet been billed to a primary carrier Place Charge on Hold This allows the user to put the charge Charge Functions for Charge 301 on hold Place Charge on Hold Create Claim Allows the user to create a claim for one eden charge Edit Charge E Enter Patient Adjustment Wite Off Balance x Void ap Goto camer KAISER ape View in Carer Ledger Enter Memo GP View History Edit Charge Allows the user to edit the details of the charge Enter Patient Adjustment This allows the user to enter a patient adjustment Write Off Balance This allows the user to write off the balance Void Allows the user to void the charge Go to carrier This will take the user to the insurance carrier for the patient View in Carrier Ledger This allows the user to view the charge in the
105. 11 Click the Save amp Resubmit button in the upper left corner Proprietary Information 67 READING AN EXPLANATION OF BENEFITS EOB An EOB explains how the payer adjudicated a claim This communication can also be called a Remittance Advice or RA Generally an EOB will communicate the following information Member name Member number for Medicare the number is called a HIC Account number this is the provider s account number for the member Document control number DCN may also be called ICN for Internal Control Number Provider s name and number Place of service Procedure codes Modifiers Billed amount The amount the provider billed for the services Allowed Amount This is the max payable for a procedure per the payers fee schedule Deductible The dollar amount applied to the members deductible Coinsurance The dollar amount applied to coinsurance provisions COB The amount the primary paid for a service line Withhold amount The amount the payer withholds when there is a risk sharing arrangement Payment The amount paid per service line Remark adjustment reject codes The codes assigned to service line items that communicate information on why the service line was adjudicated the way it was Most Payers will also have a section at the end of an EOB that totals the entire EOB Generally this section will be the last page of the EOB but it may appear on each individual page
106. 11 00 AM 1001 2008 01 45PM STAFF 10 01 2008 02 00 PM STAFF visit Type 30 MINUTE MASSAGE SN3 SNOOO0S H510200 SN SNOO002 SNOO008 SNOOO03 SN4 SNOO001 SNOOOo0 Acct HS10201 SNOO002 SNOO008 SNOOO03 3 items Last Name First Name er MARTIN HOLLY Signed In ADAMS WILLIAM Cancelled yr NOBLE ANTOINETTE Rescheduled pr WILLIAMS JORDAN Pending yr LOVE AMBER No Show DICKSON GREG Pending e SCHLOTMAN EUGENIA Pending e MARTIN LILY Pending e CALLAHAN TOMMY Pending J PALERMO MICHAEL Pending Last Name Signed In Last Name First Name e LOVE No Show DICKSON GREG Pending J SCHLOTMAN EUGENIA Pending 10 01 2008 10 00 AM STAFF 10 01 2008 02 30 PM STAFF O01 2008 03 30 Phi i Page 237 of 248 SNOO001 NOooo Fe MARTIN HOLLY e CALLAHAN TOMMY SALERNO MICAS Signed In Pending Pending Reference Manual Tax Report The tax report is a report that can be generated to tell the facility how much money has been collected in tax for a specific time period If Sales and Use tax is paid quarterly this report can be generated for the quarter for which sales tax is due To generate a tax report follow the instructions below e Click Reports Click Tax Report Tax Report The Tax Report Options screen will be displayed tal Tax Report Report Options Sil x ay Close o gt Ruin Report E Clear Criteria Last Payment Date
107. 2 secondary link Whether you can send the Secondary claim information in your inbound claim files will depend on which format you use to send your primary claims The 2 format types are listed below e NSF As a NSF submitter you may send secondary claims in a NSF file In the NSF format the two most important records are the DAO and DA1 records e X12 As an X12 submitter you would send your claims in an ANSI 837 X12 format the important loops for filing a Secondary claim are the 2320 and 2330 loops You can also use the 2 link on our web site to enter the COB information and submit the secondary claim 2 Start slowly Get to know which payers will accept secondary claims electronically Do not be surprised if your first claim rejects Just like primary claims secondary claims are subject to each payer s unique billing requirements Learn the data elements required by each payer This will increase your claims accuracy and minimize payer rejections 3 Just know it will get easier each time you send one Proprietary Information 61 Steps To Send a Secondary Claim Using the 2 Link Go to Professional Claims Claims screen STEP 1 Locate the original primary claim submitted on the Claims screen STEP 2 Click on the 2 link for the primary claim The 2 link is located under More in the Action column on the claim screen The Claim Editor screen will display in a new window f Z d Demo Medical P
108. 23 MAIN STREET Statement of Account ois LOM 200s SANDUSEY OH 44870 Al 222 3211 Mail To Patient Insured HOLLY H NARTIM HOLLY H MARTIN HOLLY WARTIH 3519 LAMP POST LANE 3519 LAMP POST LANE 3519 LAMP POST LAHE GAINESVILLE GA 30504 GAINESVILLE GA 30504 GAINESVILLE GA 30504 Primary Insurance KAISER PERMANENTE d Croup HONE HIC Available Crett for ihi account 53300 Date of Serie Billed Paidby Insurance Deducible PatientPayment Adjusimen Balance Due by Pat 0924 2 389 00 0 00 0 00 9 OM 0 00 320 00 i 73050 GO 00 LEO DOOR TIO ME PPS OR MORE TR AF Oia OES i Falz 223 00 CBRPTRAL COMPLETE STOO Totak Billed Paidhy Insurance Deducthe PatentRaymen Adjyusimenk Avail Credit Total Due by Pat LO 2008 389 00 0 00 0 00 ca OO 0 00 533 00 153003 Jdunfornanon has changed please indicate changes below MASTERCARD WISA DISCOVER mont to Par TC Expiration Date Sigtiahire Name as appears oncarl Current Due 41 to 60 ol to 90 Over 90 Days Avail Credit Total Due 360 00 0 00 0 00 0 00 233 00 153 00 HOLLY H MAETI ih ENG punt Remitted 678 989 5731 NEVER PRINT STATEMENTS FROM INSIDE OF THE AA ALWAYS EMAIL THEM AND THEN PRINT FROM EMAIL Published 1 6 2009 Page 188 of 248 Reference Manual Location Ledger Using and Understanding the Location Ledger This location ledger is just like the patient ledger It displays all of the same tabs Charges Checks Balance Totals and Aging Voided Charge
109. 248 Reference Manual e s Providers Understanding and Setting up a Provider sssssssssseeccccssssceccccososssscccecosssssscecocsssssseeocsssssseo 38 Seine up a Provide eisiea E aar E eiii 39 Payment Methods Understanding and Setting up Payment Methods sscccccssssssssssssccccsesseeeees 41 Setting 1p anew Payment Methodes ue aa a NE e E NEE 43 Patient Statuses Understanding and Setting up New Patient Statuses ssssescecccssssscececccsssssececosssssso 45 AE Ee AIDU a i EET E E T E I E T TN S S 47 Understanding and Adding Referral Source Groups and Referral Sources essnessssssssssseeeeeresssssssssssssssssseerreeessse 47 Relerral SOUT COIS serch cece cinerea E ONAE A EEEE EA EEEE OEE EAA EA Aae 47 Adding a Referral Source Group ccccccccccccsssssssssssseeeeeeccccceeeesnaaaeesssssseeeeeeecceeeeeessessuaaeesasssseseeeceeeesssauaggasssseseeeeeeeess 47 Adding a IS TCH al SoU Gerssen A O EE EEE OEE EAA EAE EENE 48 Adding a Referral Source through system setup ccccccccccccccccesessssseseeeeececeeeeeeesaaaaeeesssesseeeeeeeeeeeeeeessaasaaesseeeeeeeeees 49 Adding a new Referral Source through the New Patient Entry screen neeeseeesssssssseeeerererssssssssssssssssseeeesssssse 50 Updating a Patient Record with a Referral SOULCE cc ccccccsssssseseeeeeeeeeeeeeeeeeeaaaaeeeeensseeeeeeeeeeeeeeeessaaaasssseseeeeeeeess 52 Markenno AU CC OUI EG assenso nas aE EATE EEE EA EEE E A 53 Pro
110. 25456789 FOR CUSTOMER 5076 Total Claims 3 Total Charges 1 293 00 Discarded Claims Since ZirMed only notates that a claim was matched to Discard Claims and does not keep the claim this report will display information on those claims lf a claim was matched to Discard Claims in error you will need to e Un Match the Payer in Name Matching Show Matched Names e Regenerate the claim from your Practice Management System e The claim will now reject for Name Matching e Match the rejected claim to the correct payer e Resubmit the claim IMPORTANT IF YOU MATCH A PAYER TO DISCARD CLAIMS YOU WILL NEVER SEE THOSE CLAIMS IN ZIRMED Claims Matched to Trash Date Range 04 01 2005 04 30 2006 Patient Name Amount Batch Hame Pat Number Date of Service Date Time Sent BLUEGRASS FAMILY HLTH FAST FRED W fz34 00 1 25 05 EFEARMNHAROTSS8 0622003 0420 2005 03 35 00 Ph CHA HEALTH HEART HALE F254 00 1146 04 ESRNASRDOTSSS OBE A005 O4 20 2005 03 55 29 Ph Proprietary Information 37 Claims Summary This report will give you a current snap shot in a summary format of all claims submitted to ZirMed for a given date range From the drop down box you can choose the sequence of the report by selecting Batch ID Date or Payer After specifying the Date Range click on Submit and the report will appear in a new window In addition to showing the total number and amount of claims this report also shows the number and amount
111. 4 YTE H 12 Mio Total 12 Mio Sy A Day Day Calculation total for the date for which you are running the report WTD Week to Date Calculation total for the Week MTD Month to Date Calculation for the Month YTD Year to Date Calculation for the Year 12 Mo Tot 12 Month Total Calculation from this date to 12 months prior So if you are running the report from 08 01 2008 then the 12 Mo TOT will go back to 08 01 2007 12 Mo Av 12 Month Average Average calculations for the last 12 months The report is always run for a day and then calculates the Day Week to Date WTD and Month to Date MTD as of that day For end of week statistics run the report for the last day of the week 1 e Friday or Saturday Published 1 6 2009 Page 223 of 248 Reference Manual Show previous 12 months You have the ability to see the previous 12 months for trending purposes This allows you to see every calculation broken down This is especially useful in the spreadsheet format to graph or use red and green background fills to indicate good or bad trending You have the ability to Email the Snapshot report in a spreadsheet or print it Email Spreadsheet This will send the entire spreadsheet including the previous 12 months to your email address that you entered into system settings This spreadsheet is in Excel format and allows you to analyze all information and perform additional calculations inside of the sprea
112. 5 Carrier Payments Understanding and Entering Carrier Payments cccooososssssscececcccececcesocsosssssoe 195 Pnterine a Carrier PaymieNi aiseee meenen een seb veiwxesnensdaavelyensveuwaundsdvocsswainsnesenenedatieosventsanseeidseauer ESNE ei ean Eii 196 RIT Me Mea E E ees E E E E E E O E 201 Uoan phbed C PEC ESE E E AEE E E E 202 Clearing House Balancing ZirMed sssssesessssssseseeeosssseseeeecccssssseeeeccccssseeeeeccccssseeeeeccccosseeeeeeeesessees 203 A conns PECADO ei E EEEE EEE EEE E E 205 Understanding What A R and Collections Should Be essccssssseeececccsssssccecocsssssececoossssseccesossssseccecosssss 205 Understanding Credits and Collections siciscssceccstescsssesescesissessasisceecusectesssnseiessastarsvanstecccausseceusseseteceestavers 205 There are Three Parts to Accounts Receivable cccccceeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeseeaaaaeaaagaaaaagaaaaagagaaagagags 206 Preventing Procedural Problem A R ccccccsssssssssssseeeeccccccececeeaaaeesssssseeeeeecceeeseessaeaeeessssseeeeeeeeeeeeeeeeeeeeuaaaggeggssses 206 D e aE CS e E E E E E lei E TE E E TEE E E A E A 208 The Mandatory Daily Items to keep your office running eeeesessssssssssseeereressssssssssssserererrrresssssssssssssseeeeereeeo 208 The Weekly Items to keep your office running 0000sosoooooeeeeeesssssssssssssseeereressssssssssssseetreererreressssssssssssssseeeeereeeo 208 The Monthly Items to keep your offic
113. 6 Help Settings Provider XYZ MEDICAL PA CLICK M overrides On Charges 218 00 My Claim ID 0947 29 00 firMed Claim ID 6205 ef Instance ID 76173821 Editing insurance sequence 2 Secondary Add another insurance sequence Inzurance view Enter Information about the a Payer f Org Individual Subscriber s Sex Male 3 w A Service Limes wiew Payers Hame ID and Address Subscriber s Hame a First Middle Suffix amp Address Subscriber s middle name Patient Relationship To Insured J Unknown 21 wt Benefits authorized to be assigned to provider 10 Yes Insured or authorized person authorizes benefits to be assigned to the provider wt Patient Subscriber Signature Authorization 4 Signed HEFA 1500 form block 12 and 13 on file ha Patient Subscriber Release of Information 12 ves Provider has a Signed Staternent Permitting Release of Medical Billing Data Related to a Claim V Provider numbers for this destination insurance sequence Billing Provider YZ MEDICAL PA SB Provider Number 111111111 Other Billing Provider Numbers Select a type and enter the provider ID for each Up to eight can be entered wt Rendering Provider DR DOCTOR ME Provider Number 222222222 Other Rendering Provider Numbers Select a type and enter the provider ID for each Up to five can be entered Screen Print for STEP 3 Proprietary Information 63 Now you are ready to enter the Primary Payer s COB Information ST
114. 8 00 FRANCIS FRANCES F O300205 Medicare B Kentucky 435 00 1 Received by Payer O225 07 DOCTORIMS Adiminastar SME YO 0947 29 00 FRANCIS FRANCIS F 02205 Humana and subsidiaries 215 00 1 Received by Payer O225 07 DOCTORDR claims 61107 Check All Clear All T EE ton Selected Claims More Actions Fage Certain data for this new screen format iS only accurate since August 1 2006 includes Date of Service Range Sequence Source and Transaction Date Proprietary Information 62 STEP 3 Click on 2 Payer at the top of the screen to highlight the secondary payer name Enter or verify the following Secondary Payer information required for the secondary claim 1 Payer s Name This is the name of the secondary payer 2 Payer ID This is the ID number of the secondary payer If you are unsure of the payer s ID click on the eyeglasses to search for it Subscriber s Sex Subscriber s Name If same as insured it must be entered exactly as the insured name is entered Subscriber Address Member ID Birth Date Policy Type if Medicare is the secondary payer Patient Relationship to Insured 10 Benefits authorized to be assigned to provider 11 Patient Subscriber Signature Authorization 12 Patient Subscriber Release of Information 13 Billing Provider Number mn COON DE Claim Editor Patient FRANCIS F FRANCIS Rejection Message Time amp Date Payer MEDICARE SMKY0O Sorry no history exists for claim 68692387
115. 8 of 248 Reference Manual e Apply Credit If there is credit available on the payment then the credit can be applied to a charge from the green function flag Payment Functions e Refund Credit If the patient needs a refund for an overpayment then the t Apply Credit user can go to the refund credit and quickly distribute the money back to the Refund Credit patient amp Edit Payment Pi Unapply Payment e Edit Payment This allows the user to change some information on the Y Void Payment payment that was entered originally into the system Fields in yellow cannot be edited and the fields in white can be edited e Unapply Payment This function allows the user to unapply the payment if it was applied to the incorrect DOS Once the payment is unapplied the user can then attach the payment to the correct DOS e Void Payment This allows the user to void a payment that has been entered into the system Payments CANNOT be deleted They have to be voided You DO NOT have the ability to see payments for a particular case because payments can be divided between cases Payments are applied to charges regardless of the case On the grid payment lines you have the payment Number Date of Payment Method Amount what has been applied Available credit the reference number for the payment notes on the payment and the payment entry date If the applied amount is not 100 then the Avail Credit field will be denoting tha
116. A aA that particular primary carrier SEC Carrier This allows the Account Ledger to be generated for a specific secondary carrier for one patient or all patients that have that particular secondary carrier Guarantor This allows the Account Ledger to be generated for one guarantor Case Type This allows the account ledger to be generated for a specific case type Account Ledger In Motion Chiropractic 123 Main Street Account Date Range Sandusky OH 44870 SN3 10 22 2007 9 24 2008 419 222 3211 HOLLY H MARTIN 3519 LAMP POST LANE GAINESVILLE GA 30504 Date of Service Qty CPT Code Description Unit Amount Total 10 22 2007 1 98941 ADJUSTMENT THREE TO FOUR 25 00 25 00 REGIONS 10 22 2007 1 97014 ELECTRICAL MUSCLE STIM 10 00 10 00 UNATTENDED 10 22 2007 1 98941 ADJUSTMENT THREE TO FOUR 25 00 25 00 REGIONS 10 22 2007 1 97014 ELECTRICAL MUSCLE STIM 10 00 10 00 UNATTENDED 09 10 2008 1 THERAPY BALL 20 00 21 05 09 12 2008 1 98940 ADJUSTMENT ONE TO TWO 55 00 55 00 REGIONS 09 12 2008 1 98940 ADJUSTMENT ONE TO TWO 55 00 55 00 REGIONS 09 15 2008 1 98940 ADJUSTMENT ONE TO TWO 55 00 55 00 REGIONS 09 17 2008 1 98940 ADJUSTMENT ONE TO TWO 55 00 55 00 REGIONS 09 24 2008 1 98940 ADJUSTMENT ONE TO TWO 45 00 45 00 REGIONS 09 24 2008 1 98940 ADJUSTMENT ONE TO TWO 45 00 45 00 REGIONS 09 24 2008 4 97110 THERAPEUTIC EXERCISES 53 00 212 00 09 24 2008 4 97140 MANUAL THERAPY TECHNIQUES 54 00 216 00 09 24 2008 1 73030 SHOULDER
117. B Charge Entry for 83 HOLLY MARTIN Sandusky PERSONAL INJURY Patient Mame HOLLY MARTIN Account SNS Patient Info Diag Codes Diag Codes Charges HE Date of Service 10 06 2008 v Add A cdt PP GB Cinview B Modview SY ie Case Refer Rend Trest Units tem Description Unit Amt SubTotal Tax Total Moat gt 7M ao o Modity Transaction E EE SESS ASS aS Bill to tem 96941 O MELE E aaf EE s Insurance Units 1 6500 Modifiers O n ai rT E E af f oo J Employment E E S i Treating Pray HOLL H MARTIN pLocal Use Box 19 Related Sublux Last 4ra af Referring Prov HOLLY H MARTIN A j 3 Delete Case Pl Detaut nd 2e T H se gt Pest At the top of the screen the Patient name and Account number are displayed This information will always be displayed so you knows which patient they are entering the information for Chronic X Cancel Published 1 6 2009 Page 147 of 248 Reference Manual The Patient Info button at the top of the screen allows you to access the details of the patient s account giving them the ability to edit the insurance case and other patient information Patient Info The Diag Codes button allows you to go in and edit the diagnosis codes for the See aah patient whenever they need to Notice how the screen is broken down into sections There is the Diag Codes section the charges section the Modify Charges section the Modifiers s
118. Charges Claims and History each tab represents a different step in the billing process First the charges are approved Once approved the claims are created then the file must be transmitted and the claims are then moved to the history tab fe Charges ta Claims Ea History Anplical Published 1 6 2009 Page 177 of 248 Reference Manual Charges Tab It is important to understand what the column headers mean on the charges tab in the billing module Bulk Billing Close ml Refresh x Check Deficiencies Fi sree ae erT E m D fon YHE Entity This is the entity that the charges are attached to If the clinic has multiple entities set up then the entity will be different for the charges that are being billed Type This is the billing type for the charges HCFA or EDI EDI Type This is the type of EDI setup that will be used for the charges that are being billed If the clinic bills to CNC then an EDI Type will be set up for CNC claims and all carriers that will be billed to CNC will have the EDI Type of CNC Description This denotes HCFA 1500 Form or Electronic Claim Charge Count Total charges that are being billed Total Total dollar amount of the charges that are in the file If there are only EDI claims to bill those are the only charges that would be visible in the list In this example there is one charge to generate for HCFA claims and two charges for EDI generation Notice the green a
119. Charges on Ledger List of charges that have been voided for the carrier that is displayed Voided Checks on Ledger List of payments that have been voided for the carrier that is displayed Claims tab on Ledger List of claims that have been billed for the carrier that is displayed Totals at Bottom of Screen At the bottom of the screen you will always see the totals for that screen In the case of the Checks screen you will see the total Paid Applied Adjusted and Total Credit Total Paid 18448 47 Total Applied 18445 47 Total Adj 29574 75 Total Credit 0 00 Published 1 6 2009 Page 168 of 248 Reference Manual ID NO Setup Tab This is the tab where all of the ID numbers are set up for electronic billing A Phunkey representative assists in the setup of the ID numbers Please do NOT go into this screen and make changes gt Insurance Carriers MEDICARE 2ND Save a Save and Close LO Master Carriers Apply this Setup to All Medicare Carriers eeeessescesseescessossesecesoessseosessesocesseeseesossoesseeg E Referring Provider Primary ID No box 17b Rendering Provider Primary ID No box 24j PROVIDER UPIN NUMBER NPI NATIONAL PROVIDER IDENTIFIER Referring Provider Secondary ID Nos EDI Rendering Provider Secondary ID Nos EDI db Add Secondary ID dp Add Secondary ID Xo 2 El EMPLOYER S IDENTIFICATION NUMBER dE 1C MEDICARE PROVIDER NUMBER R
120. Credits 1252 00 300 00 952 00 Applied PaymentDate Tendered Applied Adjustments Applied Prev Credits Applied 20 00 094 7 2008 CA rs000 foo oo 20 o co 300 00 Adjustment Apply to Today Apply To Mewe Credit 0 00 300 00 0 00 amoure 10 00 Apply Urapply Tend Method CA Change Due ionos Total Applied 0 00 Unapply ll Payment Date 1006 2008 Ret Mo Motes Copay Mote Recommended Payment This field will auto populate with a dollar amount based upon the charges that have been entered into the database and the patients co pay For example e A patient is being billed for a 98941 and a 99201 totaling 72 the patient also purchased a PROTEO PLUS Soup for 15 e The 72 is billable to insurance and the PROTEO is billed to the patient e The patient has a 25 co pay The recommended payment will default to 40 25 for the co pay and 15 for the soup If there is tax on the PROTEO then you would see 40 plus tax This makes it very quick and easy to calculate what the amount due 1s Note Any item NOT billed to insurance will be ASSUMED to need payment today Published 1 6 2009 Page 155 of 248 Reference Manual All items are marked as billable to insurance when setting them up through the services and products module Today s Charges Total charges for today Total Applied This is the recommended payment for today Today s Balance This is the total charges for today m
121. Date s ZirMed Payer Charges Seq WWHITESS55555 WHITE AMME W OB2606 Mational Rural Electric Coop 2354 00 1 Accepted by Zirtied Edit Mote More O4 260F Resub JOHNSON JOHN MRECA 52152 Specify claim This allows the user to search for a specific claim by entering either of the following e Instance ID A tracking number ZirMed has assigned to the claim each time it is processed It can be found on the claim s Status History screen and is unique for each claim Enter an Instance ID and click Go and it will go to that specific claim Then click Go e Claim Prefix The six digit number ZirMed assigns to each claim for tracking purposes with Intermediaries and payers Enter the Claim Prefix and click Go It willgo to that specific claim Rejected Claims Dashboard at the top of screen This is a link to the Rejected Claims Dashboard Report see Reports section This is where you will see the rejection messages for your currently rejected claims Old Claims Screen at the top of screen For a limited time ZirMed users can switch their display back to the one line format The ZirMed development team updates our site approximately 4 times per year with enhancements that come from our users Click the link at the bottom of the claims screen to provide feedback to both the claims and batches screens User Preferences at the top of screen Users can set and save their preferences for the claims and edit screens User Preferences S
122. E Al l CEW FF New Pat F4 RE Patient Search e Enter all of the information New Patient xX Case Type Chiropractic Address 1 PO Address 2 PO cy stez O TA Phone a Phone Type Home emf i ss Cis popf tt Gender OMale Female Referral Source P Note Referring o Patient P Employment Employed Status Marital Status Married EJ cancel Save and Schedule Save and Edit Days Out to Search Include Linked E Appointment Days Available M to M Tu M weM Th M Fr T Sa Today Tomorrow 30 starting 10 02 2008 Show first available E appt each hour Pp Search ives ror oe f Tine x Selected Appointments Schedule These Appointments e Click Save and Schedule The system will ask if you are sure you want to create a new patient with the account number and the patient name Published 1 6 2009 Page 81 of 248 Reference Manual e Click Yes New Patient ks re you sure You Wank to create a new patient Account HS10207 Name WILLIAM H MARTIN You will be directed to the schedule to schedule the appointment Patient Information Tab This is the main tab in the Patient screen This is where all of the patient s information is stored This is where to go to edit a patient s address or change an insurance carrier Notice how the screen
123. EFERRAL Active C E e Click Save Sh Settings S eee Types FP cancel H Save ok AddeE Y Adding a new Referral Source through the New Patient Entry screen e Click New Pat or hit F4 on your keyboard from the main screen Published 1 6 2009 Page 50 of 248 Reference Manual Account Assistant Er Ai CEW FF New Pat F4 FE Patient Search In the middle of the screen it says referral source or PAI Co ae oe ANS Referral Source F gt Mote R e Enter a portion of the referral source that is going to be linked to the patient account This will search on the description and the code Do this to confirm that the referral source that is going to be attached to the patient s account is not already in the system e Click the green plus next to the Referral Source i e Select a group for the referral source by putting a check in one of the boxes ej Select Group for new Referral Sourc Description Direct Mail Magazine a Screenings Phone Book Referrals e Enter the description for the referral source Enter the description of the new referral source tT X FJ cancel Published 1 6 2009 Page 51 of 248 Reference Manual gt e Enter the code Enter a code for the new referral source RTP FJ cancel Updating a Patient Record with a Referral Source e Open the Account Assistant e Enter the patient s name in the patient search and click enter e Click
124. EP 4 You should see Secondary Claim in the dropdown box in upper left corner At the top of the Claim Editor screen locate the box labeled 1 Payer This will open the COB section of the screen where you will enter the Primary Payer s Payment Information STEP 5 scroll down to locate the following 1 dae ahaa aa ad a Claim Level Coordination of Benefits The payer assumed to have adjudicated this claim Here you will be entering Claim Level COB Information Populate all fields that may apply including Claim Paid Date Payer Paid Allowed Amt Patient Resp Discount Proprietary Information 64 rovider XYZ MEDICAL PA M Overrides On Charges 218 00 My Claim ID 094729 00 zirMed Claim ID 636 5876 Instance ID 76173821 Save amp Resubmit 4 Payer HUMANA Subscriber Last First ID PRANCIS FRANCIS 1017112544 Simple View 2 Payer Medicare Subscriber Last First ID FRANCIS FRANCIS 1111111114 Claim Detail view ae Brauiders way Editing insurance sequence 1 Primary Delete this insurance sequence Add another insurance sequence Insurance View Member ID Ssh Client Humber Policy Mumber r service Lines View Rendering Provider DR DOCTOR WD Other Rendering Provider Numbers Select a type and enter the provider ID for each Up to five can be entered All insurance es Sequences Facility URGENT CARE AT WELLNESS attached to this Other Facility Provider Numbers select a type and enter the provide
125. ER CRAIG 9 pa CHIRO 10 222007 98941 1 65 00 65 00 000 6500 0 00 0 00 40 00 SEC pat V 3 HHM HHM 0 SNO0002 gt LOVE AMBER 2 f CHIRO 10 22 2007 98941 1 65 00 6500 000 65 00 0 00 0 00 35 00 PAT pri V 1 HHM lt none gt ANBCBS SNO0002 LOVE AMBER 8 A CHRO 10 22 2007 97012 1 42 00 4200 000 4200 20 00 0 00 42 00 PAT pri V 1 HHM HHM 59 ANBCBS SN3 ma MARTIN HOLLY 6 p CHRO 10 22 2007 98941 1 25 00 2500 000 2500 0 00 0 00 0 00 PAT pri W 1 HHM HHM ANBCBS Notice at the top of the screen that the user has the ability to email the report in a spreadsheet to their inbox or print the report Patient Ledger Payment Reports This report allows the user to pull a report for a specific patient s payment information If the user needs a report that includes any information that is visible on a patient ledger this is where that report is generated from Published 1 6 2009 Page 229 of 248 Reference Manual Remember that the show field will display the information on the report if the show field is not checked then the information will NOT be displayed on the report The Criteria field allows the user to select specific information for that field Notice at the top of the screen that the user has the ability to email the report in a spreadsheet to their inbox or print the report Marketing Reports Patient List Report This is where all of the clinics marketing lists are generated from This is where mailing labels are created as well as any other
126. ES VILLE Joa 30504 iu 575 989 5231 Local Use Box 19 DOB osson 974 OMae Female Doo maner isl Sublux Last xray Croup Humber FO Group Mame FO Effective Date Expiration Date Lo pay Due 20 00 Co pary To 0 pay jn Mumber Chronic Pay or Deny Authorization Accept Assignment Box 27 m Date Valid Emp Mame valid for 90 days Emp Location 20 Valid for episodes xl Emp Phone I Expires 2e Delete Carrier Code This is the code for the insurance carrier that was set up under the Billing menu Search for the carrier by typing in any part of the code or name of carrier Click the Magnifying Glass to activate the search window Active Checkbox Check this box if the insurance carrier is active for the patient An insurance carrier cannot be added to a patient s case if the case is not active You can keep track of as many insurance carriers that the patient has had simply mark the older insurance Carriers inactive If they ever switch back reactivate the insurance carrier Company Name This is the default insurance carrier name from the carrier list This is the name that will print on a HCFA 1500 form Published 1 6 2009 Page 91 of 248 Reference Manual Relation This is the relationship of the insured Select Self if patient is responsible for their own billing Otherwise choose Spouse Child or Other Insured s Name This is the na
127. Enter a description for the group LLES E i s E kaiia ai re Bm Ma Mama Mam ma Ha Mw Mama Bell Bc Ma Mal Hos Mam Mell Tat tal Jt q Description MEWY REFERRAL SOURCE GROUP e Click Save 3E Settings l5 E Types Fa Cancel A Save dP Adde Y Every patient in your database must have a referral source All new patients who are entered into CHIROMAGIC are REQUIRED to have a referral source A patient CANNOT be entered into the database without a referral source There are generic referral sources that can be used as well For example you might have a referral source of YP for the Yellow Pages Ref Source Group The referral source group allows you 9f ource Group Uncategorized to categorize the referral source codes All referral Code PAT sources are required to have a group Description PATIENT REFERRAL Active E Code This is the code that is selected when entering a new patient The code is an identifier for the referral source Description This is the description of the referral source code Active If this box is checked then the referral source is an active referral source meaning it can be selected from the drop down menu on the new patient form If the box is unchecked the referral source is not active and will have a strike line through it Adding a Referral Source Referral sources can be added in two ways For managing and setting up multiple referral sources enter them through the system set up tab If a new
128. Exceptions From time to time you may find it necessary for specific claims to bypass the CCI and or LCD NCD edits and pass to the payer as you submit When this is the case you may add an exception so a claim will bypass the edits Once you have added an exception you may edit it at any time e From either Professional or Institutional claims tabs choose the Coding Tools tab then the Exceptions tab It is very important to remember that you must edit exceptions specific to either professional or institutional claims e Find the exception you wish to edit by utilizing the search bar to search for the specific exception you wish to edit e Once you have located the exception you wish to edit locate the action column of the display and click on the Edit link e Your exception window will appear and you may edit any of the fields e Save You MUST click on save for your exception to be saved Coding Compliance Exception Microsoft Internet Explorer Sea Edit Exception Close Window Required fields are bolded cc Oven O NED e Payer Hame or ID Medicare B Kentucky Qdminastar SMEVO a Specify Situation C All Situations Selecting this option vill alow claims for selected payer code pair and dates entered below to process without passing through CCl edits Procedure Code Coli 97116 Procedure Code Col 97530 Modifier Service Date From To Proprietary Information 48 Copying Exceptions
129. F Poy Help Contact Us Customer Support Center Survey Welcome SUMmMmary Account Protile hiv Profile users renors Enrollment Providers Enrollment Records Preferences Download Manage Users Mew User Fage of 0 General Accounts Permissions Reset Password beverly hills Reset Password Alice Stamp alice Stamp AMY BLACKBURN training ee O Keep Old E The password must be at tra account irainingaccount Use Mew fo or actors ahd indicates the Domain Administrator must be Alpha Numeric Reset Password Proprietary Information 5 Unlocking Users A user s login will be locked after three unsuccessful login attempts The Domain Administrator is the only one who can unlock a user To Unlock Click on Account Click Users Click on User s Name left side of screen Click Unlock User box on the right ewwa You may also need to reset their password if they have forgotten it irMe Account Prof Claims Inst Claims Femits Eligibility Print Services Patient Statements lt Pay F Poy Help Contact Us Customer Support Center Survey Welcome Summary Account Profile My Profile Users Reports Enrollment Providers Enrollment Records Preferences Downloads Manage Users Mev User Page 1 ofi oO General Accounts Permissions Reset Passywrord beverly hills Edit User Alice Stamp Alice Stamp U H x AMY BLACKBURN ftrainingi SET Pa beverly hills beverly123 First name beverly karen craigmyle
130. H MAINTENANCE ORGANIZATION CODE NUMBER EMPLOYER S IDENTIFICATION NUMBER CLINIC NUMBER PROVIDER SITE NUMBER LOCATION NUMBER SOCISL SECURITY NUMBER UNIQUE SUPPLIER IDENTIFICATION NUMBER USIN STATE INDUSTRIAL ACCIDENT PROVIDER NUMBER EMPLOYER S IDENTIFICATION NUMBER SOCIAL SECURITY NUMBER X NETWORK PLAN PROVIDER NUMBER RAILROAD MEDICARE ID NUMBER WORKER S COMP ID NUMBER Reference Manual Facilities Understanding and Setting up a Facility This is a critical tab for insurance billing purposes This is the information that prints in Box 32 of a HCFA Form If this information is not correct you will not get paid Entity This is the entity that the facility belongs to Code This is the code used for the facility when setting up a new patient s account Name This is the facility name that prints in box 32 of a HCFA form Address This is the address box for where the services were rendered This prints in Box 32 of a HCFA form City This is the city where services were rendered State This is the state where services were rendered Zip This is the zip code where services were rendered Make sure that you enter all 9 digits Phone This is the phone number for the facility Entity Code Mame Address Address City state Zip Phone Fax MPI ProviderNo Tax ID Clialum nual POS Fax This is the facility fax number Jin MOTION CHIROPRACTIC O01 IM MOTION
131. History Close Window Batch ID 2958452 Format Unknown Batch Name 2006 batch 4 User Zirlled Annette A Upload Date 03 06 2007 04 31 26 PM Submitted Charges Processed Charges Discarded Rejected Hidden 0 0 Date Time Status ON0e200F 04 31 26 PM Error Duplicate batch detected Proprietary Information 12 CLAIMS Go to Professional or Institutional Claims Claims screen The claims screen is where you can go to do any Claims Searching check the Status or History of claims Hide claims and Edit claims as needed For the purpose of this training document the screen below reflects the Professional Claims tab Most of the functions described are available under the Institutional Claims tab The Institutional tab has the same sub tabs under it as Professional Claims Throughout this manual we will reference the Professional Claims tab f ZirMed Training Account 5076 Log Off ZirMed Account Prof Claims Inst Claims Femits Eligibility Print Services Patient Statements lt Pay 4Pay Help ContactUs Customer support Center Survey Claims Batches Mame Matching Providers Reports Enrollment Payers Coding Tools Settings Search Claims Rejected Claims Dashboard Old Claims Screen User Preferences Specify Claim a Displaying 1 30 of 64 Claims Page ot 3 gt Go Claim Number Patient Name Service Trans Date Rendering Provider Date s ZirMed Payer Charges Seq Status
132. ICHAELDIY 1477738367 201361054 128K BDI 1174686570 6154 WD100381 ARLIE FORSBERG p CHRO PR f2 MICHAELDIX 1477738367 201361054 128K6DI 1174686570 5 DIX WO100454 ALANA FECIE FPF MICHA amp ELDIX 414r r306 201361054 201361054 1174686570 Published 1 6 2009 Page 184 of 248 Reference Manual Statements Statements should be generated on a monthly basis Statements are way to generate income in the clinic If the clinic is sending out patient statements on a monthly basis then patients will pay their bills on a regular basis Statements will be generated for all charges that have not been paid by the patient If a patient purchases a product and does not pay at the time of service a statement will be generated for the patient Patient Statements O X E Close TH Statement Settings Statement Date E view Audit 1o07 2008 Specific Patient Do gt General Statement Message Run Statements Use last name range to Mark charges billed a View Statement Date The date the statements are generated Specific Patient The name of a specific patient to generate a statement for General Statement Message If you need to enter a message that will print on all statements Run Statements Section User last name range If statements need to be generated by last name This is useful for larger clinics that like to print statements by last name Mark Charges billed Will note on the statement
133. IENT S OR AUTHORIZED SIGNATURE SIGNATURE DATE 13 INSURED S OR AUTHORIZED SIG SCNATUREONFILE 1 14 DATE OF ILLNESS INJURY ACC 15 IF PATIENT HAD SIMIL 6 DATES P amp TIENT UNABLE TO WORK AR ILLNESS 17 NAME OF REFERRING PHYSICIAN 17a REFERRING PRoV sd 18 HOSPITALIZATION DATES CLOUDY Jee S REFERRING UPIN usssss FROM Loo Sd ool Ef Proprietary Information 20 View View displays the most current version of the CMS 1500 08 05 form GREATHEST LIFE ARR ITT 1000 CREATHEST OR 1500 EFERHETT MO S3a573748 HEALTH INGUAANCE CLAM FORM PP a Le Ld ki Oe hi rca T L oe Gea i SSD PAHE Fe gee Gee T jie df G ees EER aaa mee ee RES1LL9 paa To ee Poem r ihi eami l at ey ee ee JOHES HAHET C E JOHES HEHCY C 0 PST EEEN Hi brna REPE EIMI h na 130 RASC TRACE 13 BARON TRACE oni ori Fur x LOUISVILLE 0O LIVI amp VILLE EIT DF oo TREM 7 TULSA abide LIEFE armele 502 2680923 E bE LS E hA pa ra o Gra ehia Hom E A E ca a ne ela SoMa A FPL Be 358999 1S EPE ee LS eres m Ferari E E OF RTH CE E Om E 1 a7 1073 E E h um eee me a fo BLATT Be CT BLED es i DEPL E LA HEEL FEE The View button displays a claim for you as it would print it on a CMS 1500 08 05 form using Adobe Acrobat Reader You can then print this form on white paper Note Some payers require a signature Some payers require an original paper claim and will not accept a claim printed from this screen You should first confirm th
134. IS CODE POINTER 6000 WHICH POINTS TO A NON EXISTANT DIAGNOSIS CODE PROBLEM The claim contains the diagnosis code in the diagnosis pointer fields instead of the actual diagnosis code field RESOLUTION The claim may be edited online Enter the diagnosis code and enter the correct diagnosis pointer The diagnosis pointer indicates that the service line directly relates to that particular diagnosis REQ RENDER NETWORK ID FOR PAYER RENDER ID PROV ID INVALID FOR PAYER PROBLEM The payer is indicating that they require the rendering doctor to submit the provider ID assigned by the payer RESOLUTION If you have the provider ID you may edit the claim online and resubmit Be sure to enter this provider ID in your practice management system as well to prevent future rejections If you do not have the provider ID you will need to call that specific payer to obtain it HEALTH CARE DIAGNOSIS CODES S 78959 IS INVALID MUST BE A VALID DIAGNOSIS CODE FOR THE DATE ON WHICH THE SERVICE WAS PERFORMED 2300 HI PROBLEM This rejection message is stating that you have either an incomplete or invalid diagnosis code or the HCPC or CPT code is invalid for that date of service RESOLUTION You can edit the claim enter the correct diagnosis and resubmit Be sure to correct the diagnosis code in your practice management system to prevent future rejections RLSE INFO INV RELEASE INFO CERT MUST Y N M A PROBLEM The payer is requiring a relea
135. LCD or NCD edits then the claim will appear as a rejected claim The claim will be rejected by ZirMed and the rejection message will indicate if the is rejection is for CCI LCD or NCD If you have a rejected claim and know exactly what the issue is then you may simply click on Edit from your claims screen to edit the claim thus correcting the error For Proprietary Information 53 detailed information on how to edit a professional claim click here For detailed Information on how to edit an institutional claim click here lf you are unsure as to why your claim has not passed CCI LCD or NCD edits you may research the edit utilizing CodeCorrect To access this feature e Locate the rejected claim e The status message is a link that when clicked provides a detailed history of the claim and a link to CodeCorrect Rejected by firMled MCD e At the end of the rejection message there is a link titled More Info Click on that link to access CodeCorrect O lf your claim has rejected because it did not pass multiple CCI LCD or NCD edits then you will be taken to a screen to choose which edit you would like to research first Source User Message 01 14 25 Ph IRMED CLAIM LOADED FOR PROCESSING 01 14 58 PM AIR MED Rejected CLAIM REJECTED BY SECOND EDITS NCD PER MEDICAL NECESSITY EDITS MA TIOMAL LEWELI THE BOO O0 1S 4 MON CoOVERED CODE FOR THE PROCEDURE amp MEDICAL MECESSITY EDITS MATIOMAL LEVWELJ THE PR CODE 65025 IS A
136. NG Leaving this box checked while matching names will cause S SEE See eS longer delays as this section will refresh upon each match performed System Payer Name Delwery Actions ACORDIA MATION AL Acordia National a Electronic Un Match Overrides ADMINASTAR OF KENTUCKY Medicare B Kentucky Sdminastar SMK YO Electronic Un Match Overrides AETHA Aetna 60054 Flectronic Un Match Overrides AETHA US HEALTHCARE Aetna 60054 Flectronic Un Match Overrides ANTHEM BCBS of Kentucky ZBK YO Electronic Un Match Overrides ANTHEM BCBS BCBS of Kentucky Ek Electronic Un Match Overrides If you need to un match and re match a Payer that had been incorrectly matched or temporarily matched to paper 1 In Show Matched Names click Un Match next to the Payer 2 Place a checkmark in the Include Names That No Longer Have Held Claims box above the Un matched Payers section 3 Then name match the payer appropriately f Z d zirMed Training Account 5076 training account Log Off irMe Account Prof Claims Inst Claims Ferme Eligibility Print Services Patient Statements lt Pay F Poy Help ContactUs Customer Support Center Survey Claims Batches Hame Matching Providers Reports Enrollment Payers Coding Tools Settings Payers Billing Pay To Rendering Facilities Referring Supervising Ordering Primary Care Purchased Service Held My Un Matched Payers Name Contains Starts with Search Include names that no longer have held
137. NT PHASE ll START NEW PATIENT Note You can increase or decrease items to PHASE Ill START Code make adjustments to quantity on hand during PROT een Oe el onic ANT ee PECFD PROT BAR CRE physical inventory counts You can NEVER Sonar Rue CARL DH DRC I r ltem Functions EAL adjust the quantity on hand of an item directly PROTI BAR CHC i Edit Item you can only adjust quantity up and down ERO RAR eel SGHSEAR vor E3 Set Item Tax Fates DOLE a EY poee PUDDING CHOC Add to Fee Schedule Quantity is depleted every time you sell an item mac i 3 OCOl This is to create a complete audit trail of your PUDDING vanih Gy Feceive Inventory INK inventory Once the initial quantity is entered GULICK FIC ENTRER f 9 Delete Item REAL you can account for every item ae ale The Qty Adjustment screen will appear E Account Assistant Inventory ioixj 5 ae Man pp amp R E H S S 2 M CEW F7 Mew Pat F4 Claims F8 Reports Billing Utilities Applications Calculator Support Log OFF Patient Search close a Refresh Reports ge Select Itemis x Clear Items Add to Inventory t tems E Categories Tax Fee Schedules ch Receive Products Description Sel NcDL NUTR4 15 COLD DRINKS LEMON E PO 123 4 Hz sjyuswpuioddy s epa L SE NCOMP NUTRA 15 COLD DRINKS WILDBERRY PASSION BY POH 123 4 jro o PHASE Il START NEVY PATIENT PO 123 4 Use the spinner cont
138. Navigating to another screen during the upload process will cause your file to fail FE Progress Windows Internet Explorer Uploading Estimated time left 0 min 0 secs 0 KB of O KB uploaded Transfer Rate 0 KB sec Information Connecting Uploading File NOTICE Navigating to another web page during this upload process will cause your upload to fail f ZirMed Training Account 5076 training account Log Off ZirMed Account Prof Claims Inst Claims Femis Eligibility Print Services Patient Statements lt Pay 4 Poy Help Contact Us Customer Support Center Survey Claims Batches Mame Watching Providers Reports Enrollment Payers Coding Toas Settings File Upload The upload is complete The detailed information is FileName Size Bytes BatchiD CLP 200407 13094103900 txt 1595 3657097 Batch upload complete Click here to return to the batches screen Proprietary Information 11 Common Batch Upload Errors Error during batch processing is an error that could occur it may mean that the file you created was not a good claim file or at least not in the format that we were expecting it to be in Error Duplicate batch detected is an error which means that the file you just uploaded was an exact duplicate of a previously uploaded file You should go back to your practice management system and go through all the steps to recreate the file You should be able to do this without
139. O 31to60 erent 90 00 2 273 00 9400 2310 231 83 00 2 e Click the criteria button at the top of the screen once this button has been checked the user then has the ability to display more information on the report For example if the user wants the primary ID number and group number to be displayed then that needs to be selected from the second list of criteria e Select the show button for all of the primary and secondary group and ID numbers they are at the bottom of the list e Click Run Report If Fri Group Mo E W FrilD No E i PriDOB E WO Sec Group No If Sec IO No E m Published 1 6 2009 Page 232 of 248 Reference Manual 61to90 Overg0 0 00 1 4 96 00 1 4 98 90 0 00 ji 4 968 00 D 0 00 148 00 D 83 00 D Account Ledgers Account Ledgers are reports that can be given to a patient to turn in for a Health Savings Account and attorney or just for their general information The account ledger is like an index card of everything that has happened on a patient s account By default when the Account Ledger Report Options opens the Field Criteria patient box is checked and so is the charge date box When these Patient Iw boxes are checked the patient window appears and so do the charge Charge Date m date boxes allowing you to select patient and the dates to be printed on the ledger report Patient sing HOLLY MARTIN X Charge Date between 10012008 to 100172008 Today
140. Patient Statements lt Pay Leads Admin F Po Help Contact Us Customer Support Center Survey Claims Batches Mame Matching Providers Reports Enrollment Payers Coding Tools Settings Billing Pay To Rendering Facilities Referring Supervising Ordering Primary Care Purchasing GET WELL CLINIC BARDSTOWN OFFICE General Information Payer Specific Information Description Organization GET WELL CLINIC BARDSTOWN OFFICE individual Last First IMiciclle Suffix Address 1 815 wW Market Street Address 2 40202 City state Zip Code Country Tax ID and Type SSN O EIN MPI Specialty i ee Custom Field SELECT FIELD Custom Field SELECT FIELD Primary Contact Secondary Contact Mame Busy Bee Phone 502 444 1234 Fax 502 555 1234 E hail Save information for selected provider Payer Specific Information lf you need you can also add Payer Specific Information for a Provider Payer Specific information will override General Information for the Provider To do this Highlight the Provider s name in the section on the left Click on the Payer Specific Information tab Locate the Payer using the Payer Search click eyeglasses A new window will display allowing you to search for the Payer You can narrow your search by entering a portion of the Payer s name e g Medicare and click on Search 5 Click on the appropriate Payer It will be added to the list of Payers and a
141. Payer ID If the carrier does not need a payer ID number this will turn off the deficiency for this carrier Ignore Missing group number of NONE for Medicare If the Medicare that the claims are processed through do not require the group number of NONE then check the box and the deficiency will be turned off for the carrier Published 1 6 2009 Page 170 of 248 Reference Manual EOB Settings gt Insurance Carriers MEDICARE 2ND H Save Gl Save and Close LO Master Carriers The EOB Settings tab 1S where all default Fit Information ss Ledger MEDIC2 le ID No Setup MEDIC2 BE Biling Settings MEDIC2 EOB Settings MEDIC2 information is set up for payments that are E DE Default Pay 0 00 received from the carrier that is selected alta The purpose of this is to make EOB posting SS easier This is where the allowed paid and adjustment amounts are created for a carrier and specific CPT codes For example you are billing a 98941 to Medicare and the billed amount is 53 00 and the patient has a 6 11 co pay It is a known fact that Medicare allows 30 54 on the 98941 and that the payment will be 24 43 This is where that information is entered into the computer so it does not have to be entered every time an EOB comes in from Medicare Options Auto calculate Allowed amount and Paid amount from Fee Schedule percentage Auto populate from History If this button is clicked the computer will
142. Primary KAISER Secondary ANBCBS ie Fatient Status Responsibility iP re Bill Billed to Primary Billed ta Secondary t Billed to Patient Last Billed 114 ef2008 Charge Information Diagnosis Charge Log Charge Date Jromarzoo8 Patient Case F Default tem 97110 CPT Code 97110 Description THERAPEUTIC EXERCISES Units 1 Unit Price 53 00 Tax 0 00 Total 53 00 Balance 0 00 Rendering Prov HOLLY H MARTIN Referring Prov HOLLY H MARTIN Treating Prov HOLLY H MARTIN E F E TE E Local Use Box 19 Sublux Last ray Employment Related Chronic Fay or Deny Clear information about the charge that is highlighted in the list above There are three tabs on the Edit Charge Screen they are Charge Information Diagnosis and Charge Log Read below to understand the details on all of the tabs Published 1 6 2009 Page 101 of 248 Reference Manual Charge Information Tab 39 This is the screen where the charge information can be changed All of the fields that are in white can be edited and all of the fields that are in yellow can NOT be changed e Charge Date The date of the charge can be changed e Patient Case The case that this charge attached to can be changed e Jtem This is the item code for the charge e CPT Code This is the CPT code that is attached to the item this can be overwritten if it needs to e Descript
143. Reference Manual Published 1 6 2009 Page 158 of 248 Reference Manual Daily Balancing Balancing Once all claims have been entered for the day it is important to balance those claims and payments for the day CHIROMAGIC has tools that will assist in this process There are two steps to balancing for a day First balance the charges and second balance the payments Why two steps Because it is important to confirm that every patient who walked through the door has a charge and payment if they made one entered into the database The only way to confirm that this has been done is to balance the charges for the day To have an accurate A R all of the payments have to be in the database Whoever is responsible for balancing should not try to balance at the close of business If you have been staring at a computer screen all day then most likely you will be unable to catch mistakes quickly If your mind is fresh then something that can take you 45 minutes to find at the end of business will take you 5 minutes to find first thing in the morning When balancing your charges make sure that you have the following in front of you the sign in sheet from the day that you are balancing the DC Notes for confirming the charges have been entered correctly and the Encounter Forms to confirm that all of the accounts have been updated appropriately Below are the steps for balancing Scheduler Reconciliation Report Print a Schedule Reconciliation Repor
144. Reference Manual Do not send referring physician in 2310 A If this box is checked the referring physician will not be submitted in the loop stated above Send Ordering Physician in 2420E This is for DME claims If submitting DME claims and the carrier needs the ordering physician then check the box Send date range for all service Dates If this box 1s checked Send Claims with a zero balance If this box 1s checked claims will be sent to the carrier if there is a 0 00 balance on the claim This is necessary if the patient has a co pay of 5 00 and they had a service that was 5 00 when the co pay is paid the balance on the charge would be 0 00 but the claims will still need to be submitted Do not send decimal places for zero decimal monetary amounts 1f the carrier does not want decimal places for zero decimal monetary amounts then check this box Send Employer Name instead of group name in Loop 2000B SBR If the carrier wants the employer name instead of the group name for the patient Ignore missing patient SSN If the carrier does not require a SSN then check the box this will turn off the deficiency for missing SSN Do not send taxonomy code in loop 2000A If the carrier does not want the taxonomy code sent over check the box Ignore Missing Initial Treatment Date If the carrier does not require an initial treatment date check the box this will turn off the deficiency for this carrier Ignore Missing Carrier
145. Sec Bill Type FeeSched PayerlD ClaimFilingCode HCF amp 4Digit ear EDI Setup Master Carrier v moc MEDICARE 0 Po B0x 1829332 O00 COLUMBUS on 4321 8 2932 aa mu Ic J Medicare HCFA 500 Form HCFa 1 500 Form MEDICARE OHMCR mB m e Enter the claim filing code CI for Commercial MB for Medicare MC for Medicaid BL for Blue Cross Blue Shield e Check the box if the carrier needs the date displayed in 4 digit year e Select the EDI Setup from the drop down e Select the Master Carrier from the drop down e Click Save Published 1 6 2009 Page 172 of 248 Reference Manual Adding EOB Settings to a Carrier e Highlight the carrier from the grid on the left MEDICS L MED F MEDICA MED e Click the EOB Settings Tab E08 sae BLUE AMERI e Click the Add button dP Add a e Select the CPT codes from the list by placing a check in the box and click OK Fj Add CPT Yalues 215 00 e Click the grid and enter the allowed paid and ADJ amount for all CPT codes that were selected Published 1 6 2009 Page 173 of 248 Reference Manual Allowed Percentage 7110 Fe 210 D0 210 O0 0 00 0 00 M110 135 00 135 00 0 00 0 00 Morn 4000 4000 0 00 0 00 e Click Save NOTE Ifa CPT code was selected accidentally click the red x to the left of the CPT code Published 1 6 2009 Page 174 of 248 Reference Manual
146. TWO VIEWS OR MORE 80 00 80 00 09 24 2008 7 LR LUMBAR ROLL 12 00 84 00 09 24 2008 1 72052 CERVICAL COMPLETE STUDY 225 00 225 00 09 24 2008 3 NICOL THE BEST 100 00 300 00 Grand Total 151805 Published 1 6 2009 Page 234 of 248 Reference Manual Appointments Appointment reports are now in the grid format meaning that a report can be generated and sorted however you choose Remember that all reports that are displayed in the grid format can also be emailed to you in a spreadsheet giving you the ability to manipulate the data The appointment list report is generally used as the scheduler report for the day To generate the appointment reports follow the instructions below e Click on Reports e Click on Appointments Appointments Tax reli e The Appointments Report Options will be displayed Ey Appointments Report Options 2 a Close g gt Run Report O Clear Criteria Appt Date Time between l acm 2008 to ion 2008 Today Appt Status x E PatientID Mo ApptDate Time M Ere W Visit Type C Rescheduled Wo Provider E Cancelled Wo Acct E No Show Wo LastName E Fending W First Name E 4 Appt Status lw Facility By default the criteria for Appt Date Time will be checked and the default value for the criteria will be today You can overwrite this date with a custom date or one of the preset dates from the drop down Notice how the criteria are listed and that there are t
147. Tab button Patient Payment Show receipt after entering patient payment If this box 1s Patient Payment checked when you take a patient payment over the counter for a l l M Show receipt after entering patient payment statement or after a charge has been entered it will automatically pull up a receipt to print for the patient Published 1 6 2009 Page 23 of 248 Reference Manual Printing HCFA S Order By Carrier or Patient If the button is in the carrier option HCFA s Printing HCFAS _____ will print in order of carrier If the button is in the patient box HCFA s will CON ee eae print in order by patient Entering Charges CEW Charge Entry Options Number of Previous visits to display When entering charges at the bottom of the screen the last three visits are displayed by default If you would like to see more than three visits change the number and the system will display however many visits you want to see Entering Charges Humber of previous visits to display 10 a a For Last 3 Visits show Billing Code instead of CPT Code r Display Claim Authorizations I Allow blank Referring Physician E Automatically enter PAY OR DENY IN 30 GAYS in Box 19 for all charges For last 3 visits show item code instead of CPT Code If this box is checked when you enter charges the item code will be displayed and not the CPT code If the box is not checked then the
148. The tender amount can always be overwritten at the data entry level Entering Patient Payment Default payment method This will allow you to set the most common form of payment for your front desk If the majority of co pays are received in the form of a check then set this to CHECK and the payment method will default to CHECK Remember the system 1s intelligent so if the patient who you are checking out made a patient payment with cash on their last visit the system remembers that and will automatically set the default payment method to cash for this patient This can always be overwritten at the data entry level I Auto populate tendered amount for patient payment Default payment method cash W Force Reason for Adjustment entry Force Reason for adjustment entry If this box is checked when checking out a patient if staff has the ability to adjust off balances then this requires them to enter a reason as to why that money was Published 1 6 2009 Page 25 of 248 Reference Manual adjusted off This is a great way to make sure that staff members are not writing off balances that should not be written off Service Types Service types are the businesses within your organization The purpose of service types is to allow you to organize the different aspects of your business You should try not to create additional service types in the system Service Types are the highest level of hierarchy in the organiza
149. This number will come to you via email or on hard copy in the mail although Enumerator assigns you this number the number then has to be registered on the NPI website They will NOT do it for you Some clinics are not even aware that they have a Type II NPI number If you are not sure what type of NPI numbers you have you can contact the NPI Registry at 1 800 465 3203 NPI Toll Free or1 800 692 2326 NPI TTY Type I NPI Numbers Type I NPI numbers are numbers that are assigned to the rendering doctor at your clinic All doctors should have a Type I NPI number If you do not have a type I NPI number then your claims will NOT be paid Published 1 6 2009 Page 243 of 248 Reference Manual Here are the guidelines below for billing EDI with NPI numbers e Register your NPI Numbers Please make sure you have registered your NPI numbers If you have not registered them you can go to https nppes cms hhs gov and do so You must register your Type I and Type II NPI numbers e Please provide Phunkey with your NPI numbers They need to be loaded into the system e Type IH NPI number will be loaded at Entity level Click on Utilities at the top of the screen and then click on the Entities tab and enter the NPI number e Type I NPI numbers need to be loaded at the provider level click utilities at the top of the screen Click the providers tab Select the doctor from the list and then load the NPI number e Please provide ZirMed with ALL o
150. UIRED TO BE PRESEN Hidden Claims The Hidden Claims Report will list those claims currently with a Hidden status The date range entered will select claims based on the date ZirMed first received the claims The claims display in descending Submit date sequence i e most recent claims first It will also display the status and text of when the claim was hidden Proprietary Information 36 Under the Additional Criteria section you can further refine your search by entering certain keywords If you see a claim on this report that should not be hidden e Go to the Claims tab Search for the claim be sure to check Include Hidden in your search criteria Remove the Hidden checkmark for the claim Click on Save Hidden Status This will help you monitor what claims specifically have been hidden it should be printed regularly Hidden Claims Report trom 0401200410 04 30 2006 Submit Dt Batch Name Patient Hame Service Ot Charges Payer Status Text 054172005 051105ke2 TRUE TERR YL 0740172003 954 00 CENTRAL STATES Rejected RENDERING NAME MATCHING REQUIRED 08 56 AM BILLING MAME MATCHING REQUIRED 054172005 051105ke2 DEAN DELTA YY OB282003 234 00 CBA Rejected PAYER MAME MATCHING REQUIRED 08 56 AM RENDERING NAME MATCHING REGUIFED BILLING MAME MATCHING REQUIRED REFERRING MAME MATCHING REQUIRED OFA 32004 071304 FLINT FRED T1001 105 00 MEDICARE KENTUCKY Rejected by ZirMed CLAIM REJECTED BY SECOND EDITS 09 39 AM ENROLLMENT FOR PROVIDER NUMBER 1
151. UST watch EVERY CARRIER like you were going live for the very first time Published 1 6 2009 Page 211 of 248 Reference Manual If you do NOT you are risking your cash flow All you have to do is pick one or two claims contact the carrier let them know you have just switched over to the new ANSI format or are new to electronic billing could they please call up a claim and let you know that it was received and if they see anything wrong It could take a whole day to contact each of your carriers and do this but it could save tens of thousands of dollars or more in cash flow Fast Resubmit Most importantly know that you will be able to resubmit all your claims in MINUTES after fixing what the insurance carrier says is wrong using the Claim Utility in your account assistant So even if there are format issues and all the claims are rejected within 72 hours of the original submittal you will have ALL the claims resubmitted correctly And then follow up again to make sure In short EXPECT problems FOLLOW UP to confirm integrity and know your cash flow will be intact If you submit blindly and wait for two months to follow up your cash flow will suffer Published 1 6 2009 Page 212 of 248 Reference Manual Reports Menu The reports menu is where all of the reports for the clinic are located Reports are constantly changing and being added It is imperative that your email address be entered into system setup because Phunke
152. Us Customer Support Center Survey Claims Batches Mame Matching Providers Reports Enrollment Pavers 4 Coding Tools Exceptions Procedure Code Search ICD 9 Search Coding Compliance Billing Report Transaction Date s Columns Filters This Year Edit Type All a Last Year Custom From 01 01 2007 Te 0870172007 Generate Report Download CSV Data for this report is only available for the past two years Data current as of 08401 2007 03 00 33 Phl SETTINGS The Settings screen contains many settings that instruct the system how to process your claims Only ZirMed Customer Support Personnel may change these settings users can view them only To discuss or change any of these settings please contact ZirMed Customer Support at 877 494 7633 opt 5 You can go to Professional or Institutional Claims Settings Account Preferences to test a Provider ID for a valid NPI number Proprietary Information 60 SECONDARY CLAIM SUBMISSION If you are ready to begin sending your Secondary Claims electronically you will need to do the following 1 Find out your Format If you do not know the format in which you send your claims to ZirMed our Support Team can help you determine this What type of format do you use to send your claims to ZirMed We can help you determine this if you do not know There are two ways you can send the Secondary Claim COB information e In your inbound claim file e Use the
153. WOM COVERED CODE More Into o If your claim has rejected based on one CCI LCD or NCD then clicking on the More Info link will take directly to CodeCorrect where you can research Once you enter CodeCorrect for research please be aware that you will first land on the icon that is most appropriate to your rejection For example if your rejection is due to a CCI edit you will first start at the puzzle icon The puzzle icon contains information specific to Comprehensive and Component code edits However if your rejection is due to a LCD edit you will start at the chain link icon The chain link icon contains information specific to LCDs and NCDs Additionally please be aware that every icon described below may not always appear on the screen The icon display is dependant on the reject you are researching For example If your reject does not pertain to anesthesia services then the A icon will not display Below is a description of the icons Puzzle Comprehensive and Component code edits Pull down menu defaults to the current version of CCI edits but can be changed to a different version of CCI edits to review the correct results for a given time period required Clicking on the link CCI Version will return the different versions of CCI edits along with the date range for which each version is in effect Find the date range for Proprietary Information 54 the date of service note the version number close out t
154. a Eil Clear Fill Min to Max Feset sam Jos fio is 20 25 Jao as ao as so ss Team Jos 1o fis 20 25 Exceptions dh Add Edt Delete Providers Sections This is where all of the providers who are listed can have appointments scheduled If a doctor is missing from the list check the system setup Most likely the box is not checked that says you can schedule for this provider They may also be inactive Show All Providers If this box is checked the doctors who are not active or not checked to schedule will be displayed Code This is the code for the doctor Name This is the name of the doctor Published 1 6 2009 Page 71 of 248 Reference Manual Options Section Active for Scheduling If this box is checked the doctor is active for scheduling Override Color If this box is checked the color for the doctor will override the visit code color Time Blocks Section This is where to indicate which hours the providers work Make sure that the provider s hours are populated appropriately Exceptions Section This is the section to update if the office will be closed for a Holiday or if the doctor will be on vacation This will indicate that you cannot book appointments for providers and staff members because they are not going to be in the clinic Exceptions dh Add Edt Delete Add Click this icon to add an exception Edit Click this icon to edit an exception that ha
155. acasacacsecsraeeess 25 FREI OO TS A S E cae sels csepe csc aden deeartans 31 ENROLLMENT ccsccscsccscscsscsececsececsscecsscecsscscsseacsueacsvcassucassucarsueseavsacsreatsveutseeaceeeecavee 42 PANY EAS E E E ER 43 ODIN CO0 ESP 44 OV AVEN aa A 44 DTE e O A enetenee 44 PROCEDURE CODE SEARCH CPT 4 cccccssssssessssessesessesessescsessesestsscsteseaveeeeeees 57 DIAGNOSIS CODE SEARCH ICD 9 cccccccsessssessesessesessesecseseseseeststesssestaeeeeeeees 58 IGP OU cess etched hese eta te nei edad metnetirettneda cette 60 SETTINGS eacescacreseve cnctictecasrienisdeviesaesateh tater td auni unian ANUE NENAU NENNEN ENUIE sh erevabsecasaveree 60 SECONDARY CLAIM SUBMISSION ccccsscscsessesecsesessesscsesessesscsessestsvestseseseseaveees 61 SIE a P E E E A T E N 62 TEP A ance rec nem 62 STEPS E E E 63 a e E E E E 64 SA os eee ee ee E E E er ener 64 STEEP e A sae sesh teense sine nes aae ec ieenac E 66 READING AN EXPLANATION OF BENEFITS EOB 68 GLOSSARY OF TERMS sxctcsscccesscecesexertosecasucicctiunuss nceevcauedt insi0l ceim Nane Nannona neonan 70 REQUIRED FIELDS FOR SECONDARY CLAIMS NSF amp ANSI cccccccesseceeseseeeeee 71 SECONDARY CLAIMS FAQS uu ccscsccsesessssecsesscscsscscssestsssscsucscsueacarsstsrestsrsstavesesveataveees 72 PAYER WEBSITE Ss saceoscssescszessace eves cxbesncaciieacsncss seve eal donevseGhoteceaGheacaveddazensnteuteeasesrs 74 MEDICARE SECONDARY amp CROSSOVER CLAIMS aiiis 76 CLAIMS esas text sinnnnn
156. acs ae ec g Edit Charge STMENT f F Fa Edit Check Fo ae FONE WATER PILLOW Ae 06042008 CASH cash a Unappl Payments BRY PAYMENT Balance Tab Charge Functions Balance Tab Check Functions Published 1 6 2009 Page 121 of 248 Reference Manual Totals and Aging Tab This is a total representation of the account There is no date range The totals include all cases However you will see the breakdown of each case with charges and charge balances You will see everything that has been billed paid adjusted and written off charge balance credits and total balance You will see everything pre bill waiting for payment by primary insurance secondary insurance and due from the patient There are no functions to be performed on this screen It is there only for you to view the account activity RR103575 KATHY MORALES Test 2 Close 4 Save gop Utilities Pta Patient Information EE Case Information a Insurance IE Diagnosis Codes F Notes Ledger Weight Lass A Close Refresh Ledger Case lt ALL gt pea Charges Payments Balance Totals and Aging oided Charges oided Payments Claims Billed Payments Paid Adj Writeoft Charge Balance Credits Total Balance 2634 34 2599 34 1320 20 1279 14 0 00 35 00 0 00 35 00 Pre bill Primary Ins Secondary Ins Patient 5 50 00 0 00 0 00 15 00 Oto30 31060 61to90 Overd0 50 00 0 00 0 00 15 00 Case
157. additional services and products offered by ZirMed The Welcome screen also includes the following Action ltems This section contains a summary of rejected claims If your login contains multiple accounts under your primary account i e Billing Service or multiple geographic locations you will see the summary for each account here By clicking on the account listed it will direct you to that account s specific information If you have any rejected claims it will notify you in this section It will show you the total number of rejected Professional or Institutional claims and it will show how many claims you have waiting for name matching It allows you to view your rejected claims by clicking the Rejected Claims Dashboard link Rejected Claims Dashboard This link will take you directly to the Rejected Claims Dashboard and display all currently un hidden rejected claims for your account If you have a single account when you first go to this screen your rejections will be grouped by rejection message You can change the way the rejected claims are grouped by selecting a different Group By category from the drop down list and clicking on Go You can separate any group of claims into smaller groups by selecting one of the grouping categories in the Drill Down column and clicking on Go The link in the Qty column will take you to the Claims screen and display that group of claims where you can Edit and resubmit them individually Resub
158. all the way up to see the top of the screen again Click in the little white box Include names that no longer have held claims Then the name will appear in the big box on the right Then match it correctly Q If have already name matched a payer why do I have to name match it again A You only have to name match a payer name ONCE the first time it comes over But if it comes over spelled differently then it will treat it as a new payer name and you will have to name match it the first time too Q How do I un match a payer name and then match it correctly A Click the Show Matched Names box in the bottom left corner of the Payer Name Matching screen It will display below a list of all the previously matched payer names and the payer id they were matched to You can click the UnMatch button on the right then scroll back up to the top of the screen and check the box that says Include names that no longer have held claims This will display the payer names again in the big box on the right so that you can then match them correctly Q How do upload a batch of claims A Click on the Professional Claims tab and select the Batches tab Enter your Batch Name Click on the Browse button and choose the file you wish to upload Once you have selected your file click the GO button on the right to begin the upload Q How can I check to see if my claims went through A After you have uploaded your claims you will notice i
159. ame Matching screen is divided into three sections 1 On the left is the Payers Search List section It is here that the Payers names their corresponding IDs and Delivery Method will be displayed You can search through this list by providing either a portion of the Payer s name or the Payer s ID in the Name Contains box or by specifying the starting letter in the Starts With box In the section on the right Held My Un matched Providers will display Inquiries for a given spelling of a Payer s name will be grouped together allowing you to match the Payer Name assigned by your PM System with the corresponding ZirMed Payer ID one time for all occurrences e g Aetna Aetna5 and Aetna PPO would be in different groups because the payers names are not spelled exactly alike Below the Un Matched Payers section are the buttons you will use to tell the system how to match the inquiry To Name Match the inquiry 2 3 4 U Highlight the Un matched Payer name in the section on the right Search for the correct Payer in the section on the left Click in the circle next to the Payer s name Click Match to Selected Payer located on the right below the list of n matched names lf the Payer s name does not appear in the section on the left you have the option of fA 7ZirMed Match to Trash WARNING Anything you Match to Trash will be discarded and will not be processed in any way by the ZirMed system
160. and all of the default information needs to be set up such as billing code modifier codes and expected amounts To set pricing follow the instructions below e From the Services and Products screen left click on the price tag e Click the Add to Fee Schedule button e Select the Fee Schedules that you want to add the pricing for and click ok Wj Select Fee Schedule Select All EJ Deselect All TASH MEDIT ARE fF oo STANDARD PRICE Fr Mpr e Enter the unit price Description E3 cancel d o Note Click select all and set the pricing for all of the fee schedules at the same time and then go back and edit a specific fee schedule 1f needed OK e Enter the expected amount this is for insurance billing items e Select the type of service which should be O1 e Enter the CPT code this is what will print on the HCFA form aif h Edit Item ca E Set Item Tax Rates cok Add to Fee Schedule ay GD Receive Inventory o e Select any default modifiers that you would like to print on the HCFA form e Check Bill to Insurance if this is a service that normally bills to insurance or uncheck the box if a product or a special service item For example for some Medicare fee schedules you may NOT want to EVER bill that service to the carrier e Click the save button or cancel to abort Note If adding a service that would never be billed to an insurance carrier uncheck the box t
161. ar in the section on the left you have two options for Name Matching 1 Match to Paper ZirMed will create a paper claim either CMS 1500 or UB92 and mail the claims to the Payer Normally this option is only used when a Payer cannot accept electronic claims Once a Payer is able to accept electronic claims you will need to make the appropriate update i e un match and then re name match the Payer 2 Discard Claims WARNING Anything you select will be discarded and will not be processed in any way by the ZirMed system Only use this if your PM system does not have the ability to exclude a particular payer s claims from going to ZirMed This is useful for offices that are printing claims in the office but are unable to eliminate those claims from the electronic claims files Proprietary Information 26 Below the Payers List section is the Show Matched Names section To view this section place a check in the box labeled Show Matched Names As indicated by the red warning message this section should be hidden when you are performing Match to Payer To hide this section uncheck Show Matched Names J Ace Industries Medicaid yvyoming SRO Electronic ACEC 59140 Electronic O ACM UHC OH Ancillary Care Management OME ACM Contract 20070 Electronic Providers Only ACM EverCare 1190 Electronic O ACM UHC Benesight Harrington f 10 4 Electronic ACM UHC Empire Provider 21075 Electronic Jed raded u WARNI
162. ase ba cers A ceace follow the instructions below mae e Click Reports gf E J Billing Utilities Calculator F6 Support Log OFF Fee Sched a EF tE E Encounter Forms FS Code Reports Billing Utilities Ca EZ Report Description EPgounter Forms FS Royalties Report Det Units ie Daily Reports Det Unit Price E Report CPT Code Marketing Reports Mod Mod ModS Mod4 Bill Amount Exp Amount T Products and Services e Click Lists e Click Products and Services Management Collections My Reports ttt om M M m M M M M M M M m M e Select the criteria that will be displayed on the report e Click Run Report Published 1 6 2009 Page 65 of 248 Reference Manual gt Utilities Schedule Settings for Visit Types If the schedule settings are not setup properly for the visit types the schedule will not allow you to schedule appointment appropriately Scheduled settings for visit types are the settings that are behind the visit types in the system Notice the screen is divided into sections There are the visit types section the settings for the visit type the hourly start time and the time blocks Schedule Settings isit Types ET Close H Save oP Add Mew visit Code Remove Visit Code e Provider Settings dap Other Vist Types Settings tor WABO C Show All Types P I Code aco Minutes eo Description BO MINUTE MASSAGE G
163. at check Follow the instructions on posting a carrier payment for posting a check NOTE If checks come in at end of business on Friday log the check through the carrier payments screen and do not apply the check Once the check is logged it will show up on the collections report Published 1 6 2009 Page 202 of 248 Reference Manual Clearing House Balancing ZirMed Phunkey Incorporated uses ZirMed Clearing house for its electronic financial transactions Here are the key features and benefits of using ZirMed e When you process your claim batch it will be up on their website within 15 minutes e When they receive the batch they show initial rejections on the web site within minutes e All non rejected claims go out instantly to the carriers e 90 or more of claims will go directly to the carriers not through any other clearing houses e The more efficient carriers show rejections almost immediately seconds with some with feedback e Payment from most carriers through ZirMed average 3 to 7 days Medicare and BCBS still taking the longest e Rejected claims can be fixed directly on the web site and instantly resubmitted no more delays e The Claim edit ability can override ANY setting even the quirky changes by Medicare e ZirMed has 165 Customer Service Employees e ZirMed s web site shows the batch that was sent the total of claims and the totals to confirm receipt In addition to claims management ZirMed pro
164. at is used for communication from Phunkey Please make sure that ALL users have an email address If they do not currently have an email address then please obtain a free email address from Google Restart Account Assistant EDE Password This is the password that is used to My nio open reports that are emailed to you from Phunkey This a EEEE password can be reset at anytime If you forget your ae hmartin phunkey com password then go into the settings tab and re enter the EDE Password pete password and email the report again New Patients Account Prefix This can be used to set a prefix before an account number to designate a specific location For example Phoenix patients might have New Patients PHX as a prefix A prefix is NOT required If there are l RR multiple offices sachets patient lists sometimes it is i a i Bak nice to see PHX100001 and TUC123111 so you can Next Account 106010 aa quickly identify which patients belong to which location PHX or TUC Next Account This is the where you set up your Next Account for new patients This number follows the Prefix if you have set up a Prefix The binoculars will take you to a list so you can select next available number Published 1 6 2009 Page 22 of 248 Reference Manual Patients Number of patient diagnosis codes This defaults to 8 If more than 8 diagnosis codes are needed per case change the default value
165. at the Prev Pmt box is pink This is to notify you that a payment has been applied to this charge Click the next to the charges function flag and the payments will be displayed Date Last Mame First Mame Acct Total Allowed Paid Adj Balance Prey Pmt Applied EA 1 Je 09A 7 2008 DICKSON GREG F SNOOODS 65 00 0 00 0 00 0 00 10 00 55 00 0 00 Charge Total Allowed Paid Balance Deduct Adj Pat Resp Prey Prt Chg oP Bil To Status It is imperative to understand the flags that are seen on this screen These are situational flags When the charges are listed in the grid the first level is the visit functions flag When the is selected next to the visit the blue flag will appear This is the charges function flag Click the next to the charges function flag and the orange payment functions flag will appear Clicking on the flags will bring up a functions menu Visit Functions tr Ctrl 1 Zero Out this Visit s Charges Er Ctl 2 Copy Previous Auto populate from last similar entry E Ctl 3 Auto populate amounta from Carrier EOB Settings a Ctrl 4 Auto distribute x Ctrl 5 Remove Visit P Ctl 6 Adjustment Hote z Ctrl 7 Enter Memo Ctl 8 Resubmit this Visit s Charges Ctrl 1 Zero out defaults If auto default populate was on will zero out Ctrl 2 Copy Previous from same CPT codes Takes the previous allowed paid adjusted Published 1 6 2
166. atient as signed in follow the below instructions e Find the patient on the schedule e Find the clock on the left hand side of the screen this clock means that the appointment is pending e Double click on the clock and the clock changes to a check mark this means that the patient has now been signed in Published 1 6 2009 Page 138 of 248 Reference Manual If the appointment time has passed then the clock will disappear this means that the appointment is no longer pending so the appointment has to be signed in using the following Steps e Click on the wand e Click the sign in button e The check mark will appear and the appointment is now signed in Marking a Patient as a NO Show All appointments that are true no shows need to be marked as a true no show What is a true no show A true no show is a patient who is on the schedule when the clinic opens in the morning and who does not show up for their appointment If they do not show up for their appointment then they need to be marked as a No Show It is important that this be completed so your stats on the Snapshot Reportare accurate To mark them as a no show follow the instructions below e Find the appointment that you need to mark as a no show e Click on the wand e Click No Show This will mark the appointment as a No Show Published 1 6 2009 Page 139 of 248 Reference Manual Cancelling an Appointment Appointments can be cancelled whenever they are n
167. atus 2e Delete Patient Status T X Code s ae Carle Deserintion FZ Ossotnon selai Cy e hoem T Transiert e Click the Add Patient Status button goo Settings ls Service Types IE Cai dP Add Patient Status Ed Delete Patie vx Code Description ahs e Enter a code This is a code for the Patient Status e Enter a description This is the description of the code e Click Save Published 1 6 2009 Page 46 of 248 Reference Manual Referral Sources Understanding and Adding Referral Source Groups and Referral Sources Referral Sources are a way to track how patients hear about the clinic Referral source groups are a way of organizing all of the different sources that are in the database Referral Source Groups Description the description of the referral source group Adding a Referral Source Group e Click Utilities Calculator F6 Support Log Of P S m Setup ez User Manager D Inventory o Schedule Settings For Visit Types Schedule Settings For Providers fea Scheduler Open Today Tab Schedule Appts I Restart Account Assistant e Click System Setup SSS SSS ae F Utilities Calculator F Support Log Of ie System Setup if Us Manager te Inventory e Click Referral Source Groups Tab on Published 1 6 2009 Page 47 of 248 Reference Manual gt e Click Add Referral Source Group ge Add Referral Source Group ie Y e
168. atus codes and what they mean e RS Rescheduled for future appointment e NS No Show no communication e SI Signed in e CW Cancelled Will Call If the visit was rescheduled then it is not a No Show A No Show is for a visit that the person did NOT show up and did not call to reschedule Co Pay 100 in co pay means cash patient Co pays are entered into the patient screen in the Account Assistant The co pay should NEVER be 0 00 it might also be a percentage meaning that the patient owes a of the bill Cross reference the co pay with the Payment Field THIS IS CRITICAL if there is a co pay listed and no payment then that money was not collected not entered or stolen If a co pay was not collected there should be a notation in the Special Instructions field in the patient screen so that the next time Encounter Forms print the front desk will know that a co pay does not need to be collected Charges look at the charges you normally perform similar services for each client it should be noticeable if there is a missing charges The person who does the billing should know any special nuances about what can be billed to the different carriers You may need to cross reference the Encounter Form insurance carrier memo or the Insurance Bible Diagnosis Codes make SURE that you have diagnosis codes entered ALL PATIENTS INCLUDING CASH PATIENTS should have diagnosis codes They are too important for marke
169. available by clicking on the Appled Payment orange flag Fa Edit Payment Se Go to Insurance Check af View in Patient Ledger Edit Payment Takes you to the payment that was applied to that charge and allows it to be edited Got to Insurance Check If payment was a primary payment then it will take you to the insurance check View in Patient Ledger Moves directly to the patient s ledger Once the charges have been selected you will be taken back to the screen where the payments are entered From this screen move the mouse to the grid below stopping on the primary account number Once the focus is on the primary account number hit the enter key and the charges will drop down for the patient Tab over and enter the Allowed Paid Deduct and ADJ amount Continue hitting the Tab key to move to the next charge The tab will then take you to the next patient Hit Enter again at the account number Hit Tab and you will move to the next set of charges until the whole check is applied Note When posting a check ChiroMagic requires the payments be posted at the charge level for statistical purposes Posting payments at the charge level empowers clinics to know what services they are getting paid for If you choose to distribute payments and post them at the visit level your payments will NOT be included in the regional numbers for statistical purposes Note As the check is being applied notice the applied line moves as the
170. ay next to the right of the File prompt 5 Click GO f Fi M d ZirMed Training Account 5076 ZirMed Trainer Log Off 1r Account Prof Claims Inst Claims Remit Eligibility Friot Services Patient Statements lt Pay FaPoy Help Contact Us Customer Support Center Survey Claims Batches Mame Matching Providers Reports Enrollment Pavers Coding Tools Settings Upload a New Claims Batch Batch Upload Status Multiple Sr e Search Batches Batch Name 00000 Submission Date s 6 Months i Specify e BatchID Batch Status Format include Hidden Geach Displaying 1 of 8 Batches Page 1 Submit Date Batch Name Processed BatchiD Format User Submitted Processed Charges Rejected Discarded Status Offs 2007 medicare claims Zirkle 1 1 60 00 0 Processing complete More 3657097 2ndary PRINT 1 10 Proprietary Information 6 A pop up screen will appear describing the status of the upload process Do NOT exit from this screen until the process is completed doing so will cause the upload to fail 7 Once completed the File Upload screen will display showing the File Name Size and Batch ID 8 Click on To upload another batch click here 9 The new batch will be displayed in the Claims Batches section lower portion of the screen 10 Verify the accuracy of the number of claims and the dollar amount If you suspect all claims were not uploaded please contact Customer Support Note
171. ay or may not have Account as option If you are an account that is set up as a parent child then Account will be an option The default is blank so you must enter an Account number if you wish for one of your filters to be Account o If you are unsure of the account number then click on the eyeglass icon e Payer The default is blank so you must enter a payer if you wish for one of your filters to be Account o If you are unsure of the account number then click on the eyeglass icon e Billing Provider Default of blank so to filter with this option enter the Billing Provider you wish to filter on e Rendering Provider Professional Claims or Attending Provider Institutional Claims Default is blank so to filter with this option enter the Rendering or Attending name you wish to filter on e Facility Default is blank so to filter with this option enter the Facility name you wish to filter on e Submission Source If you wish to filter on Submission source use the drop down to choose the source The following are the sources to choose from Proprietary Information 33 All default Batch DDE Real Time Resubmits O O O O Submitting your report request Once you have chosen the criteria you are ready to submit your request e Generate Report If you choose this option the report is generated in a new window e Download CSV If you choose this option the report is generated in Excel Rejected Claims Dashboard This
172. ayment record Clicking the next to the payment will give the user the charge that the payment was applied to If the users click the orange flag there are payment functions that are Applied payment functions that become available as well again the applied payment functions are different for the patient payments and the insurance payments Applied Payment Functions for a patient payment Applied Payment Function e Edit Payment This allows the user to edit basic information on the insurance check gp Edit Payment i Unapply Payroent e Unapply Payment This function allows the user to unapply Ja Go To Charge 1176 the payment if it was applied to the incorrect DOS Once the payment is unapplied the user can then attach the payment to the correct DOS e Go To Charge 123 This allows the user to go directly to the charge for that payment without having to scroll through the list of charges on the charge tab Applied Payment Functions for an Insurance payment Appled Payment Functions e Edit Payment This allows the user to edit basic ge Edit Payment information on the insurance check Be Void Payment e Void Payment This allows the user to void a Camer Refund for KAISER KAISER PERMANENTE payment that has been entered into the system fb Go To Charge H199 Payments CANNOT be deleted They have to be voided e Carrier Refund Allows the user to do a carrier refund this was created so if an insurance carri
173. be in different groups because the payers names are not spelled exactly alike Below the Un Matched Payers section are the buttons you will use to tell the system how to match the claim To Name Match a Payer is 4 easy steps 1 Highlight the Un Matched Payer name in the section on the right 2 Search for the correct Payer in the section on the left 3 Click in the circle next to the Payer s name Click Match to Selected Payer located on the right below the list of Un Matched Names Proprietary Information 25 f ze d Log oft ZirMe Account Prof Claims Inst Claims Remits Eligibility Print Services Patient Statements lt Pay Leads Admin 4Poy Help ContactUs Customer Support Center Survey Claims Batches Hame Matching Providers Reports Enrollment Pavers Coding Tools Settings Payers 42 Billing 42 Pay To Rendering 42 Facilities Referring L Include names that no longer have held claims History Supervising Ordering Primary Care Purchased Service Held My Un Matched Payers Payers Matched To Paper Name Contains healthlink 2 Starts with Search 1 BLUE CHOICE 29 BLUE CROSS BLUE SHIELD System Payer Name Payer ID Delivery K Healthlink HMO 96475 Electronic 2 MEDICAID Heatthlink PPOMational Capital Preferred Provider Organization S0001 Electronic 9 MEDICARE NCPR A Match to Selected Payer Match to Paper Discard Claims lf the Payer s name does not appe
174. be reinstalled If the applet Published 1 6 2009 Page 17 of 248 Reference Manual does not appear then the program needs to be installed and the workstation rebooted Please note you should not be connected to Phunkey during any installation or reinstallation of the Print IT Client software e The existing installation of EOL was not removed during the installation of Print IT e Uninstall Print IT and the EOL Universal Printer Then install Print IT again and reboot the computer Nothing prints This can occur for several reasons e There is a problem with the communication between the customer computer and the printer e Try printing a test page from a locally installed program to ensure communication between the client computer and the printer If the test page does not print please address this with your local support e An extended feature of the Print IT Client is activated e When connected to Phunkey right click the Print IT Icon in the system tray these icons are next to the clock in the lower right hand corner of the task bar and ensure that the Apply additional printer properties setting is not checked Report prints strange characters This typically occurs if you use the Alternate Print feature on Phunkey reports With the implementation of the Print IT Client Alternate Print should not be used Report prints like microfiche This is typically caused by two things e Print resolution is set inappro
175. being worked on The memo will be displayed in the history of the charge 1 1492008 03 33 Pra Memo by hmeartin Spoke to Holly about this charge View History 11411 2008 05 04 PM This function allows the user to view the history 10 31 2008 12 39PM Billed by traing 45 00 billed ta KAISER PRI ED of the charge History includes when the charge 10 50 2008 01 10 PM Payment entered by traing Patient Payment CK of 5 00 applied was billed if the diagnosis codes have changed 10 30 2008 01 10PM Charge created by traing 98940 CPT 99940 1 unit 45 00 Payment entered by traing Patient Payment CK of 40 00 applied 1OS0 2008 01 10 PMi traing Diagnosis 72210 was shown at position 2 1002008 01 10 Phi traing Diagnosis 7391 was pointed at position 1 on the charge any memos that have been entered on the charge as well as payment information Published 1 6 2009 Page 106 of 248 Reference Manual Payments Tab The Payments tab shows all Payments Adjustments and Write Off s that have been made for a patient Notice the different color of the flags If a function flag is green then that means that the payment is from the patient If the function flag is yellow then it means that the payment is from the insurance carrier Notice the different colors in the Avail Credit column the orange box means that this was the original payment for the credit The yellow boxes mean that the patient has available credit left on that payment that was ma
176. blished 1 6 2009 Page 83 of 248 Reference Manual gt Gender This is a REQUIRED field Indicates whether the patient is Male or Female Use the arrow keys to move between male and female on the keyboard and the space bar will select male or female Employment Status Indicates if the patient is employed The default is employed You can overwrite the status when entering or editing a patient Marital Status Indicates if the patient is married The default is married You can overwrite the status when entering or editing a patient Emergency Information This is the emergency contact for the patient Enter the patient s emergency contact and phone number here Contact Name The name of the emergency contact Emergency Information Contact Mame MATTHEYY MARTIN Relation SPOUSE Phone 555y111 2222 Relation The relation of the emergency contact Phone The phone number of the emergency contact Marketing Information Section This is where marketing information is kept This section changes continuously as new marketing information is added into the system Email This is the email address for the an Marketing patient Itis important to get an email E Email holly homatt com address from the patient so the clinic can e p h h ti t It a cant Referral Source Fe HEMT REFER RAL Fa communicate with the patient t is important petemngpat snooooza
177. carrier ledger Enter Memo Allows the user to enter a memo for the charge View History Allows the user to view the history of the charge all activity that has happened on the charge Published 1 6 2009 Page 99 of 248 Reference Manual a Here is an example of the charge functions that are available for a charge that has been billed to an insurance carrier Take Charge off Hold This allows the user to take the charge off of hold Edit Charge Allows the user to edit the details of the charge E a e l Enter Patient Adjustment This allows the user to enter a patient Di adjustment o B Enter Patient Adjustment Write Off Balance This allows the user to write off the balance t Wiite Dit Balance Void Allows the user to void the charge a Vor af Goto camer KAISER Go to carrier This will take the user to the insurance carrier for the View in Carrier Ledger patient Enter Memo E View History View in Carrier Ledger This allows the user to view the charge in the carrier ledger Enter Memo Allows the user to enter a memo for the charge View History Allows the user to view the history of the charge all activity that has happened on the charge If there is a to the left of a charge that means a payment adjustment or write off has been applied to that charge Click the next to the charge and the drop down appears with detailed information about the payments adjustments and write
178. ccepted by Zirlled Edit Mote More 4 26 07 Resub JOHNSON JOHN Administrators 87815 Available search options in the More View Click More in the right corner by Search e Sequence 1 Primary 2 Secondary or 3 Tertiary for the last instance of the claim e Source The Source refers to the origin of the claim Batch The claim originated from a batch upload DDE The claim originated from a direct data entry claim Real Time The claim originated from a real time claim e Status From the drop down you may choose any possible claim status e Trans Date s This will let you customize the Trans Date if other than 6 months or 2 years Enter any date range needed Note this date range will override any date appearing in the dropdown above e Hidden Only To display only those claims that have been hidden by the user check this box Proprietary Information 14 f 4irMed Training Account S076 karen craigmyle Log Off ZirMed Account Prof Claims Inst Claims Femits Eligibility Print Services Patient Statements Pay F4Poy Help Contact Us Customer Support Center Survey Claims Batches Mame Matching Providers Reports Enrollment Pavers Coding Tools Settings Search Claims Rejected Claims Dashboard Old Claims Screen User Preferences Specify Claim Overrides Rejected Only above Overrides Trans Dates above Displaying 1 30 of 64 Claims Claim Humber Patient Name Service Trans Date Rendering Provider
179. company Formatting Options Section Use the Guarantor address information if available If this box is checked then the statement will print the Bill To information with the guarantor s information Show charge level detail If this box is checked then the statement will give detailed information about the charges that are on the statement Show Patient payments If this box is checked the statement will include the patient payments information Ledger Options Section Show accounts with a zero TOTAL balance If this box is checked then the statement will print statements for patients that have a 0 00 total balance This means if the patient has a 100 00 charge that has not been paid but the patient has a credit of 100 00 that has not been applied then the statement will still print Published 1 6 2009 Page 186 of 248 Reference Manual Payment Options Section Show Payment Stub If this box is checked then the statement will generate a payment stub Show Credit Card information area If this box is checked the statement will display a credit card payment stub Show MasterCard and Visa Will display MC and Visa on the payment stub Show American Express Will display American Express on payment stub Show Discover Will display Discover on the payment stub Published 1 6 2009 Page 187 of 248 Reference Manual e s Example of Patient Statement IN MOTION CHIROPRACTIC Account Statement Dae 1
180. count Assistant Calculator F6 Support Log of m Setup Published 1 6 2009 Page 73 of 248 Reference Manual e Click on Schedule Settings for Providers Utilities Calculator F6 PE System Setup i User Manager Suppork Log to Products and Services Schedule Settings For visit Types fe Schedule Settings For Providers r e Click on the Provider in the list stare AvaLASLe STAFF gt Make sure the check box Active for Scheduling is checked Options Active for Scheduling m e Uncheck the override color to allow visit colors to show Override Color e Select the days of the week to schedule by clicking boxes Iw tio fv Tu i we ff Th I Fr Sa e Click fill Fill Published 1 6 2009 Page 74 of 248 Reference Manual Setting up a Provider such as Massage Therapist who works special hours e Click on the Utilities ee To A tilities or F6 Support Log Of Calculat 5 m Setup User Manager Inventory Schedule Settings For Visit Types Schedule Settings for Providers Scheduler Open Today Tab Schedule Appts G il GEB COB Na Festart Account Assistant e Click on Schedule Settings for Providers Utilities Calculator F6 PE System Setup pa User Manager Oo M Suppork Log Th Products and Services Schedule Settings For visit Types Schedule Settings F
181. d you will be able to access Phunkey For support email support phunkey com Published 1 6 2009 Page 15 of 248 Reference Manual Setting up the Printer To print from ChiroMagic you have to install the Universal Print Driver PrintIT This print driver prints to your local printer Whatever printer is set up as your default printer on your local machine is the printer that CHIROMAGIC will use to print Please follow the below instructions to install the Universal Print Driver The print driver must be installed for all Windows user names e Go to www ChiroMagic com e Click on the Print Driver Update link Universal Print Driver v5 9 in the top left hand corner e Save it to your Desktop e Once Downloaded close the Internet browser and go to the computer desktop e Double click on PNUPCLILEXE e Follow the wizard e Click Next e Click Next This needs to be done for all computers that need to print from CHIROMAGIC The print driver should now be installed When you log into CHIROMAGIC for the first time after you have installed the print driver you will be prompted for an updated version of the print driver Click yes to start the download and follow the prompts This requires a reboot You only have to do this one time Once you have completed the update you are now ready to print from CHIROMAGIC Print a test page from ChiroMagic to confirm that you can print Published 1 6 2009 Page 16 of 248 Reference Manual
182. dd Marketing Category e Enter a code Code TURKEY 08 Description Turkey Promotion 20008 e Enter a description Code TURKEY08 Description gt Turkey Day Promotion 2008 e Click Save i Settings I gt Sane Types X Cancel A Save dP ddE Y Published 1 6 2009 Page 54 of 248 Reference Manual Calculator F6 oe System Setup User Manager Products and Services Module 3 Products and Services l Schedule Settings for visit Types From the Utilities menu on your CHIROMAGIC desktop select Products and Services F Schedule Settings for Providers mH Scheduler The following screen will appear with the tabs Items Categories Tax Fee ae Schedules and Receive Product Aa Schedule Appts Restart Account Assistant Account Assistant Inventory fen A Ra H 2 9 E f CEW a New Pat F4 Claims F8 Reports Billing Utilities Applications Calculator Support Log Off Patient Search CO O O i 5 Close x Refresh Reports dh Add Item OK items le Categories f Tax I Fee Schedules E Receive Products Services and Products Screen Items Tab This is where all of the CPT codes Services and items Products are created This is where pricing is created for all items in the database Before items can be placed into a category or sales tax assigned to the item the item must first be added into the list An Item is either a Product OR a S
183. de Once all of the credit has been applied then the box will turn orange The Ref No is the number that the user enters into the system this is typically a check number The Entered column is the date and time when the payment was entered into the computer Charges Payments Balance Totals and Aging oided Charges Voided Payments Claims Payment Date between 1072072008 gt and 1119 2008 Last 30 Days Pomena oae _Wathod _ amoure Alea aval cre rero Ne AEEA E E TE NN EC AE asa E a e a sajas homs preo 20 20 000 17225545 check fe 112234455 Wom KASER REFNO eran 103R T023 AN IDE A iDTTOAM sala pom e oof 1000 E C E sala poeme e to000 2500 e rr 085 fe ze roneaes raraoy 1000 tooo ogo Wesco r 0 HA Jeja poeme ca ao 2500 a a Jeja pome ja 2500 o o o Sr 082 TE E ooo ite 2082 Jela hemja so so ono Yr TOE E E E ite 02 SDE fem soo E e i rr 2a 200fromrraooe E 500 oof asa rimeaooa_ E e E PY E DAE E E ogo r E JA a em E E E S Yr Published 1 6 2009 Page 107 of 248 Reference Manual If there is a next to a payment clicking the plus will display the charges that the payment has been applied to RR103575 KATHY MORALES Test 2 Close H Save t Utilities F B Patient Information IE Case Information le Insurance lE Diagnosis Codes BA close g Refresh Ledger Date Range osmscons to osmano Last Charges Payments Balance Total
184. dsheet You can highlight numbers to work on make notes or even generate graphs Report Calculations Charges A total of the gross claim charges Collections Payment Date The day that you specified as the payment date during Carrier Payment Entry or Patient Payment Entry Collections Payment Entry Date These are payments entered into the system during this date range You may have entered payments this month for previous payment dates which do not figure into your true collections bank statistics If you ever see this number change from a previous period it is due to CREDITS being applied to a previous period after the date passed 12 Month Adjustment to Gross This goes back into history and calculates all of your payments and claims and figures out the normal write off of claims This is a quick calc number to help you manage your cash flow If your Adjustment to Gross is 40 and you bill 80 000 a month then you know that when all is done your collection department should have collected around 48 000 for the month A R as of Today This is your A R as of the day that you run the report Even if you run your Snapshot Report for end of last month the A R figure is as of today Going back in time to calculate A R is very difficult and inaccurate AVI Average Visit Income The total of your bank collections divided by your patient visits for the month Historical AVI The total of your bank collections for th
185. ducts and Services Module ss ciscsiecccsessdaccatacocccasssaacssrasoccsaaasscasasesccasdesscsacaniuccssasoscuaassuecsasaenedsasssiuccsaasess 55 PECTS WAG Giese cada vaaganseassadadouadyassoqnanasdoundiqaiesaesgsosaaaaceGascosa A A E EE E E 55 Adding or Editing Services and Products nnessessssssseeeseeeeeteeresssssssssssssseerreeresssssssssssseeeteeeeessessssssssseeeeeeeeesesssss 56 Ca S T a E E E E N 56 Grid Expansion and sseeeneeeesesssssssssrsreerresssssssrereecerreeeesssssssssnsseeerereeesssssasseneseereteeesssesssssnseeetreeerressssssseeseeerenee 58 T Te E E EE E E EE E A E E E E 58 FSS CC due eee E E E E E E O E 59 Receive Produc TaD ceruse tenips niied iee Ennet iiet Caaan a REES PEE aa EENE EEEE NA O 6l Services and Products Received Progress Report ccccccccceccceceeeceeesseseeseeeeeceeeeeeeeeeeaaaeaeesseeeeeeeeeeeeeeeeeaaaaaaeeseees 62 Set up Pricing for Products and Services ccccccccssssssssseeeeeecceeeeeeeeeeaaeeesesseeseeeeeeeeeeeeeeeeeaaeaeesseseeeeeeeeeeeseeeeesaaaaagaaeses 63 Editing Pee Schedule Pricing iis ioc teasncwcesssranadedradoavcubavineddentanscewalenadebeadawsnssaideentnssionedanndonee Te AEA aTa O aaa aia 64 PS WUC EE e A E E E A E A A A E E E E 64 Services and Products Item Grid Expansion ccccsssssssssseeecccceeeeeeeeeaeeaaaassesseseeeeeeeeeeeeeeeeeaeaeeesseeeeeeeeeeeeeaaaaaaeensees 64 Live ltem Active and Enc PICs sss sdensssiatainwstinndieysinulen vvtnVeoneben edi unSeu
186. dustry is in a state of disarray Some carriers have switched over to the new standards and some have not Some of the carriers have switched over to the new standards and gotten them wrong for example date formats are incorrect to the national specifications and they are rejecting claims And then most importantly you have Medicare Medicaid and Blue Cross Blue Shield who have different formats in EVERY state In some states like California there are multiple BCBS s and are all different formats Where this comes into play is the FIRST office in each state that we deal with is like walking into a dark room having no idea what will happen Our only weapon is to KNOW that something is going to go wrong and be aggressive with the insurance carrier to confirm integrity of the submitted claims whether paper or electronic Also please know that the formats for Paper versus Electronic claims are COMPLETELY different so electronic could be perfect and paper could be wrong NPI Numbers Do you have your Type I and Type I NPI Numbers If you need to apply for an NPI number Type I or Type II please go to the following website https nppes cms hhs gov Type II NPI Numbers The first thing that we want to share with you is something common that we have seen when becoming a member of ChiroMagic If you have incorporated then you have been assigned a Type II NPI number This is a clinic NPI number that will be assigned to you by Enumerator
187. e Mo Sh Wo Last Name E riei Fendi W First Name E enon 2 Appt Status M C l Remember that the show field will display the information on the report if the show field is not checked then the information will NOT be displayed on the report The Criteria field allows the user to select specific information for that field e Select the Criteria e Click Run Report The report will be displayed Close 2s Criteria Email Spreadsheet Bs Print Charges 301 records FirstName Charge Date SNOOOO2 Loy o AMBER o 3 fi CHRO 10A 52007 i 97012 fe CHRO 1047 2007 98941 F in i gp H i SNoo004 EE MILLER P 1 SNOOOOG gt BENDER CRAIG g CHRO 10222007 989 1 6500 6500 oOo 85 00 SNOO0O2 gt LOVE AMBER 2 CHRO 10222007 9894 1 6500 85 00 oOo 85 00 ARIANA rb Lovee SC MAFA 5 ih CHIR TS Ankeny ee 4 A A a7 nn nan a7 nn Notice at the top of the screen that the user has the ability to email the report in a spreadsheet to their inbox or print the report The function flags are live on all of the reports so if the user sees a blue function flag then they can go directly to the charge Published 1 6 2009 Page 228 of 248 Reference Manual Charges Report Charge reports are designed to allow the user to view the charges that have been entered into the computer The criterions that can be selected are very detailed Remember that the user has the ability to view as much detailed information as needed on charges that have been ente
188. e payer s acceptance policies For a minimal fee ZirMed can arrange to have your claim printed and mailed to the payer View using Old Form ns cenarwuer Lies amure OT a MOT 1000 REATWEST DF TNE a FEMHETT HO 63857374 Fra HEALTH MSURANCE CLAIM FORM Pea TIE HEHE EJ PFE H TFH T 9951139990 __ u F E3 Se H eel 1 iH TH r BES SE T 130 FAHZOH TRACE a i 130 RAHBOH TRACE Im in LOUISVILLE FLERSSS6 phe Se cel OF COTE TE EHH FHL FIFA Ce B02 gegana o p ee ae SA ___ Soa geaoo22 EIEEE i FaF CaS RAFF S OH PFE 2 OS ILS ES HETH eet A b ANE A EHT EEF Plea mle HESA H ETOH T A E l Proprietary Information 21 COMMON REJECTIONS amp RESOLUTIONS Enrollment Rejections CLAIM REJECTED BY SECOND EDITS BILLING PROVIDER NUMBER REQUIRED FOR ENROLLMENT WITH ORGID xxxxx FOR DESTINATION xxxxx IS MISSING PROBLEM This rejection message is stating that there was not a provider number on the inbound file nor was a provider number setup on the provider screen RESOLUTION Check your enrollment tab Go to professional claims enrollment you should see a provider number set for the payer referenced in the above rejection message payer is listed next to ORGID Look for the number set up on the enrollment table You will want to 1 Populate your practice management system with this provider number for that specific payer 2 lf unable to populate your practice management system you may use ZirMed provid
189. e will typically be first initial and last name like hmartin e Domain enter PHUNKEY There is no need to enter your password The computer will always ask you for your password due to HIPPA compliancy e Next click on the Display tab to set your Screen Resolution to Full Screen and Colors to 256 Colors Remote Desktop Connection Choose the size of your remote desktop Drag the slider all the way to the ight to go fullscreen 256 Colors High Color 15 bit High Color 16 bit True Color 24 bit Highest Quality 32 bit Display the connection bar when in full screen mode Published 1 6 2009 Page 14 of 248 Reference Manual Remote Desktop Connection E Choose your connection speed to optimize perfomance Broadband 128 Kbps 1 5 Mbps Allow the following E Desktop background Font smoothing Desktop composition F Show contents of window while dragging V Menu and window animation Bitmap caching Reconnect if connection is dropped comes nes ep a e Please make sure the box Reconnect if Connection is Dropped is Checked e Once you have typed in all of the above information e Click the Save As button e Change the File Name at the bottom of the screen from Default rdp to ChiroMagic e Click on the desktop icon on the left hand side of the screen e Click Save Close all of the screens and you should see a CHIROMAGIC icon on your desktop Go ahead and double click an
190. e appointment button e Fill in the new appointment date and time and hit search e This will bring up a list of all of the appointments that are available e Select the appointment e Click Schedule these appointments Multiple Booking an Appointment The purpose of the scheduler is to give you the capability to quickly multiple book appointments for a patient You can schedule 12 appointments for a patient just as easily as you can schedule one appointment To schedule multiple appointments for a patient follow the instructions below e Open the Account Assistant e Type the patient s name in the patient search box above the patient functions screen comes up e Click schedule appointment e Enter the visit code e Enter the provider who will be treating the patient if it is different from the default treating provider e Enter the appointment criteria e Enter the days that you would like to schedule the appointments If you want to schedule 12 appointments in the next 90 days then place 90 in the days to search box e Click Search e On the list click the green check marks for the appointments you would like to schedule Published 1 6 2009 Page 137 of 248 Reference Manual Note As you are checking the green check marks you will get a count of how many appointments you have scheduled when the count reaches 12 that means that you have booked 12 appointments e Click Schedule these Appointments all of the appointments are n
191. e items once the fee schedules or tax rates have been assigned to the items Clicking on the will expand the view allowing the fee schedules and taxes applied to an item to be displayed From the expanded screen you can edit the taxes or the fee schedules by clicking the status icon to the left and then clicking Edit You can also delete any fee schedules or tax rates If you delete a fee schedule and attempt to charge out the item the system will use the default price that was added to the item Published 1 6 2009 Page 64 of 248 Reference Manual Live Item Active and Enc Fields From the main item screen grid you have the ability to check on any of the Active or Enc Print on Encounter Form Fields You do not have to save this The database will be updated automatically te Inventory Searching for Items Bl cose QI refresh E Reports At the top of the Services and chee YIX Products window next to T gt tems a categories E Tax Fee Schedules le Receive Products B cription Add Item the standard search TURAIs GSs ess ee grid is displayed H J FROTI MAX MEAL REPLACEMENT CHOCOLATE Prod Enter any part of an item code or description Clear it by clicking the X or click the funnel icon to filter items How Do I print a list of all of my products and services a Close gt Run Report To print a list of all of the products and services that are in the datab
192. e past 12 months divided by the total patient visits for that same period AVS Average Visit Services The total of your charges divided by your patient visits for the month Published 1 6 2009 Page 224 of 248 Reference Manual Patient Visits If a patient came in for the day and signed in that equals one patient visit The system takes the claims entered and groups them by patient so you may have had four claims in one day for a patient who saw two providers but from a patient visit standpoint it is ONE patient visit Total Active Patients The total individual patients representing Patient Visits Prospects Chiro These are prospects who have come into your office and you have performed a 9920X examination These are automatically calculated for you each night You no LONGER have to use the short cut codes Report of Findings Chiro This is the following visit after your prospects visit that you performed any adjustment or therapy or a 99212 code There must be at least one day since the prospect date of service before it will register and it must be within 30 days of the Prospect visit That means that if you do not follow ChiroMagic protocols and do an examination and ROF and adjustment all in the same day your internal new patient count will NOT match the official ChiroMagic patient count Converted Chiro This is the 2nd visit and date of service after the Prospects visit and MUST be within 30 days of the ROF visi
193. e running 2 0 0 ccccccccsssssssesseeeeeeeeeeeeeeeeeeeeaeaaaeessesseseeeeeeeeeeeeeeeeeeeeaaaaaaeeaeees 208 Reviewing the Scheduler Reconciliation ccccccseseeecceeeceeceeeeaeeeseesseesseseeeeeeeeeeeeeeeeaaaessseseeeeeceseeeeeeeeeeaaagaagasenes 209 Balancing the Diaw einemi A EEEO EEA SEO EE E EA AEEA 210 UT RCT BIN Soaps EE EEE EEOAE E A SUAE EARTE 210 PUOLA TOOT OT aN E ENTE OEE AEE EN 211 L TENG e e sortatsers asjodluarsasitsles E E E E 1 setes6 aepeee E A waeeenk aero 211 Constant Vig Ante isser a E a E AE AREA 211 Fast Resubmit anotau iE Re an ne nN ENERE rn Te inn ere eee er ee 212 TECH OWES VICI EAE A E E EE A E EA E A E E E A E EE 213 ERCON E OLMS ii a E E E 213 Printing Daily Encounter Forms cccccesessessseeeeeeeeeeeeeeeeeeeeeeaeeeeeseeeeeeeeeeeeeeeeeeeaaeeeeeeeeeeeeeeeeeeeeeeeeeeeseeeeeeaaaaaaaeasses 218 Printing an Encounter Form for a Single Patient 2 0 00 cccccsssssssssssssseeeeeeeeeeeeeeeeeaeaeesseseeeeeeeeeeeeeeeeseeseeaaeasagesaees 220 Snap Shot REPOT ac ssesis es escitanconsetececectsiecenesdicivvsduiaconstidsomicessesanobidecaielanacenstadsesisssdanreldistndsiuixeesstadeasusssiessieks 222 Main Snapshot REPOS ClO Sis sirosis eeir iaeaea ae Anr Neaken E Aip Eana Eea aaka eai EEEa 223 Report AIC UN AUIS c sascatcaseenaneeu iesene EER ERE i ee EE EEEE N E EEOAE 224 Daily RODOS aenar E E A E E E E OE E 227 C barots Kepol eaire eE aae a n NENONEN oE o nE EEEE a 229 Cole Nons REDOT Siir TE E ERE 231 ACCON LCC
194. e the Wand which allows you to do anything for that patient like schedule appointments print a statement or look at existing claims To add a new claim into the system click the Add New at the bottom of the screen or ALT A Notice at the bottom of the screen that you have a Copy Selected option The purpose of the copy button is to allow you to copy an existing date of service without having to re enter the charges from new This feature is wonderful when you have a patient who 1s on a calendar and has the same procedure done every day That way you do not have to enter a new charge every time Enter the Procedure Code and hit tab You cannot proceed until you see the description for the charge in the description box Units Change units here if needed Treating Provider This is the doctor who treated the patient This will pull the default information from the patient file You can however overwrite this information here if needed Billing Rendering This is the doctor name that goes on the HCFA form This will pull the default information from the patient file You can however overwrite this information here if needed Published 1 6 2009 Page 129 of 248 Reference Manual Referring Provider This is the Referring doctor for the patient Remember that if they do not have a true referring doctor then this is equal to the rendering doctor This will pull the default information from the patient file You can ho
195. eauticsctnana ite dententecma binds owiaces E SE 183 StS C0 fe B circ Peeeeerenne nt tee ct nen nn erent cnet te Mr E een errr Rte er creer eer rt arte rt Tre er rere cer re mere 184 SSE ALCTIIGIIS E E E E E EE O E E 185 ICUS LACE le Her Sc CLIO inienn E EEE scoss ane aeesnsndnsee ees 185 SPACE ment SeN OS bc craassavevacsseveatonetenenedcsangonstecuanendeatenexaenossuerwaandecneandiudioqorsceuewttuermessdianaeoiemaepeuencsoisveuaesdeanetentadioen gt 186 POE Ss SCI Wis 15352s2535squdonsanaaaago E E E EAEE 186 Formatting OHHO SECU ON eirese oeo aa aai 186 Ledger Options SC CHOM iesacecenecescesosascvernoassianacenctesovenwsdueveiteesmunnssaserensveiSanasveuecesiaier Paen icara PiN En raS Perei SAT TUSEA NER eeik 186 Payment Oplions SCCHOM sereireicsrincrescmnidsrupi ie eeen aei e Enaria NE a Cae Eanna ren aen iCare iir Eekan aT EESE cacetendvetouene 187 Example of Patient StATCMMEML s c cevorcsvnnssnenarhon rrenen aeea aE Ra Ease EEN EEEa EEEE EEN EEEN EAn EEN ENEE Nean Raa 188 Location Ledger Using and Understanding the Location Ledger sseecccsssssceccccosssseceecosssssceeecosssso 189 Charge Review Using and Understanding the Charge Review eeecccssssscecccccsssscecccccsssssccecosssssssee 190 Published 1 6 2009 Page 5 of 248 Reference Manual Using the Charee IRC FC a ser claapra darscivarse es Saapdecnasaiclveselnapna danaisani eas aea Ead E aA ETENEE CENTENA E aE sep ernia ene 191 PaA A EE a a OE EEE E E E 19
196. ecific claims to bypass the CCI and or LCD NCD edits and pass to the payer as you submit When this is the case you may add an exception so a claim will bypass the edits Once you have added an exception you may remove it at any time e From either Professional or Institutional claims tabs choose the Coding Tools tab then the Exceptions tab It is very important to remember that you must remove exceptions specific to either professional or institutional claims e Find the exception you wish to remove by utilizing the search bar to search for the specific exception you wish to remove e Once you have located the exception you wish to remove locate the action column of the display and click on the Remove link e Once you click on the remove link you will receive a confirmation box which will display o Payer associated with the exception you are removing o All procedure codes associated with the exception you are removing o All diagnosis codes associated with the exception you are removing o The modifier associated with the exception you are removing o The service dates associated with the exception you are removing e You will be asked if you wish to proceed with removing the exception o If you do you MUST click on OK o Ifyou do not you MUST click on Cancel and this window will close and you will return to the Exception screen Researching a CCI LCD or NCD Rejection If you have a claim s that have failed to pass CCI
197. ection and the Local Use Box19 section The Diagnosis Codes Section This is where all of the diagnosis codes are listed for the case that you are entering the charges for Here you will see what diagnosis codes are listed for the patient It is important that you understand the difference between the red check mark and the green filler box Red Check Mark lf the box to the right of the diagnosis code is a red check mark that means that the diagnosis code will be pointed to Ea A S Green Filler Box If the green filler box to the right of the diagnosis code is filled with a green box it means that the diagnosis code will print on the HCFA form but the charge will not point to the diagnosis code To add a diagnosis code to a case and charge follow the instructions below e Click the Diag Codes button at the top of the screen When the diagnosis codes screen opens the default case diagnosis codes will be displayed Published 1 6 2009 Page 148 of 248 Reference Manual 8 Diagnosis for SN3 HOLLY MARTIN Sandusky9 Close lA Save EJP PERSONAL INJURY e Click in the box with the Magnifying Glass e Enter a portion of the diagnosis code or the actual diagnosis code and click enter e Select the diagnosis code from the list and click ok e The green arrows allow you to move the diagnosis codes up and down in the list e Click Save at the top of the screen You will then be taken back to the charge detail screen
198. ed 1 6 2009 Page 85 of 248 Reference Manual e Stats This is where stats for a patient are quickly visible First Visit Date This is the first visit for the patient The first time a charge was entered into the database Notice the three dots to the right of the visit dates These are here so the user can Last Visit Date 1448 2008 es override this information if needed The reason a user Stats First Visit Date TOO nan TI i i _ i YTD Wists 2 might need to override this information is if a database conversion was completed for the clinic Future Appts E l _ Next Appt Date 11 20 2006 Last Visit Date The date of the patient s last visit s A charge had to be entered into the system for this to be populated Notice the three dots to the right of the visit dates These are here so the user can override this information if needed The reason a user might need to override this information is if a database conversion was completed for the clinic YTD Visits Year to Date visits for a patient Future Appts The number of future appointments scheduled for a patient Next Appt Date The next appointment date for the patient Categories Categories are a catch all used for criteria selection in marketing or communications For example you might have a Baseball Category for a patient who loves baseball You have the ability to generate a marketing list for a patient appreciation night for al
199. ed Patient Chiro Same at Average Future Appointments per Patient but ONLY for your Converted New Patients this number should always be higher because it includes more acute pain patients rather than wellness patients Avg Charge per Employee This is the Total Charges for that period divided by the number of employees you entered in the Snapshot ReportSetup Avg Charge per Office Sq Ft This is the Total Charges for that period divided by the Office Square footage you entered in the Snapshot ReportSetup Avg Collections per Employee This is the Total Collections based upon Payment Entry Date for that period divided by the number of employees you entered in the Snapshot ReportSetup Avg Collections per Office Sq Ft This is the Total Collections based upon Payment Entry Date divided by the Office Square footage you entered in the Snapshot ReportSetup Published 1 6 2009 Page 226 of 248 Reference Manual Daily Reports The daily reports can be generated by clicking on the reports Encounter Forms F5 menu at the top of the screen and then clicking daily reports u EZ Report P Royalties Report The reports that can be generated from the daily reports are Daly Reports Account Ledgers reports that staff members will typically need to generate on a Hel cus Repani t E Appointments daily basis Below is a list of all of the reports that can be a t A charges generated from the Daily Reports tab Managemen
200. eeeseessasaasaasseseeeeeeeess 93 DiaSnOsis Code TaD E EEEE ERa 93 PST AOE Diap nosis CodeS serrera E TEE TE a a 93 Ee EEn AN E O A E E E E E A A E E A E E E A E EE 94 Diagnosis Funchon DOK era scttnrct ue aursa tee e AO EEEE EEEE 94 IN G6 ST A wxiscsesssensicsszeescsssepusdsassastessspasdcassnesteasesdsdeasssastessssedssssessssassscsdeassessesousestesnssseteassesestesasiestescesiedeseseecs 95 How do I add a new note to a patients account 000 cecccccccccccccessseeeseeeeeeeececeeeeeeseeaaaeessssseseeseeeeeceeeeeessuaasaasseeeeeeeeeess 96 MOOR AND osare EEE EE E EER 96 Understanding Charges Invoices ClaiMS sssssscecccossssseccoccsssssecccccsssssececoososssssccecoosssssceccosossssseecosssssssee 97 CHa ee TaD A E E E E E E os 97 Carre Fm o Oa A AE EE A E snane enna 99 Toke Charte on off Dold siren E N E E E EEEN E E E E EEEE 101 Edit C Daro e oe a a N E E E N E nhasauee 101 Wite OHM HUA CS ats cea dbase ae nin a cade E E E E E N EE E 104 Payments Tabeaio EEE EEE EEE OA 107 Understanding Credits and Unapplied Payments ccccccccccccsccccnssssssessseeeeeeeeeeeeeeeeseaeeaessseseeeeeeeeeeeseeeeaaaaesaesnses 109 Balance Tab oc seacisescenctdecccncssnacesssaessessissascndsdecsunssaaacuacsasescnceassesdsssasendsiveseecsisasssesssussodiseasscuseiencuasssdessasiienseness 120 TOtAalS and Apine TAD ess ceccsecssssevecacecessssscevcescenswewsessceeseccssuasesee voces cesswavsusnsSoveacesesseussouussscuewaveeseesesssesssexesseues 122 Voided Char c6
201. efault case The previous charges that are displayed on the CEW are the previous charges for the case If the Modify Transaction 2p charge that JOu CEW C S ti j S ase Selection creen tem be it PP E NUTRITIONAL EY ALUATION want to COL 15 us 14 40 00 not listed it ee 1000 means that the incorrect case has been selected Treating Prov DEAN WASSON DC P Once the case type has been selected override the case at Biling Fenderin at ya DEAN WASSON DE F the individual charge entry level When adding in items enter an EXAM 98941 for Chiro and then add a Nutrition Bar or Weight Loss Soup and simply select the drop down CASE field and change to WL for Weight Loss CEW Add Item Case Override Understanding Entering Charges Entering charges is a very important step in using the CHIROMAGIC system If charges are not entered properly then claims will not be billed properly Remember patients have claims and claims have charges The encounter form is where the information is located for what charges to put in the system Definitions used when entering in charges Charge A charge is ONE individual service or item that was entered into the Charge Entry Wizard An adjustment 98941 exam 99201 or PILLOW for a water pillow Invoice A collection of the charges that were entered into one session of the Charge Entry Wizard Claim A collection of charges from an invoice that need to be billed to a ca
202. eferring Provider Legacy ID No box 17a x z Biling Provider Primary ID No box 33a x Billing Provider Secondary ID No box 33b Rendering Provider Legacy ID No box 24 Billing Settings This is where Billing Settinesare A eee eee ee established for carriers in the database Do not send Referring Physician in 23104 Each carrier has parameters that have to Send Ordering Physician in 2420E be followed when submitting electronic Send date range for all Service Dates claims this is where Phunkey maintains Send claims with a zero balance carrier specific settings This list is Do not send decimal places for zero decimal monetary amounts constantly changing If an EOB 1s Send Employer Name instead of Group Mame in Loop 20008 SBR received from a carrier that states the clinic is not going to be paid because it is missing information that is not being sent over electronically make a copy of the EOB and fax to Phunkey and we will resolve the issue for electronic processing within a business week Ignore missing Patient SSM Do not send Taxonomy Code in loop 20004 Ignore missing Initial Date of Treatment Ignore missing carrier Payer ID TOO Oo 1 1 a a Ts Ignore missing group number of MONE for Medicare Send Group ID and Group Name If this box is checked the patient s group ID number and the group name will be sent electronically Published 1 6 2009 Page 169 of 248
203. ejected claims tor any Batch Name Payers Matched to Paper Detail Report Remits Opportunity Report Proprietary Information 31 Claims Billing Report Replaces the Claims Activity Report This report allows for flexibility in what data is pulled F 7 d ZirMed Training Account S076 e irMe Account Prof Claims Inst Claims Remis Eligibility Print Services Patient Statements Pay Leads Admin Far Help ContactUs Customer Support Center Survey Claims Batches Mame Matching Providers Reports Enrollment Payers Coding Tools Settings Claims Billing Report Transaction Date s Columns Filters Scope O Today Submission Source account fo O O oy Include Charges O This Year Facility Last Year Submission Source O Custom From 05 01 2007 To 05 31 2007 Generate Report Download cS Data for this report is only available for the past two years Data current as of 054 5 2007 01 00 17 PM Paper claims may show as electronic claims for up to two business days after submission Scope Depending on the type of account you have with ZirMed you may or may not have Scope as option If you are an account that is set up as a parent child then Scope will be an option The default will be Domain but can be changed to Account by using the drop down Group By You may change the primary way the report will be grouped by selecting options utilizing the drop down menu The following are the choices
204. en action on Click on the payer and type combination you wish to review the history of A separate window will open which provides details arranged in reverse chronological order regarding that payer and exception type The following is the data you will have in the history Date The date the action was taken Time The time the change was made User The user who made a change add edit copy or remove Type The type of exception a change was made to o CCI o LCD o NCD e he history screen will divert at this point and the information displayed is dependant on the type of exception CCI Exception e Procedure Code Col 1 If the change recorded is the deletion of a code then the history will display as blank If the change recorded is the addition of a code then the code will display e Procedure Code Col 2 If the change recorded is the deletion of a code then the history will display as blank If the change recorded is the addition of a code then the code will display e Modifier If the change recorded is the deletion of a code then the history will display as blank If the change recorded is the addition of a code then the code will display Proprietary Information 51 service From Date If the change recorded is the deletion of a date then the history will display as blank If the change recorded is the addition of a date then the date will display service To Date If the change recorded is the deletion of a date then
205. ence the Encounter Form insurance carrier memo or the Insurance Bible Diagnosis Codes make SURE that you have diagnosis codes entered ALL PATIENTS INCLUDING CASH PATIENTS should still have diagnosis codes They are too important for marketing analysis and just an excellent habit to form More claims are not paid based on wrong or missing diagnosis codes than any other reason Published 1 6 2009 Page 209 of 248 Reference Manual e Please note that the Reconciliation report will actually show the diagnosis codes next to the CPT codes Many insurance companies and states are now expecting line level diagnosis pointing for payment e Note Make sure that you highlight the Carrier Memos on the Encounter Forms as that is where you put the higher level target coding information about what billing codes and diagnosis codes get maximum payment from the insurance carriers Balancing the Drawer e Once the Scheduler Reconciliation report is confirmed B should balance the incoming cash from mail and front desk e The RG Collections Report found in AA is the best place to see broken up by payment type code each payment brought into the office for the day e You are welcome to have your payment codes broken down by individual credit cards for easier reconciliation Submitting Billing e Once the drawer is balanced billing manager must handle billing e Billing should be done DAILY e Billing should go out by 9 30 am each Day e Yo
206. endering Facilities or Service Location Referring Supervising Ordering Primary Care Purchased Service The Provider screen is divided into three sections On the left is the window where individual Providers are displayed On the right is the window that can toggle between General Information and Payer Specific Information Directly below this section is a window where a description of the information required for a field will display To ADD a new Provider Go to Professional or Institutional Claims Providers tab 1 Click on the tab for the type of Provider you need to add 2 Click on Add New Provider located at the bottom of the Provider Display section 3 Click on the General Information tab Any information entered on the General Information screen will be applied to all claims for this Provider regardless of the Payer or Intermediary receiving them Proprietary Information 28 4 Position the cursor in the Description field and begin entering the required information The information you put in the Description field can be helpful when performing Name Matching 5 Drop down boxes searches and Custom Fields are provided to help with entering information When you have finished entering the General Information click on the Save new provider information button below this section fj ZirMed Training 4ccount 50761 Log CHE d d ZirMed Account Prof Claims Inst Claims Remit Eligibility Frint Services
207. ends The purpose of this manual is to provide an in depth reference tool In order to make your office run efficiently it s important that you have computers and an Internet connection that will support the ChiroMagic software Hardware Configuration It is critical that your hardware have a minimum of the following specifications Pentium 4 or higher In the HP AMD world Athlon 64 or higher Windows XP or Vista BUSINESS not Home A minimum of 1GB or 2GB RAM is recommended Hard drive space doesn t matter to ChiroMagic The more RAM you have the faster your computers If you are buying a new monitor get an LCD 19 20 or 22 only 239 at Sam s widescreen BUY TWO MONITORS FOR YOUR BEST STAFF Run extended desktops and dual displays Make sure your video card supports dual displays Network You must have a network in place that connects all of your computers together through cabling or wireless into a central hub and subsequently a router that distributes Internet Connectivity to each workstation Internet Connectivity You must have your Internet Connectivity in place for at least a week before going live We need to make sure that you have adequate bandwidth and stability to your connection Please have at least 768K or higher bandwidth The Internet provider should guarantee you this speed for both upload AND download The more you get the faster your operation you may find the difference between 768k and 1 5mb o
208. ent s appointment date and time print as well as the visit code The doctor who is printed on the Encounter Form is the doctor who the patient s appointment was scheduled with If the patient has multiple appointments that day the Encounter Form will print all times and all visit codes in the top left hand corner e Patient Information This is the patient s name address and phone number Notice the Cell phone number box Itis important cell phone numbers are entered into the database for patients If they have NO cell phone number enter 000 000 0000 Then the staff is not constantly asking the patient for their cell phone number e Email This is for the patient s email address Itis important that email addresses are entered into the database If the patient does not have an email address then enter Published 1 6 2009 Page 213 of 248 Reference Manual NA This way the staff does not continue to ask a patient for information that they do not have e SOF Date This is the Signature on File date This date will default to the date that you add the patient into the database Some clinics change the SOF date annually when they have the client sign a new HIPPA agreement e Special Date I In the setup of the Encounter Forms this is a date field that can be custom programmed by the staff For example if a patient purchases orthotics and the doctor wants to know when orthotics were purchased use the custom date field e
209. ents values are provided in the Medicare Physician Fee Schedule MPFS by technical and professional components for the code RVU values for each component will display 7 Other indicator information from the MPFS will be displayed in this section such as global days code type etc A user can click any of the hyperlink words in the first column to receive additional information for that specific item A user can also scroll further down on the screen to view the information Chain Link LMRP and NCD code links 1 State The pull down menu allows the user to change and reference another state s LMRP information 2 Carrier The pull down menu allows the user to change and display other state Carrier information 3 This window will allow the user to search the diagnosis descriptions or enter a full or partial code to narrow the search on the code list Clicking Go will return a list of diagnosis codes matching the search criteria in the Proprietary Information 55 LMRP A message will be displayed if no codes are found within the displayed LMRP 4 This link will be used when needing to reference the National Coverage Decisions database for the listings of payable or non payable diagnosis codes for the specified CPT HCPCS code most NCD s are written for lab codes only 5 The policy numbers are hyperlinked to the specific full text policy in KnowledgeBase CP The CP icon will provide CPT HCPCS that occur
210. equirements Also allows the Secretary of HHS to exclude providers from Medicare if they are not compliant with the HIPAA electronic and code set transaction requirements and to prohibit Medicare payment of paper claims received after October 16 2003 except under certain situations Allowed charge Individual charge determined by a carrier for a covered SMI medical service or supply Approved Amount The fee Medicare sets as reasonable for a covered medical service This is the amount a doctor or supplier is paid by you and Medicare for a service or supply It may be less than the actual amount charged by a doctor or supplier The approved amount is sometimes called the Approved Charge Carrier A private company that has a contract with Medicare to pay Medicare Part B bills Claim Adjustment Reason Codes A national administrative code set that identifies the reasons for any differences or adjustments between the original provider charge for a claim or service and the payer s payment for it This code set is used in the X12 835 Claim Payment amp Remittance Advice and the X12 837 Claim transactions and is maintained by the Health Care Code Maintenance Committee Contractual Obligation Amount of the designated write off amount Coordination of Benefits Process for determining the respective responsibilities of two or more health plans that have some financial responsibility for a medical claim It is also called a cross over
211. er Sar perl ned Last 30 Days Last 30 Days Last 60 Days Last 90 Days Last 180 Days Today Week to Date Month to Date Guarter to Date The Date Range can be a custom range or from the quick dropdown select All Date Last 30 Days Last 60 Days Last 90 Days Last 180 Days Today Week to Date or Month to Date Let s look at each tab separately Charge Functionsfor Charge 74 J edger Function Icons The Function icon is like the Magic Wand Whatever functions are available for the charge payment will be shown e Take Charge off Hold Edit Charge i Unapply Patient Payments Depending on the period being displayed or status of the charge payment Q Refund different options will appear This is the quick way of navigating From 4 Go to carrier ANBCBS h View in Carrier Ledger Enter Memo H View History charges the user will see the payments that were applied From payments you Published 1 6 2009 Page 96 of 248 Reference Manual will see the charges the payments were applied to So like the Magic Wand the Function icon is anticipating what you might want to do from that screen The Detail Every time the magical is displayed next to a charge payment or anywhere else that means that there is detail underneath the plus i iii Simply click on the and the detail will be displayed From the detail there i ne are function flags letting you per
212. er has to do a take back it can be done properly e Go To Charge 123 This allows the user to go directly to the charge for that payment without having to scroll through the list of charges on the charge tab Published 1 6 2009 Page 117 of 248 Reference Manual How Do I Do a Carrier Refund What is a carrier refund A carrier refund is typically also referred to as an insurance take back This is typically when a carrier sends and EOB and removes payments from services that where paid months ago To do a carrier refund follow the instructions below e Go to the patient file that the carrier is doing a refund for e Click on the patient ledger button from the magic wand SNJ HOLLY MARTIN Sandusky9 Patient Functions g Schedule Appts M Print Future Appts Enter Charges Charge Review E3 Enter Payment amp Patient Ledger Encounter Form e Click the payments tab gt Ledger for SN3 HOLLY MARTIN Sandusky by Close mz Refresh Charges Balance Payment Date between Z nor24 2008 e Change the Payment Date Boxes to reference the payment that needs to be refunded e Click the Plus next to the payment 2 pe Pe ooo l aaa anaal 104 62008 Applied Satan Functions ike Edit Payment ake Void Payment RIO Carmer Refund for KAISER KAISER PERMANENTE BI Go To Charge 96 e Click on the Carrier Refund option e The Refund screen will appear Published 1 6 2009 Page 118 of 248 Re
213. er screens to populate the inbound file 3 Perform one of the following e Edit the claim online enter the correct provider number and resubmit the claim e Populate the provider screen resubmit the claim and be sure to check apply provider overrides e Enter the correct provider number in your practice management system hide the claim on ZirMed and resubmit from your practice management system CLAIM REJECTED BY SECOND EDITS ENROLLMENT FOR PROVIDER NUMBER xxxxxxxxx FOR CUSTOMER xxxx WITH PAYER xxxxx AMERIHEALTH ADMINISTRATORS HAS NOT BEEN COMPLETED PROBLEM This rejection message is stating that the enrollment screen contains a different provider number for a specific payer than what was submitted on the file For example if the enrollment screen showed 1234 as the approved provider number for Anthem SBKY0 and your file contained 5678 as the provider number for Anthem then this rejection message would occur RESOLUTION Check your Enrollment tab Go to professional claims enrollment Verify that the provider number set up on the enrollment table is correct If there is a discrepancy please contact our enrollment department as soon as possible at enrollment zirmed com e Ifthe number on the enrollment screen is correct for that payer then follow the steps for Enrollment Rejection Message 1 Proprietary Information 22 Invalid Data Rejections CLAIM REJECTED BY SECOND EDITS THE PROCEDURE CODE ON LINE 1 HAS A DIAGNOS
214. er unit SubTotal The subtotal for the charge Tax How much tax will be billed for the charge if the item is taxable Total The total amount for the charge Mod1 1 Mod2 Mod3 Mod4 The modifiers that are attached to the charge Pointer The diagnosis code pointers for the charge Diagl Diag2 Diag3 Diag4 The diagnosis codes that will print for the charge on the HCFA form Published 1 6 2009 Page 150 of 248 Reference Manual Modify Charges Screen The modify charges screen is the screen that is used to enter a new charge or edit an existing charge You can use the Edit Key Pencil Icon to edit or delete a charge that has already been entered into the database Modify Transaction Bill to tem 95943 EATRASPIMAL e P a Insurance v Units i 45 00 Modifiers caren E Total 45 00 1 2 afi 4 Employment a Treating Prov HOLLY H MARTIN Local Use Box 19 eects Biling Renderin SE eee HOLLY H MARTIN F E cancel Sublux Chronic Last ra Referring Prov HOLLY H MARTIN F gt j pd peice a SAYE Fay or Deny lear Case Pl Detant Item This is the item code or a portion of the description for the charge that you are entering Units The number of units being billed for this charge Total The total amount being billed for this charge If more than one unit is being billed then it will give the total of all units Treating Prov This is the treating provider for
215. ering Fo X Referring F9 X 2 Secondary 3 Patient 4 Do Not Bill 1 Primary Iv Me e Inthe Payments from E T Last Billed Pr mary section check ae C Never Billed Billed Use DateRange Al us Values the box that says No BPM n Je e P 5 Pre Bill primary payment 1 Primary Electronic status P Seconds Electronic e This will give you a eral X C Non electronic list of claims that you E ______ __ have not been paid on G Bill To Status v Status Edit Charge Edits A Commit Changes by the primary carrier ail You can roll back this group of claims at one time e Once the query is on the screen click the red backwards arrow to set all of the claims to re bill to the primary carrier NOTE If you need to roll back the claims for just one patient e Follow the above criteria and then Enter the patient s Account Number in the ID number box e Click Run query e Inthe results window below it will list all claims that have not been paid by the insurance carrier either for one patient or for all claims based upon the criteria that you used Published 1 6 2009 Page 247 of 248 Reference Manual TO UPDATE THE ONSET DATES Click the drop down next to Claim Edits and click Edit Onset dates Change the onset date and save the changes TO UPDATE THE INITIAL TREATMENT DATE Click the drop down next to Claim Edits and click Edit Initial Treatment Date Change the i
216. erts Under Alerts you will see links to messages that fall into the following categories e General Alerts Messages from ZirMed regarding system status application updates training notification production issues scheduled down time payer issue etc e Payer Updates Payer specific information e g new Payers or changes to existing Payers deletion of payers will be posted here e Enrollment Activations Enrollment activation or de activation notifications Each User will have the ability to view all Alerts To see ALL of your old Alerts again click on Include Read and click Search Please be sure to read all Alerts posted F l 7i M ZirMed Training Account 5076 training account Log Off p if C Account Prof Claims Inst Claims Remits Eligibility Print Services Patient Statements Pay F Poy Help Contact Us Customer Support Center Survey Welcome Account Protile Users Reports Downloads Alerts General 5 Payer Updates 350 Enrollment issued Subject Read ll 02 06 2006 02 43 PM Eliqubill stem Batch Responses prior to February Tth 7006 _ 1206 2005 08 28 AM C 10 34 2005 10 43 AM _ 10 04 2005 09 29 AM 10 03 2005 10 54 AM Save Read Status i Proprietary Information 8 CLAIMS FILE CREATION The following are the steps to create a file of claims to upload into ZirMed 1 Input your claims data a batch of claims into your practice management system 2 Once you
217. ervice An Item Product or Service can either be billed to insurance or NOT billed to insurance A Claim is Items Products or Services that are billed to insurance All Items or Services NOT billed to insurance are invoices either paid or owed to you by the patient Published 1 6 2009 Page 55 of 248 Reference Manual s Support Log Adding or Editing Services and Products ee Hew hem From the Items screen click the Add Item button rest Description TEST ITEM Code Give the item a code and put in a description l tein Type Eroa E Category CASH Note If you are adding a CPT code the code can be whatever you want because you set the CPT code at a 7 ay the fee schedule level which is what prints on the eee Price 18m HCFA form If the code is 97140 then the CPT code eus 1i can be G0283 G0283 would print on the HCFA form estes M gt Users Can Edit Description E Description The description for the item that you een eT mn want to print on the HCFA or a Patient Receipt Brinton Pp Encounter Form Item Type Select the item type from the drop down n list The choices are Product or Service If this is a FJ cancel E save CPT code that will be billed to insurance make sure that you select Service If this is a product that you will be selling make sure that you select Product Category Place the item into a category Cost Cost wi
218. erwork had mistakes missing wrong or transposed data 1 REASON No excuses here Check it twice and have somebody else in your office check it again before sending it You never got an NPI Number This is required by law and easy to get http www cms hhs gov NationalProvidentStand You never got your correct Taxonomy Codes for NPI This is easy as well Here is a good link about Taxonomy Codes http ezinearticles com Taxonomy Code For NPI Number What Is A Taxonomy Code And Why Is It Important amp id 453343 You changed from a Sole Proprietorship to a Corporation and never re filed your paperwork with the carriers If you have changed your business entity structure this may mean you need to get an additional NPI Number and let your carriers know You added doctors but never credentialed them with a provider If you are coming from a cash practice to bill you must be credentialed with the provider under a group or individual doctor number You added a doctor but never let ZirMed know If you hire an associate Dr in your clinic you must get all of their information to ZirMed so they can be loaded into the system before the associate s claims can get paid as well You are now billing an insurance carrier that you never did before If you are billing in network with an insurance carrier you must be credentialed to bill to that carrier There is normally an application and approval process required Many insurance
219. ess e All claims must have an initial treatment date o To enter the initial treatment date Open the AA go to the insurance tab and enter the initial treatment date e All claims must have the group number of NONE o Toenter the group number of NONE Open the AA and then click on the insurance tab and enter the group number of NONE If you have claims that have been billed without this information then all of the claims need to be updated and re billed Published 1 6 2009 Page 246 of 248 Reference Manual Phunkey has created a way that this can be done quickly in bulk so you do not have to go in and update each claim record that needs to be re billed Quickly Adding the Three Do s for Medicare and Re billing Account Assistant t cew F7 New Pat ie e Open the Account Assistant setae sii e Click on the Claims Utility at the top of the screen e In Bill to Values check all boxes except 4 e In Status Values check all boxes except 4 e Enter a DOS if you want to query on a certain DOS e Select the Insurance Fi Claim Review ToL Carrier code for i BA xk Reset Fi f Medicare in the Bill To Values Primary Carrier section DOS Primary Carrier Use Date Range C All al 7 Mcoot PX from or 28 2008 to or 28 2008 ayments From Primary C Have primary payment No primary payment C All econdary Carrier I PR Physician Treating Fs X Rend
220. ew ES Enter Payment w Patient Ledger Encounter Form Enter Charges This allows you to enter charges for the patient Charge Review This allows you to access the charge review for the patient and review charges Enter Payment This is where the patient enters a patient payment for a patient if not entering a charge for the patient Patient Ledger This allows you to open the patient ledger and look at the charges payments and aging information for a 4 Edit Information patient E Statement Encounter Form This allows you to print an Encounter Form Notes for the default case for a patient Edit Information This allows you to edit the patient s demographic insurance and other patient information Statement This allows you to print a patient statement Notes This allows you to enter scheduling CEW and memos for the patient Published 1 6 2009 Page 142 of 248 Reference Manual Main Screen Once a patient has been selected from the list the Main CEW screen will be displayed Notice how the screen 1s divided into sections There is the Menu Bar across the top the Patient section the Authorization Section and the Past Visits section E Charge Entry for SM3 HOLLY MARTIN Sandusky Close D Patient Search Cp Today s Patients a y Fatient Sh HOLLY MARTIN Current Case P Default Fatient Balance Total Balance Avail Credit Fri Carrier Fri copay Futu
221. ew York Paper Statement is for statements you ll send directly to patients For example Weight Loss would be set to Paper Statement so that the case would NEVER bill to an insurance carrier The system is intelligent and the Charge Entry Wizard will automatically mark those items for the case to the patient This keeps you from having to place items on hold bill them and then take items off hold Facility The default facility for the case This is the information that prints in box 32 of a HCFA form Referring Provider This is the default referring physician for this case type Billing Provider This is the default billing doctor This is a critical field that tells the system which doctor will be shown on the charges when they are billed Confirm that you have the correct doctor set for the case Treating Provider This is the doctor who treats the patient This is used for reporting purposes only Signature Source This is the signature source information for the HCFA form The default will read for blocks 12 and 13 however if you need to change this for a PI case then the default can be changed Accident Type This 1s the accident information that appears on a HCFA form The default for the Accident Type will be No Accident However if you are setting up defaults for a WC case change the default to Employment Nature of Condition This is the nature of the condition The default will be routine but if it needs
222. f your NPI numbers Not getting paid by Medicare These are the most common things that happen when not getting checks from Medicare These are the Medicare DO S If you do not do this then the claims will be rejected and you will NOT get paid by Medicare e All claims must have an onset date on the claim o To enter the onset date open the AA go to the Case Information Screen Select the case that is the Medicare case and then confirm that the onset date 1s listed e All Claims must have an initial treatment date o To enter the initial treatment date open the AA go to the Case Information Screen Select the case that is the Medicare case and then confirm that the initial treatment date is listed e All Claims must have the group number of NONE o To enter the group number of NONE open the AA and then click on the insurance tab and enter the group number of NONE If you have claims that have been billed without this information then all of the claims need to be updated with this information and they need to be re billed Phunkey has created a place that this can be done rather quickly so you do not have to go in and update every claim record that needs to be re billed If you have been assigned a Type II NPI number and Medicare has you listed as a Sole Proprietor then Medicare will still require you to submit your claims with just a Type I NPI number They will Published 1 6 2009 Page 244 of 248 Reference Manual not a
223. fOrmation cccccssesccccccccccsssssssccccccccccssssscccccccccccscssscccccccccecssssssscecees 79 New Patient F4 Using and Understanding the New Patient Menu ssssssscccssssssssssssccccsseeeees 79 INP AN a IN E TE E E E E EE E E A A O E OT 79 Addim a New Paineita E E E OE E 81 Patent TNLOFMANOM TaD scssscissseseiscsvevesdsineieicssecvesdvenenedsossevesdeineisiensseverneessnedsousevesdeiuosedsnieevasssisensteondevesdeiens 82 TCH PICS Se CON ieee csconsoetu ceca eaexcen dunt eget E EEEE EE O bortuectuaduennssantanss 83 Emerscncy OE NAL OD eeen E T caches tamenmensicataneduatuane EO ESTREN 84 Marketing Information Section see ssssiirreoesenn egredi EEE AE OEEO AEE EEEE KETE 84 Mir MOE e e E E E E E 85 NEED TIL E1 I REA PE P E EA OE A AO A A O O O E E S 85 PPI S aes OA E O A I OE E E O A E OE OS O N A E Y E A E T A E O 86 OU OI E e A ET OE E A EET E T E EAT A A 86 Case MmMiormanon T a Dosa E EEA EE 87 AUT AIG 5 e O PE EE T E N EE E E E A AE E 89 Wina Ea EE EE E N E A A A N E E S A E E T E EE E T 89 SPS WOU IM AAT a O a E T E EE NT NE NO E EET TE NO N 90 Adding aC aseto a Panen t ACCOUM aiora eiA E ENERE men etre ne eee ert 90 l s rance Carrier VAD lt scescvesseiesssevsucesiceswnssravssasussiessvevsuesdueveesssaveceasndssiussvevestesduapewssanssetestzarswssienessesiuseanes 91 CO BO eee a E E O E ecaieatencaces 92 How do I add an insurance carrier to a patient s account ccccccccecccceccccceceeeeeaaeaeesseseeeeeceeee
224. fault by clicking List My Codes on any line Once you have created a My Codes List the Procedure Code Search page will only show your codes as a default This should greatly reduce the amount of time you spend searching for specific procedure codes Proprietary Information 5 f Z d zirMed Training Account SO76 wt training account Log Off irMe Account Prof Claims Inet Claims Remis Eligibility Print Services Patient Statements lt Pay Fa Po Help Contact Us Customer Support Center Survey Claims Batches Mame Matching Providers Reports Enrollment Pavers Coding Tools Settings Exceptions Procedure Code Search ICD 9 Search Reports Procedure Code Search Search for excision Service Date 08 01 2007 Search only search my codes List My Codes Displaying 1 10 of 587 Codes 10125150 Page of59 Go Code4 Description My Codes O01 4 Anesthesia for intraoral procedures including biopsy excision of retropharnyngeal tumor 01444 Anesthesia for procedures on arteries of knee and popliteal area popliteal excision and gratt or repair for occlusion or aneurysm mie C 01758 Anesthesia for open or surgical arthroscopic procedures of the elbow excision of cyst or tumor of humerus 01951 Anesthesia for second and third degree burn excision or debridement withor without skin gratting any site for total body surface area TESA treated during anesthesia and surgery less than four percent total body surface area 01952 A
225. ference Manual Refund for KAISER KAISER PERMANENTE x Patient HOLL MARTH Amount 10 00 Method PRI REFUND Reason x Cancel neff Apply The amount is an editable field just in case the carrier did a partial take back This allows the user to overwrite the original payment amount and just place in the dollar amount that is on the EOB e Click Apply Once the refund is applied it will be eye on the ledger like this fe 215 TO232006 PRI REFUND 2 00 if 2149 1O24 2006 PRI REFUND 2 00 00 R 1122334455 Check R 1122334 1TO2S 2006 10 29 AM 2 00 2 00 O 00 R 1122334455 REFUND This is a TO24 2006 10 10 Ahi Notice how the line says PRI REFUND the Reference number will always display with a R and the reference number from the original check also 1f the refund needs to be edited then just click the yellow flag Published 1 6 2009 Page 119 of 248 Reference Manual Balance Tab The Balance tab gives the user the big picture and allows them to perform any function on an account Z RRLOSS 7S KATHY MORALES Test 2 del Close A Save Utilities i Patient Information a Case Information Ki Insurance E Diagnosis Codes ID Notes Ledger Weight Loss Close a Refresh Ledger F Charges Payments Balance Totals and Aging woided Charges Date Description pi oa0sS200s 97010 CRYOHEAT THERAPY oided Payments Claims Payment Chg Bal Balance Closed
226. for provider City State and Zip This is the address for the provider Phone This is the provider s main telephone number CellPhone This is the provider s cell phone Fax This is the provider s fax number Email This is the providers email address UPIN This is the provider s UPIN number NPI This is the provider s NPI number Entity in MOTION CHIROPRACTIC Code HAM Lasthame MARTIN FirstName HOLL hil H Suffix Address 123 MAIN ST Address2 City SANDUSKY state JOH Zip aggro Phone 41 9222 3211 CellPhone f J Fax 419 222 3212 Email hotchickst hot com OPIN 54321 MPI 12345676910 Taxonomy lode 10 xx000081 2 Tax ID 123456759 Reterring Provider Rendering Provider Treating Provider a 1 4 4 Can Schedule Published 1 6 2009 Page 38 of 248 Reference Manual TaxonomyCode This is the provider s taxonomy code TaxId This is the provider s tax id number Setting up a Provider Providers are also known as physicians It is important that all providers be loaded into the system If you have a provider who you are not going to send bills out for but you will be scheduling appointments for them they have to be set up as a provider and the appropriate boxes have to be checked To set up a provider follow the instructions below e Click Utilities at the top of the screen 4 Calculator F6 Support Log Of Wy Setup Use
227. for which you may group by e Account This will be the default if you are an account that is set up as a parent child e Attending Provider Institutional Claims e Billing Provider e Date e Month e Payer This will be the default when the scope is Account e Rendering Provider Professional Claims Proprietary Information 32 Order By You may choose to order your report in different ways The dropdown allows for the following choices e Account e Claim Count If chosen will display on report in descending order Transaction Date s You can define the time frame you wish the report contain by choosing either a pre determined time frame by clicking in the radio dial The following are the time frames you may choose Today Yesterday This Month Unless changed by you this date range is the default Last Month This Year Last Year If none of these options fit you needs then you may choose e Custom This option allows you to enter and date range you wish However your From Date can not be any older than two years from the present days date Columns You may choose how your columns will display by choosing either e Submission Source e Electronic Paper This option is the default for you columns unless changed by you o Include Charges If you would like charges included on your report then click in this box and charges will be included Filters e Account Depending on the type of account you have with ZirMed you m
228. form tasks a F Al 250 i fl 133360 Understanding Charges Invoices Claims In order to understand what is being displayed in the Ledger tab it is important to understand the concept of Charges Invoices and Claims Charge A charge is ONE individual service or item that was entered into the Charge Entry Wizard An adjustment 98941 exam 99201 or PILLOW for a water pillow Invoice A collection of the charges that were entered into one session of the Charge Entry Wizard Claim A collection of charges from an invoice that need to be billed to a carrier ONLY THOSE ITEMS that are billed to a carrier will appear on the claim A claim will not have more than one invoice A claim will not have more than one date of service Charges Tab The Charge tab shows every charge for the selected case type and the selected date range CASE TYPE Charge Status Date Item Description Total Charge and Balance Every line item charge has a charge number associated with it When multiple charges are entered into the Charge Entry Wizard all of those charges are grouped into an Invoice Remember that there are no CLAIMS on this screen CLAIMS are a container for charges processed when the billing manager generates the billing file Claims will be seen on the Claims tab in the ledger Published 1 6 2009 Page 97 of 248 Reference Manual amp 5M3 HOLLY MARTIN Sandusky9 A gave HI Save and Close X Cancel Utilities SB Add N
229. g Utilities ne hrer e Click Guarantors SIF E Biling Utilities Zalculat MS Carriers Guarantors eg m ll D e Click Add Guarantor da Add _ e Fill out all of the appropriate information e Click Save Published 1 6 2009 Page 176 of 248 Reference Manual Bulk Billi ulk Billing a Utilities This is the button that will be clicked to process billing for the clinic arriers Uarantors The Bulk Billing Module located under the Billing Menu from the Account Bulk Billi Assistant DEEE MPS Location Ledger pat Carrier Payments Unapplied Checks Understanding Charges Invoices and Claims It is important to remember that Charges are individual items that were entered onto an Invoice through the Charge Entry Wizard Only charges that are entered for a patient who has a carrier are sent to HCFA or Electronic Claim If a charge was entered for a product then it will print on a patient statement Remember a claim is nothing but a container for those charges that are being billed to a primary or secondary insurance carrier NO CLAIMS ARE GENERATED UNTIL THE END OF THIS STEP Be sure to carefully follow the Entity Facility and Provider setup information found in this manual It is that setup that dictates the Provider NPI and billing numbers needed to make the claims successfully transmitted received and paid Notice how the Bulk Billing screen has multiple tabs
230. g Old Form below Proprietary Information 17 Professional Edit Screen HCFA The Edit screen is the HIPAA ready Claim Edit Screen This screen accommodates all of the fields and field values in the HIPAA claim transaction To edit a claim click on the field you need to change enter the required information and then click on the Save and Resubmit button located in the upper left corner The field you need to edit may be in any of the five different views on the left Click to the other views to find what you need Note The Overrides On box near Save amp Resubmit is the same thing as the Reapply Provider Screen Data upon resubmit box that is on the Old Edit screen Claim Editor Patient PANCAKE SYRUP __ Rejection Message Time amp Date A Primary Claim Payer KEYSTONE MERCY HEALTH 44444 CLAIM REJECTED BY FIRST EDITS 1 22 37 PM _ Help Settings Provider BEST DOCS IN THE WORLD PAYER NAME MATCHING REQUIRED on 03 28 2006 loverrides On Charges 364 00 RENDERING NAME MATCHING E My Claim ID 4444444 ZirMed Claim ID 72172732 Instance ID 79774041 hee o v Cave amp Resubmit Claim s Simple wiew Hame Last First Middle Sutfixj and Address Accident Cam Deisi view SYRUP pancake aoaccent sae INSUrance View Providers Wie d444 HAPPY WAY perenceview art arty Resp LUCKY PA FFT T Other Accident Birth Date 97 8 1981 Pregnant Accident Date Destination Insurance Patient Relationship Self 18 wt
231. g up the category functions window da Add Category VF x tems we Categories Tax I Code Description i aus a alg Bie CHIROPRACTIC EHE E Category Functions go Edit Category Description Ah Allltems Active A Allltems Inactive Gy Print All Items on Enc Form Do Not Print tems on Enc Form af al Laf Add ltem Tax Aate From here you can Edit Category Brings up the code and description All Items Active Sets all the inventory items to Active and makes them available to sell through the Charge Entry Wizard All Items Inactive Sets all inventory items in that category to Inactive making those items unavailable to enter in the Charge Entry Wizard Published 1 6 2009 Page 57 of 248 Reference Manual Print All Items on Enc Form Quickly sets all items in that category to appear on Encounter Form Do not Print Items on Enc Form Quickly set all items in that category to NOT appear on Encounter Forms Add Item Tax Rate Quickly set a tax rate for an entire Category i EE a ee le a i Code pee OOo pelle i IB CHRO CHIROPRACTIC ie a plese nme o o Code Description Dc DIET COKE Grid Expansion and There is a and a to the left of the categories when all items have a category set When you click the it expands the view displaying the items that are assigned to that category Pressing the will roll up the expa
232. g was paid cash at the time of services then Total Collections would ALWAYS equal Bank Collections When those two totals are different there is an issue with credits Then you need to look at Payment Date versus Entry Date If a payment is received on Friday the 31 and entered into the system the 1 of the following month the payment date report will show it on the 31 and the entry date will show it on the 1 Published 1 6 2009 Page 205 of 248 Reference Manual There are Three Parts to Accounts Receivable Real A R People owe you money you have billed properly to the carrier or patients and are waiting for payment There is nothing to keep you from being paid Uncollectable A R People owe you money but you are going to write it off knowing that you will never collect it This may be due to a settlement bankruptcy from a patient contractual adjustment payment plan or you just knowing it will never be collected Procedural Problem A R This is the irritating frustrating A R because it is money that SHOULD BE in your bank account but is sitting in oblivion creating frustration for everyone This guide has been designed to address Procedural Problem A R and to some extent Real A R but that s a pretty short part Preventing Procedural Problem A R What are the most common reasons we have Procedural Problem A R ZirMed Paperwork and CHIROMAGIC Phunkey Paperwork was NOT received back timely ZirMed Pap
233. ge Under Additional Criteria you can request if rejected and in progress claims should show and how much detail to display for each claim events Payers and Provider information By supplying information in the Filters section you can further reduce the number of claims displayed on this report This report will have 3 sections e Rejected Claims This section will show the detailed information for each claim and exactly why it was rejected e In Progress Claims This section shows the detailed information for all in progress claims e Rejected amp In Progress Claims This would include both types Note If under Additional Criteria you have selected Rejected Claims Only or Rejected amp In Progress Claims you must provide a Batch ID Detail Report This acou m Sorn By Date Range Additional Criteria Filters Payer Provider Patient This Month From o4 o1 2006 Rejected Claims Only Batch Mame 9 5 05 Payer Patient Provider Last Month To 04 30 2006 Oln Progress Claims Only Rendering E Provider O Provider Payer Patient This Quarter O Rejected 4 In Progress Claims a Provider Patient Payer Last Quarter Baien O Patient Payer Provider This Year PROW Events Patient Provider Payer Custom SRON PREIS Show Providers Submit Fired Claims Status For All Rejected Claims 04 05 2006 Batch Hame 051105kc Rejected Claims Clams Patient Name Acct Humber Pat
234. hat says Bill to Insurance For example if there are services that will never bill to Medicare edit the fee schedule for that service for Medicare and uncheck the Bill to Insurance box Published 1 6 2009 Page 63 of 248 Reference Manual Editing Fee Schedule Pricing If multiple fee schedules have been selected they will include the FIRST information for ALL the fee schedules for that item Expand the grid by hitting the next to the Item Code and edit the individual items to set the different prices for the fee schedules Click on the Blue to bring up the Fee Schedule edit screen The Fee Schedule Detail Screen from above will appear Set Item Tax Rates fs tems Eat Et y COAC CLASSIC OATMEAL APPLE AND CINNAMON a 9 Categories haa Tax 5 Fee Schedules Description CLASSIC OATMEAL ORIGINAL HE Hf COOR Pa PROTLIS CREAM STYLE SOUP CHICKEN Expected TOS CPT Mod Feesched _UnitPrice Tax Description Rate lel Es Wj Select Tax Rates for IMMU Select All Deselect All em ount When this option is selected the Select Tax Rates window will appear with all of the tax rates that were entered into the system Select All Deselect All or select an individual tax or taxes by checking the check boxes to the left Click OK or cancel FJ Cancel a JK Services and Products Item Grid Expansion There is a anda to the left of th
235. he problem resolved and they say to re bill all of the charges for the last three months that you have not been paid on That is what the charge review screen was designed for In this scenario this is what would be done Open the charge review and then follow the instructions below e Click Billing e Click Charge Review e Set the Bill To Values In this example check all boxes because all charges that have not been paid by Medicare need to be re billed e Set the Status Value In this example check all boxes all charges that have not been paid by Medicare need to be re billed e Charge Dates Set the charge dates for the last three months e Last Billed Select All Published 1 6 2009 Page 191 of 248 Reference Manual E Charge Review Mi E A Close x Reset Filters Fa Run Query Bill To alues LI Primary lw Secondary lw Patient 1 Case Type ean Case Types 06401 2008 to 0910120085 l i Patient PX Last Billed Carrier Type ea Carrier Types CoNever Billed Billed Use Date Range GVA Tn os2272008 to os 2006 la 30 Days Teed PAK Rendering F gt p Referring x a Ea Run Query Charge Dates Status Values UM Pre Bill Primary Secondary Patient Hold status Payments From Primary Billing Type On hold Ott hold F Have primary payment L at cite tee PG ore head HF 4 e EDI STMT Charges e Hold Status All e Payments
236. he window and change the version with the pull down menu A user can select to view either the Column 1 View or the Column 2 View by changing the radio button Mutually Exclusive codes identify the services that cannot reasonably be done in the same session Component codes are services that are included or bundled in other services The legend describes the meaning of the red superscript attached to each individual code Money Bag Physician reimbursement lab fee schedule information on status codes global days multiple procedures bilateral surgery assistant Surgeon co surgeon team surgeon physician supervision and code type 1 The GPCI defaults to Medicare but can be changed with this pull down to any state s reimbursement information 2 Defaults to the current RVU year but can be changed with this pull down menu to a previous year s reimbursement information 3 Defaults to Medicare participating but can be changed with this pull down menu to Non Participating Assigned Non Participating Unassigned 4 The Transitioned Non Facility Total RVU line is the amount of reimbursement the physician will receive if the service is performed in the office setting 5 The Transitioned Facility Total RVU line is the amount of reimbursement the physician will receive if the service is performed in the hospital setting 6 This section displays if separate technical and professional compon
237. heduler Status Codes RS Rescheduled for future appointment NS No Show no communication SI Signed in CW Cancelled Will Call Scheduler Office Visit Codes NP New Patient yellow SPEC Special Consultation teal blue OV Office Visit purple MED Medicare Visit only if PT in office red ROF Report of Findings fuchsia DEC Decompression bright green PTEVAL PT Evaluation burnt orange Co Pay Codes 100 Cash Patient 99 Personal Injury 98 Work Comp 97 Trade Out VIP 96 Cash doctor who pre pays bulk Case Types Chiro Chiropractic WL Weight Loss PI Personal Injury WC Work Comp Published 1 6 2009 Page 21 of 248 Reference Manual Utilities System Setup The System setup button is found under the Utilities Menu 5 Calculator Suppo E D py Data Utilities t gt Inventory tH Schedule Settings For Visit Types This is where ALL system setup functions are found Many of the features have default values that can be set for each individual user Remember these are USER based settings meaning that the receptionist can have a setting turned on that a billing person might have turned off Settings Tab izl Schedule Settings for Providers i Scheduler P Close Today Tab Schedule Appts My Info My Email This is the email that the system uses for sending reports This is also the email address th
238. his comes into play is the FIRST office in each state that we deal with is like walking into a dark room having no idea what will happen Our only weapon is to KNOW that something is going to go wrong and be aggressive with the insurance carrier to confirm integrity of the submitted claims whether paper or electronic Also please know that the formats for Paper versus Electronic claims are COMPLETELY different so electronic could be perfect and paper could be messed up The Flow Here is the flow for electronic billing Your CHIROMAGIC Desktop sends up the electronic files immediately once they have been created After you generate the electronic files we sweep them and submit them securely via our private network to ZirMed Everything in by Noon EST each day goes up to the carriers the same day Everything after noon goes up first thing the next morning Once the files leave ZirMed they create the reports and files on the web site for you to handle any rejections or problems and resubmit the claims The files hit the insurance carrier minutes later and begin their flow through their system This is where the problem always lies NOT with Phunkey or with ZirMed that process is normally flawless But at the carrier level it can be problematic That 1s why you have to be on top of each carrier Constant Vigilance Constant Vigilance That means that whenever you start sending the NEW format of PAPER or ELECTRONIC ANSI claims you M
239. how override warning when updating provider screen Show override warning when updating payer override screen Initial selection on search section Rejected Only wal My Payer wal Save User Preferences Proprietary Information 15 The lower portion of the Claims screen contains the following items Claim Number The claim number you have assigned to the claim Trans Date The date the claim last processed through ZirMed s system Patient Name Rendering Provider Service Date s The From date will display only unless it is a span of dates ZirMed Payer This is a User Preference you could set it as My Payer Charges The calculated total charges for the claim Seq 1 Primary 2 Secondary or 3 Tertiary Status Displays the current status of the claim It will change as a claim moves through the system Clicking the Status will pop up the Claim History screen which will display all events pertaining to the claim See sample below Claim History Close Window Claim Number WWHITESS55555 Claim ID 113700625 Last Instance ID 1270990081 Payer National Rural Electric Coop MRECAS 52132 Patient Hame WHITE ANNE VY Date of Service O6 230 06 06 23 06 Billing Provider ZIRMED TEST ACCOUNT INC Rendering Provider JOHNSON JOHN Batch ID 3166946 Copy info above to clipboard Date Time Instance ID Claim Prefix View 04262007 0430 55 PM 127099061 PTFCSYYy Qld Form Mew Form O42B200F 042r a2 PM 127098047 T TFSTS Qld Form
240. iders and Max Bookings Hourly Start Time Allow All Prov A Disallow All Frov Color This is the color that ae a a T e owr avatasue starr displayed with on the meh jem vnm schedule Active If this box is checked the visit code is active and you can schedule appointments for this visit code Minutes The number of minutes allowed for the appointment Grid Start Time This is what time the appointment can start being booked in the morning Grid End Time This is what time the appointments stopped being booked Allowed Provider and Max Bookings These are the providers who can have this visit code scheduled Hourly Start Time What time in the hour can these appointments can be scheduled Published 1 6 2009 Page 67 of 248 Reference Manual Time Blocks Section 9 This is where the times for the visit codes are established The From and To boxes will be displayed with the hours that the clinic 1s open The days of the week boxes need to be selected for the days the clinic 1s open Time Blocks From o7 00 AM Ta Jor 00 Ph Clear All W tio W Tu i ve I Th i fr iT Sa Eil Clear Fill Min to Max Reset Fram os fro fas 20 as so os 40 45 50 55 tam Jos 10 15 20 25 a SSeS eee Fill Min to Max If this box is checked the grid will automatically fill for the times the clinic is Open Clear All This removes everything from the grid allowing y
241. ient DOB Subscriber ID Service Date Charges Payer AETHA 60054 Provider DOEJOHH 0001 464 7307S HARP HARRY 4 CANISTONSS555 01014969 298959599 0E0003 220 00 t CLAIM EDITED AND RESUBMITTED FIRMED on 1229 2005 t RENDERING MAME MATCHING REGUIRED BILLING MAME MATCHING REGUIRED on 12 29 2005 Proprietary Information 41 ENROLLMENT Go to Professional or Institutional Claims Enrollment tab The Enrollment screen allows you to view your organization s current status in the Claims enrollment process To do this enter the appropriate information into any of the search criteria fields e Account Select from the drop down menu your search can be narrowed to a Child within a Parent Child organization or use the default of All e Payer Enter any part of a Payer name e Provider Name Enter any part or leave blank unless this field has been populated a search will return no entries e Provider ID Enter any part or leave blank e Status Active means the claims sent will process In Progress Reject means either pending a signed form from client or pending approval from payer either one will reject claims while in progress Note If a claim rejects because enrollment is not active make sure that the billing provider number on the claim matches the billing provider number on the Enrollment screen f zZirMed Training Account S076 IL q Off ZirMed Account Prof Claims Inst C
242. if the charges have been billed Published 1 6 2009 Page 185 of 248 Reference Manual e View Audit This is the option that allows you to view and confirm any information on a statement that could be a problem For example if a patient is missing a piece of their address the audit report will let you know Statement Settings A Statement Settings i f A save EJ cana The statement settings allow you to customize the information Assess that prints on the statement Notice how the settings are broken v nse e tt 1 Po down into four sections Address Formatting Options Ledger M BSS Oo Options and Payment Options The settings can be saved for o gt CoO the statements so you do NOT have to go in every time and Prane emen select the settings for the facility Formatting Options F Ua the Guarantor address information if available fe Show change lewed chet nil It Show payments Address Section Sen TE Ledger Options Company Name This is the Company Name that TT Show sccourts wih a zero TOTAL balance prints on the statement Payment Options a fe Show Payment Sub Address I This is the address for the company that FF Show Credit Card information area prints on the statement FF Show Master Card and Visa Show American Express Address2 This is the Suite number for the company P re that prints on the statement City State Zip This is the city state and zip code for the
243. inus the recommended payment Tendered Applied This is the recommended payment amount for today s charges Adjustments Applied Any adjustments that have been applied to today s charges Prev Credits Applied This is the dollar amount from the credits screen if you have applied a credit from a previous date if service Amount to Tender The dollar amount that the patient is paying today Note Application of Payment First co pays are applied then products purchased then any balance due to insurance items unless the money has been set to Apply to New Credit Change Due Change due is automatically calculated In the above Change Due example of 40 due for the recommended payment if you enter 50 the system will automatically show that the change due is 10 00 If the patient 0 wants the change due to be applied toward a credit then you need to click on the cash register icon and click the button that says New Credit on the calculator This will then apply the overpayment as a credit on the patients account Tend Method This is how the patient is paying for their services today Payment Date This is the date of the payment Payments cannot be entered into the system for a future date Ref No This is the reference number or the check number for the patient payment Notes Any notes that are attached to the payment Co Pay Note Automatically places the text COPAY mm dd yyyy in the note field
244. ion The description pulls from the item but can be overwritten if it needs to be e Units How many units are attached to this charge this field cannot be altered e Unit Price The price of the item per unit this field cannot be altered Charge Information Diagnosis Charge Log Charge Date jrazozoos Patient Case Pi Default tem a7110 CPT Code s7110 Description THERAPEUTIC EXERCISES Units Unit Price 53 00 Tax 0 00 Total 53 00 Balance 0 00 Rendering Prov HOLLY H MARTIN Fa Referring Prov HOLLY H MARTIN Fa Treating Prov HOLLY H MARTIN Fa E E E Local Use Box 19 Sublux Last ray Employment Related Chronic Pay or Deny Clear e Tax The tax total that is attached to this charge cannot be altered e Total Total amount of the charge including tax cannot be altered e Balance Balance of the charge this cannot be altered e Rendering Provider rendering provider attached to the charge this field can be altered e Referring Provider referring provider attached to the charge this field can be altered e Treating Provider treating provider attached to the charge this field can be altered e Modifiers The modifiers attached to the charge they can be altered as well e Local Use Box 19 information that is in box 19 this field can be altered Remember all changes made to the charge information screen will be documented in the
245. ions SN3 HOLLY MARTIN Sandusky Enter Charges Charge Review ES Enter Payment Patient Ledger Encounter Form Schedule Appts Schedule appointment for the patient Print Future Appts Print future appointments for the patient Enter Charges Enter charges for the patient 5 Edit Information Charge Review Review charges for the patient E Statement Enter Payment Enter a patient Payment Notes Patient Ledger Patient Ledger for the patient Encounter Form Print an Encounter Form for the patient Edit Information Takes you to the Patient Information screen Statement Prints a statement for the patient Notes Allows you to enter notes for the patient Schedule Appointments Click this icon to access the schedule where the user can schedule an appointment for the patient See the Scheduling section of the manual on how to schedule an appointment Print Future Appointments Allows you to print a list of future appointments for the patient In Motion Chiropractic HOLLY H MARTIN scheduled Appomtments Thursday October 16 2008 2 00 pm OV Thursday October 16 2008 2 15 pm OV Printed 10608 4 43 pm Enter Charges Takes the user to the CEW to enter charges for the patient See the section on CEW in the manual to enter a charge for a patient Published 1 6 2009 Page 127 of 248 Reference Manual Charges are entered into the CEW On the first screen it will open to the d
246. is broken down into sections Demographics Emergency Information Marketing Account Status Stats and Categories 3 SN3 HOLLY MARTIN Sandusky9 lA Save E Save and Close X Cancel foe Utilities SB Add Note 5 B Patient Information A Case Information le Insurance Diagnosis Codes ID Motes e Ledger Weight Loss Demographics Account Status First Middle Last HOLL H MARTIN Active Iw enone Address 1 3519 LAMP POST LAME Address 2 City State Zip GAINESVILLE GA 30504 Home Phone ce78 989 5231 Work 0ra 5 1022 Cell E DOB osson 974 Sgn 1411 11 1111 CiMele Female Employment NONE Marital Status NONE Status Emergency Information Contact Mame Relation Phone E a o hollythomeatt com Stats First visit Date Ez B 24 16 Last Visit Date 1146200 T Future Appts Next Appt Date 11202008 YTD Visits Marketing Email Categories sF acupuncture ce a A be dae ee TS CHRO Chiropractic 7 Wass Massage Referral Source PATENT REFERRAL pa Referring Pat SNOOOO2 AMBER LOWE ENK Language English Contact Choices I Accepts Mailer MP Mev Patient PT Physical Therapy Wo Accepts Email Blast IY Accepts Phone Blast Published 1 6 2009 Page 82 of 248 Reference Manual Demographics Section This is where all of the patient s demographic information is stored Name This is the patient
247. is should never be blank There should always be 12 future appointments listed under the Future Appointments tab If this is blank the front desk Published 1 6 2009 Page 214 of 248 Reference Manual is not multiple booking the appointments ChiroMagic protocol says that a patient should always have 12 future appointments scheduled Account The patient s account number SSN The patient s social security number remember always get the patient s social security number Patients are entering into a financial agreement with the clinic If they default and do not pay the facility and they have to be turned over to collections it is necessary to have their social security number DOB Date of Birth Age Age of the patient Last Visit Date The last time a charge was entered into the system for a patient Date of Last Exam The last time an exam code was entered Date of Last X ray The last time an X Ray code was entered Date of Initial Visit This is the initial treatment date Billing Doctor This is the doctor who all of the charges get billed out under Referring Doctor The doctor that referred the patient to the clinic Treating Doctor The treating doctor for the patient Referral Source How the patient heard about the clinic This field should never be blank The patient had to hear about the clinic from somewhere Doctors are spending a lot of money on marketing and if the staff does not put in
248. l patients who have been in the office in the last year that have the Baseball category checked etc Categories ART Active Release Technique CHRO Chiropractic MASS Massage MP Mew Patient PT Physical Therapy z 7 Other examples of categories VIP Movie or Sports Star XMAS Include in XMAS List MREEF Multiple referrals ACCU Acupuncture patient CHILD Has children GOLF Golfer All of these categories could be used to generate marketing lists for patients for promotions Published 1 6 2009 Page 86 of 248 Reference Manual Case Information Tab The case tab displays all of the cases that a patient has Each case will have a case type whether or not it is the default case and the date the case was created PI Default 9 22 2008 for example Each tab represents a different case The system comes with 2 default case types CHIRO and WL Patient Information EE Case Information lo Insurance E Diagnosis Codes D Notes Ledger om Weight Loss Pl Defaut 22 2008 CHIRO 1022 2007 VWLilnactive 7 4 42008 This is the Defaut Case for the Patient M This caze is Active fw insurance Description PERSONAL INJURY CPR SEC Carrier o ANTHEM BLUE CROSSVBL pa Caze Type Personal Injury KAISER PERMANENTE cI Bill Type JHCFA 1 S00 Form Fee Schedule STANDARD PRICE Fi ial Mature of ti inancia onere Condition Acute Condition Class Chiropractic Onset Date
249. laim with the primary payers EOB information communicated in the electronic field loop or by using the 2 link enter the secondary claim COB information in ZirMed The secondary payer will adjudicate the secondary claim in accordance with plan provisions Proprietary Information 72 4 What can and cannot be done electronically Many secondary claims can be sent electronically However not all payers can accept a secondary claim electronically Many rejections occur simply because the payer cannot accept an electronic secondary claim Just like primary claims secondary claims are subject to each payer s unique billing requirements A search of the payer s web site or a call may be needed to ensure accurate filing based on their billing requirements 5 How do send a secondary claim A secondary claim can be sent by uploading the data in your ZirMed batches or the secondary claim can be created off the primary claim using the 2 link on the claims screen Proprietary Information 73 PAYER WEBSITES Medicare Part B websites BCBS Alabama http Awww almedicare com Arkansas http Awww arkmedicare com Louisiana http www lamedicare com New Mexico http Awww oknmmedicare com Oklahoma http www oknmmedicare com Rhode Island http www rimedicare org Kansas http www kansasmedicare com Nebraska http www nebraskamedicare com Missouri http www momedicare com Montana http
250. laims Femits Eligibility Print Services Patient Statements Pay F Poy Help Contact Us Customer Support Center Survey Claims Batches Mame Matching Providers Reporta Enrollment Payers Coding Tools Settings Account An Payer g Provider Name fs Provider ID OoOo f Status Search Download LCSW Account Payer Name Provider Name Provider ID Status Dt Changed Phase ZirMed Train 5076 Medicaid Kentucky SKK YO Provi 12345676 Active 08 31 2004 Enrollment Complete ZirMled Train 5076 Medicare B Kentucky SMK YO Prov 0123402 Active 01 20 2004 Enrollment Complete ZirMed Train 5076 Medicare B Kentucky SMK Y0 Prov 1234567 Active 03072007 Enrollment Complete ZirMied Train 5076 Tricare Morth Region TRICK Prove 123456769 Active 09082003 Enrollment Complete tems highlighted in pink indicate enrollment records that have changed since you last viewed this screen NOTE Enrollment is required for most government carriers and some commercial carriers Enrollment refers to the process where the payer approves the provider to submit electronic claims Please familiarize yourself with the enrollment screen as soon as logging on to ZirMed If any payers are missing that require enrollment or if you see a provider number that differs from what you have please contact our Enrollment Department immediately Proprietary Information 42 PAYERS Go to Professional or Institutional Claims Payers tab This screen will let you sea
251. ll only be used if the item is a product If the item is not a product then the cost should be 0 00 Default Unit Price This should always be filled out This is the amount you are selling the product or service for Default Units Enter the amount of units that you would like this to default to Users Can Edit Price If yous need the ability to override the price then this box should be checked Users Can Edit Description If yous need the ability to override the description then this box should be checked Use Patients Previous Visit Price This box should be checked if you want to copy the dollar amount from the previous visit Print on Encounter Form Check this box if you want this item to print on the Encounter Form Active This box will be checked by default when you add a new item If the item becomes inactive or you no longer carry the product uncheck the active box Click Save to save the Services and Products item or Cancel to abort the new item addition Categories Tab Take a few minutes to set up categories Published 1 6 2009 Page 56 of 248 Reference Manual e From the Category screen click the Add Category command button e Give the category a code and enter a Description Click save For example THER Therapies BACK Back Products Hew Category Code Description F Cancel A SAVE Once the categories are set up you can click on the category status button to brin
252. llow you to submit your claims with the Type II NPI number If you are not sure what Medicare wants you to do contact Medicare and ask them if they want your Type I and Type II NPI numbers If they tell you that they only want Type I NPI numbers you have to bill your claims that way If you have a group legacy number and a PIN legacy number then claims will have to be submitted with both NPI numbers If you just have a PIN legacy number then you will have to submit with just the Type I NPI Number BILLING DAILY It is important that you bill your claims daily If you are billing claims daily you will know if there is a problem sooner rather than later It is much easier to balance 50 claims a day then 250 claims once a week Billing daily also means that checks will come in daily Please make sure that you are billing daily If you are not then start billing claims daily How do I know what claims can be billed electronically To confirm what claims can be billed electronically there are a few things that have to be done First of all on the patient s insurance card you need to make sure that you get the payer ID number This is the electronic address for the insurance carrier Once you have received this information then we need to cross reference this with the payer list from ZirMed When you log the ZirMed website you need to download the payer list from the ZirMed website When you log in it is on your main page and you can just download the li
253. lose Refresh Ledger Date Range osinsi2008 a to 06042008 Last 30 Days Case lt ALL gt Charges Payments Balance Totals and Aging voided Charges Voided Payments Claims oid Date oidRieason Payment Applied Motes Oe 042008 01 00 PM swilliams Made entry mistake 133894 owog 79 01 1500 Published 1 6 2009 Page 123 of 248 Reference Manual 9 Claims Tab The claims screen is a listing of all the claims that have been created from billing Close m Refresh Case Charges Payments Balance To Date Of Service between aa F008 and 1420 2008 E 30 Days Gein oos came Rene Prov Diest Dieg2 Diega Dinge e eee KAISER PERMANENTE mo 72252 72271 7391 _ Charge CPTCode Mod Mod2 Mods Mod4 Unita Qual RendiDbhMo Bille The Date Range option is here It will always default to the Last 30 Days If nothing is displayed simply change the date drop down to All Dates or Last 90 days etc Click the detail button to see the individual charge detail that went onto the claim Notice the blue function flag again the user can perform any functions to the charge directly from this screen Claim History Functions Claim History Functions a wien HCFA The HCFA button is also known as a Claim History Function Flag Clicking Rollback Charges on the HCFA will display a list of functions g Go to carier KAISER e View HCFA Allows the
254. mation that has been entered into the database Authorizations 5 episodes of 11 used Expires 12 97 2008 Began 14 2008 l Edit Auth Info Authorizations Displays the memo for the authorization that has been set for the patient Setting up an Authorization To setup an Authorization for a patient follow the instructions below e Look up patient in the CEW e Click the Edit Auth info A Authorization E e Enter the Authorization information Expired Expired If this box is checked then the Number authorization is expired Datevalia ooo F Number Enter the authorization number for the Valid for EE patient l l a Valid f 11 sod Date Valid Valid date for the Authorization ia D Valid for days How many days the zapisz 12 31 2008 authorization is valid for Valid for episodes How many visits the authorization is valid for Expires Date the authorization expires Published 1 6 2009 Page 145 of 248 Reference Manual Past Visits Section This section allows you to see what visits have been entered into the database for the patient The visits are displayed in DOS order and the number of visits displayed can be increased or decreased Past Visits Number of Visits 10 Last Visit By DOS i Last Visits by DOS Entered T gt Pe poe fem e e o a 10 01 2008 385940 10022008 OJP 09720 2008 98940 10703 2008 OJP 0972472008 72052 97141004 73030 LRE 9714004 989402 NICOL
255. me of the insured First Name Middle Initial Last Name Address This is the address of insured there is only one line so enter apartment or other information on this line too City State Zip Insured s city state and zip Copy Button The copy button will copy all of the patient s information from the demographic screen to the carrier screen so the information does not have to be entered again If the patient is responsible for their bill click the Copy button Phone This is the phone number of insured DOB This 1s the date of birth of the insured Gender This is the gender of the insured ID Number This is the ID number found on the insured s insurance card Group Number This is the group number of the insured Remember when billing Medicare this field should read NONE Group Name This is the group name of the insured Effective Date This is the effective date of coverage from the insurance carrier This is an important field because the Insurance tab will show the Carrier Code and the Effective Date BCBS 1 1 08 Expiration Date This is the expiration date of the insurance Co Pay Due This is the co pay that is due for the patient If it is a flat amount enter that here 25 for example Co Pay If the insurance is a of the bill enter the percentage here 10 for example Accept Assignment Box 27 If the clinic accepts assignment on the insurance payme
256. ment Employment Related Box10a related check this box This is the Accident Type auto accident information that appears in box 10a of the H State F HCFA form Accident Type This is the type of accident this case is Select the accident type from the drop down list No Accident Accident Other non auto Accident State This is for the state where the accident occurred Select the state from the drop down list Signature Source The different written options that appear in claim file On File Date This is the signature on file date Adding a Case to a Patient s Account There will be a separate tab for each case that a patient has To add a case to a patient s account follow the instructions below Ge Utilities Je Add Not e Click Add Case EP add Insurance 2e Delete Patient e Click Utilities at the top of the screen e Fill out all of the Case information for the patient ay Change Account P Merge Account Published 1 6 2009 Page 90 of 248 Reference Manual Insurance Carrier Tab Like the Case tab there will be a separate tab for each insurance carrier SNS HOLLY MARTIN Sandusky lH Save Gl Save and Close Cancel Utilities qk Add Note y Patient Information EE Case Information i Insurance JE Diagnosis Codes ID Motes Ledger ANCES KAISER Carrier Code ANBCES Active W Relation Self Insured s Mame HOLLY JH MARTIN Address 3519 LAMP POST LANE EN GAIN
257. mit This mass Resubmit screen will let you resubmit all claims in that group You can use this feature after the reason for the rejection has been corrected For example if the claims rejected because Payer enrollment had not been completed once enrollment is completed you can Mass Resubmit Or if you need to supply Provider override information after updating the Provider information on the Provider Proprietary Information 7 screen the Mass Resubmit can be used to Re apply Provider Screen data upon resubmit by placing a checkmark in the box then clicking the Save and Resubmit button f Zi M d Demo Medical Practice 729 Log Off ITTV LCC BT prot claims OO 4Pay Help ContactUs Customer Support Center Survey Claims Batches Mame Matching Providers Reports Enrollment Payers Coding Tools settings Current Claims Rejections Age at Scope Oldest Days oe Rejected Group By Rejection Message W Claim Include Mame Matching Rejections 10 claims remain rejected from 1 days ago on duly 30 2007 Oty Total Charges Rejection Message Drill Down 436 00 SUBSCRIBER ID NOT OM FILE 43 ENTERED Resubmit F Go 1 218 00 4E COMPLETED DUPLICATE CLAIM 4E COMPLETED DUPLICATE CLAIM n E 1 130 00 CLAIM REJECTED BY SECOND EDITS lt BR PATIENT SUBSCRIBER BIRTHDATE IS Go Resubmit REQUIRED TO BE PRESENT 201084 DMG02 See the Rejected Claims Dashboard under REPORTS for more details on this screen Al
258. mn to the top of the screen into that box Tax Report 2 records tem I tem BALL 1 item 7 LastName FirstName Charge ChargeDate Tax Code Amount Last Payment Date SN3 5e MARTIN HOLLY 14 jb 09 10 2008 SALES TAX 1 05 0940 2008 Totals for Tax Report E tem 3740043 1 item SN4 5e MARTIN LILY 15 jb 09 0 2008 SALES TAX 0 07 0940 2008 Totals for Tax Report OF Published 1 6 2009 Page 240 of 248 Reference Manual Getting Support Solutions Step 1 Is your answer in this manual If it is review the section and try to resolve Step 2 GO TO www ChiroMagic com Login is Chiromagic Password is magic123 Quick Links Training Videos See if what you are going to ask about is there Step 3 Still not resolved THEN email by clicking the Support Icon in the software Support The first step in obtaining support is to email by clicking the support icon on your CHIROMAGIC desktop This will be immediately logged into our case system and you will receive a confirmation of the case tracking number When the case is closed you will receive an email or phone calls letting you know the case has been closed Test the modification or solution to the issue Email is utilized because it is the most efficient Telephones are used for training Also emails are handled before voice mail boxes are emptied so in most cases the email will be handled hours before a voice mail is retu
259. mployer s group health coverage and also be covered through a different payer under their soouse s employer s group health coverage Or a patient may be covered under Medicare and Medicaid Whatever situation creates coverage under multiple payers the result is the same one payer is primary and the other is secondary 2 Can you have more than two payers Yes it is very possible that a patient will have coverage under three or more payers Regardless the same principals apply one payer is primary one payer is secondary one payer is tertiary and so on 3 What are the Basics of Filing a Secondary claim When there are multiple payers involved you will submit the original claim to the primary payer The primary payer will adjudicate the claim in accordance with their plan provisions There can be exceptions to this For example Wisconsin Medicaid will adjudicate a secondary claim before the primary payer has adjudicated the claim Once you have received the Explanation of Benefits EOB from the primary payer a secondary claim will be filed This secondary claim MUST contain the primary payer s adjudication information There are two ways you can communicate this to the secondary payer e Filing a paper claim with the primary payer s EOB physically attached Each payer has their own requirements for secondary claims and a requirement could be that they do not accept secondary claims via a paper submission e Filing an electronic c
260. n Week View Displays appointments for the week ea ae n A RO jaj j j a on on 6 7 8 91011 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 293031 1 2 3945 67 69 o o n Month Displays appointments for the week m e a 8 5 58 a al l YON NNN NNN N on on o Schedule settings can be accessed by clicking on the Schedule Setting button in the bottom left hand corner re Scheduler Settings on on The view can be changed to show all appointments or just appointments for a provider or a visit code Note Appointments CANNOT be scheduled from this screen Published 1 6 2009 Page 77 of 248 Reference Manual Utilities Open Today Tab Open Today Tab Clicking on this button will open the schedule for the day Billing staff might not have the schedule open If it has been closed and they need to open it click on the Open Today Tab and the schedule will open wH Scheduler 3 Open Today Tab Schedule App Utilities Schedule APPTS Clicking the Schedule APPTS button from the Utilities menu will bring up the patient search screen Search for the patient who needs to have the appointment scheduled and schedule the it from here LiL Open Today Tab ie Schedule Appts I Restart unit 45sisbant Utilities Restart Account Assistant Clicking this button will Restart the Account Assistant without logging off and back on Sched
261. n out by the option you selected You can select up to three 3 Drill Downs Each time you select a different Drill Down and click on Go the screen will refresh and also display in the center of the top portion of the screen the selections you specified with a description of the group selected These descriptions become links which when clicked will take you back to the previous view There will also be a Start Over link which will take you back to the original screen display Action If your Group By selection or a subsequent Drill Down selection has been Rejection Message then the Action column will contain a link to either Name Match if the group of claims had rejected for Name Matching or Resubmit e Name Match link will take you to the Name Matching screen where you can then complete Name Matching for those claims e Resubmit link will take you to the Mass Resubmit screen where you can resubmit the entire group of claims The Resubmit and Name Match links will only display if you have been given permission to use these features f 7i M d ZirMed Training Account 5076 Log Off 1r e Account Prof Claims Inst Claims Femits Eligibility Print Services Patient Statements lt Fay Leads Admin 4Pay Help Contact Us Customer Support Center Survey Claims Batches Mame Matching Providers Enrollment Payers Coding Tools Settings Current Claims Rejections Age of Scope Choose Scope Account or Domain Oldes
262. n the Batches screen under Status Processing Complete This indicates that your claims file has been processed You can then click the Claims button on the right to check the Status of the individual claims Q How do hide multiple claims A Go to Professional or Institutional Claims Claims Note link type in the reason for hiding the claim check the Also hide claim when adding note box If hiding multiple claims Go to Professional or Institutional Claims Claims then check the box on the left side of the claims screen then click the Hide link at the bottom of the screen You can also un hide a claim by clicking on the More link and selecting the Un hide option Proprietary Information 7 Q How do I get my account unlocked A If you mistype your password 3 consecutive times your account will be locked The password Is a case sensitive field if it gives you an error check the Cap Locks You must have your Domain Administrator unlock you ZirMed can only unlock a Domain Administrator by calling 1 877 494 7633 Q How do add a new user A The Domain Administrator is the person who will add new users He or she will login then go to the General tab then Users tab There will be a New User button on the left side of the screen near the Domain Administrator s name click it and it will give you some boxes to fill in to create the new user User Name First Name Last Name Email address then decide if you wan
263. n the left column you can call up the Fee Schedule Functions screen where you can edit the fee schedule or delete it E Fes Schedule Item Functions There is a and a to the left of the fee schedule when you have an item that has a fee schedule set When you click on the it will expand the view allowing you to see the items assigned to the fee schedule Pressing the will roll up the expansion Assign fee schedules from the Items Screen as detailed earlier in this document Published 1 6 2009 Page 60 of 248 Reference Manual Receive Products Tab Select Items to Receive Mel x The Receive Items screen has been designed to gt EA Select Al _ Deselect al let you quickly receive inventory items i Fee mv eee yy T PROTI 15 INSTANT HOT DRINKS HOT CHOCOLA PROTI MAX MEAL REPLACEMENT CHOCOLATE Access this screen from the Receive Products E a MEAL PEE EE TE ARE tab on the Inventory Module screen PROTI MAX MEAL REPLACEMENT VANILLA As soon as you go into the Receive Products tab TRE eee ER RN i s NCOG MUTRA 15 COLD DRINKS GRAPEFRUIT the Select Items to Receive screen will appear e Ts NUTRA 15 COLD DRINKS LEMON NUTR4 15 COLD DRINKS ORANGE From here you can Select All items Deselect NUTRA 15 COLD DRINKS PEACH MANGO All items or you can select the individual items NUTRA 15 COLD DRINKS WWILDBERRY PASSION NTRIF NUTRITIONAL FOUNDATION you want to receive PHASE START NEW PATIE
264. name If there are multiple patients who meet the search criteria then a list will be displayed Select the patient from the list Language This is the language drop down menu Select the main language for the patient from the drop down list Marketing Methods This is where you can select how to communicate with the patient based on their preference This section will expand as more and more automated communication methods are designed and implemented Accepts Mailers If this box is checked the patient wants to receive marketing information in the mail This is available as a criterion in the marketing list manager The default for this field is checked ERNE ACCES Maer Accepts Email Blast If this box is checked the patient wants to W Accepts Email Blast receive marketing information via email The default for this MW Accepts Phone Blast field is checked Accepts Phone Blast If this box is checked the patient accepts marketing promotions over the telephone The default for this field 1s checked Account Status This is the field that is used to denote the status of the patient Account Status z Account Status Indicates whether the patient is active or inactive Check the box that is appropriate for active or inactive Charges cannot be entered for a patient who is inactive If the patient is inactive select from the drop down why the patient is inactive 1 e Moved Deceased Competition etc Publish
265. nce Manual After entering charges for a patient Show Patient Receipt If checked upon entering in an invoice in CEW it will print a receipt When you are finished entering a charge what will the CEW do Select one only Open search for patients from Current DOS If this button is selected as soon as you enter a charge it will automatically bring up a patient selection window with ONLY those patients from the Today Tab that have not had a charge entered for today s date of service this is very useful for the billing department if they are entering charges for today s appointments Open search for any Patient If this button is selected upon tendering a charge it will automatically bring up the patient search screen allowing you to search for any patient in the database not just patients who were treated today Close the Charge Entry screen If this button is selected as soon as a charge is entered it closes the window This is perfect for Front desk staff Do nothing If this button is selected when a charge is entered it stays at the CEW window Entering Patient Payment in CEW Auto populate tendered amount for patient payment If this box 1s checked the software will calculate what the patient owes for their visit Remember this is intelligent software so if the patient has purchased products and has a co pay due the tender amount will be the balance of the co pay plus the products that they have purchased
266. nesthesia tor second and third degree burn excision or debridement withor without skin grafting any site for total body surface area TESA treated during anesthesia and surgery between four and nine percent of total body surface area 01953 Anesthesia tor second and third degree burn excision or debridement withor without skin grafting any site for total body surface area TESA treated during anesthesia and surgery each additional nine percent total body surface area or part thereof List separately in addition to code for primary procedure 11400 Excision benign lesion including margins except skin tag unless listed elsewhere trunk arms or legs excised diameter 0 5 cm or less 11401 Excision benign lesion including margins except skin tag unless listed elsewhere trunk arms or legs excised diameter 0 6 to 1 0 cm N m seas DIAGNOSIS CODE SEARCH ICD 9 Go to Professional or Institutional Claims Coding Tools ICD 9 Search tab This is a Value Added Service that you could choose to subscribe to by contacting your Sales Representative This page lists all of the ICD 9 Codes Since there are so many codes you can designate which codes you would like to show up by default by checking the box marked My Codes on any line Once you have done this the ICD 9 Code Search page will only show your codes as a default This should greatly reduce the amount of time you spend searching for specific procedure codes You can tell it to search f
267. ngs MEDICZ Date Range osm i2008 to oa i2008 custom ge Refresh Ledger Charges Checks oided Charges J Yoided Checks Claims mo 0g 7 2008 7 A 99203 DC NEW PATIENT ERM 130 00 13 30 00 Hs10200 Date Range The date range box allows you to customize the dates for the charges that are displayed The information that will display by default will always be the last 30 days There are pre set custom date ranges in the drop down box make sure that if the dates are changed in the Date Range box check the Refresh Ledger Charges Tab on Ledger This will display a list of charges for that U ChargeFunctions carrier that fall in the date range that has been selected above By clicking the blue flag the charges can then be edited voided taken off Take Charge off Hold of hold a memo entered and the history of that charge can be viewed E Enter Memo Patient Accounts can also be accessed from this screen by clicking on A Wiew History the Magic Wand next to the Acct field The will show all payments adjustments and write offs Published 1 6 2009 Page 167 of 248 Reference Manual Checks tab on Ledger This is a list of checks that have been posted for this carrier Clicking on the check function allows you to edit the check Remember if a payment is unapplied the check then becomes an unapplied carrier check again since there is a portion of the check that is not applied Voided
268. ninass 21 Scheduler OMICS Visk CodeS ciris riiai a Ei aE ea Curare eria 21 MOP AY DAOS E E E E ES 21 O TY DOS TEE OE E E OE EEO O I EEI AO I E EII E 21 UUN oS Sytem SCUD craes eE E E E E E E E EE EA 22 Selinos TaD sss cacisascseaisessncestacassessssausbeenseusbilvaveceaiacenwesacounchcwateusiaccavogbanacoatdaetessbudeasecddsasnsustintcenseuaumusbacsuansiees 22 Ky T tec erate E E A AE EA N A AA E nla dak aienchaiawaaeece E AEE 22 W AUC E EA AANE E E A EA A AO O A E AE A 22 EES E PA AE PE EA I O E E serene A O EEE A EE T 23 SDO ea e E E E E E 23 PE AN Drane crs E E E toca EE E asta Gata E E E EEE EEE A AONE A O EEA 23 Panen Ay Gil a E E E E seamseanectanseaceaueoieet 23 Pnn OTA ea E A E E 24 Entering Charges CEW Charge Entry Options ccccccccccssssssssssssssseeeeeceeeeeeeeeeaaaseesssseeeeeeeeeseeeseessaaaassanseseseeeeeess 24 Entering Patient Payment in CEW sacasenccancasceeccaceasconedesgatearennadaenapiesmes in aaier di ioii aniar a i aiin ai 25 OE VIGO A L E E E OE E A A I E S NE A T OE E A T 26 Cae TV M Eaa E E E 27 PUM ANCIAL CAS SOS a E 30 Entities Understanding and Setting up an ENtity ssscccscccssssssssscssccccscccsssssscssccccssccssssssssscssseees 32 Facilities Understanding and Setting Up a Fac3ility ccccccccssssssssssssccccsccsssssssscecccccsccssssssscccesssenees 35 Seng aortas steps raneetladncoenaon codensmosdaranubmenth EESE ETSE AAEE S E E ES EESE 36 Published 1 6 2009 Page 1 of
269. nitial treatment date and save the changes TO UPDATE THE GROUP NUMBER TO NONE Click the drop down next to Claim edits and then click Edit Primary Group Number Enter NONE and then save the changes To roll the claims back to re bill click the red backwards arrow in the right hand corner This will roll all of the claims back Then re bill to the primary carrier If you have any problems please send your questions to support phunkey com or press the Support Button on your Desktop Published 1 6 2009 Page 248 of 248 Reference Manual
270. nsion This functionality is used throughout the a Products and Services and the Invoice screens _ Code A Description _ mn EER or i it 3 ano E Tax Tab From the Inventory module you can bring up the new tax rates tab There is no limit to the number of taxes that you apply to a product or service Note In this version you cannot charge tax on services That will be coming out in the next build version We have to be off of Softaid in order to activate this function Business Note You need to look into city and local and state a F a B BE 9 S F 2 CEW F7 New Pat F4 Claims F8 Reports Billing Utilities Applications Calculator Support Log Off taxation requirements on the sale beaa of inventory items You are i 5 Close Refresh E Reports A selling liquids packaged food e ear YX Categories S Fee Schedules fas Receive Products products and powders Depending on your individual state you may syuaunuioddy s fepo e Description Hew Tax Rate have different or multiple taxes on ar WEIGHT LOSS SUPPLEMENT BOX lt different types of items A E Description MN PROVIDER TAX Rate 200 When you select the Tax Tab the following screen will appear 3 Cancel z a Published 1 6 2009 Page 58 of 248 Reference Manual e Click the Add Tax button to add a new tax e From this screen enter a code for the tax rate a description and the tax rate itself
271. nt Frot Claims Inst Claims Remits Eligibilty Print Services Patient statements Pay F Poy Help Contact Us Customer Support Center Survey Welcome Summary Account Profile My Profile veers Reports Enrollment Providers Enrollment Record Preferences Download Manage Users Mev User Page of 1 30 Reset Passyvyord beverly hills User To F Alice Stamp Alice Stamp ZirMed Training Account 5076 General B Check All bii AMY BLACKBURN training Access the Setup System Report beverly hills beverhy123 Edit Account information Report karen craigmyle training tra account trainingaccount Access dental claims system Report Mew User Page af 1 So Access Mass Claim Resubmitter screen Report E indicates the Domain Administrator i NS Access the Professional Claims System Report Edit a claim Report F Hidesunhide a claim Report Reset Password lf a user s password is forgotten they will not be able to login to the site You have two options for resetting a password 1 Keep Old This will keep the same password 2 Use New A password can be reset to something new by the Domain Administrator or a user that has been given permissions to change user information NOTE ZirMed can only reset passwords for the Domain Administrator If you need 2 chan onae P assword please contact your Domain Administrator lea Account Prof Claims Inst Claims Remits Eligibility Print Services Patient Statements lt Pay
272. nt check this box This is the information that populates Box 27 of the HCFA 1500 form Emp Name Name of the insured s employer Emp Location City of employer Emp Phone Employer phone Published 1 6 2009 Page 92 of 248 Reference Manual e e oa Utilities qP Add Mot How do I add an insurance carrier to a patient s account amp EH Add Case e Click Utilities at the top of the screen Add Insurance e Click Add Case 3E Delete Patient g Change Account e Fill out all of the Case information for the patient Merge Account When the patient record is saved it will save the insurance carrier for the patient Click the Delete button 1f an insurance carrier needs to be deleted Insurance carriers cannot be deleted if there are charges attached to that carrier Diagnosis Code Tab The diagnosis code tab stores the diagnosis codes for each case Every case has its own set of diagnosis codes RR103575 KATHY MORALES Test 2 The default set of diagnosis codes are ag S Close H Save g Utilities 5 for the CHIRO case Patient Information a Case Information le Insurance Diagnosis Codes D Notes je Ledger Weight Loss Bearish al _isDefault Description SOMAT DYSFUNC CERVIC REG You can change the number of diagnosis codes that can be typed in for each case by clicking on Diagnosis ce l iliti Oo Codes in the Utilities Menu System TE m S pot i Setup screen The default is
273. nt Desk and Schedullinng sssccssssccccsssssssscsccccccccsssssssccccssccssssssssccessees 132 Porn anA a Eee reenter ne cr te arena tT Tee ne me net manne ten Thr erent crt ere en tre ney te 135 Scheduling an Appointment for a Paloni eesis S E E EEEE EE dia SEEE 136 Resched u ling an Existing Appointments e ae EEA E EEEE EAE 137 M l ple B kin an Apponmeni sespe EAEE EREE EE 137 Deleting an ApPOINtMEN ssiri ni naai a ET a EENAA e ENAA aai a EEEN a Eiaa 138 Editing an Appointment osica ein a a a E a Eaa S E EE aE a a inakaa 138 Sionin na Pane M ereina a E Na E NE atone 138 Marking a Patient as a NO SHOW sescssoscseccuicduacastoorecetendausnssactinestuedmeecboovousdvectennereedttiectedantootneedusienvnesactinedtandtaeeebact eats 139 Cancelling an Appointment seisan nea E E EEEE OTE OASE EETU EEOAE 140 Printing a Daily Schedule ssiri ria ENERE EESE ENERE ERER 140 Charce Fn B A E A 27 EEA EE A 141 Macie Y AUN orrea aE ENE NAE E A ssseunsceres 142 MaS CECE T oiae E A E 143 Me D A e a E N E E E N 143 IM CC UO ii hr tert EE E EE T T E 144 Authorizations sses aa a E a aaa 145 Past Visits SCCUOM oncesi oa a E Eae 146 Charee Entry Detail SCr COM sccssotaccevenpecestvescseceueonsetusasnn nice ssucucsssewssvranctaesssacateusssssasbasieucseeaucesasacacett NEEE 147 The Diagnosis Codes Section ssa cessscccscssecedasvensesratnesecseessuwscassassdostevidedaraeaesesascacdsusesecesssnsscdesseniascaseuesesucbsassets 148 CHAT BES SCHOO eres seessecesca
274. number This gives you total access to the Patient Ledger Card when entering in payments You never have to leave this screen in order to make important changes on existing accounts or carrier payments Additional Information about Entering Carrier Payments e If for some reason the co pay was originally misapplied simply un apply it by going to the patient ledger from the Magic Wand e At any time during the carrier payment process you can click cancel and this will cancel the check or click Save Check to come back later and finish applying it e When you look at the list of charges you will see that the column next to Applied will turn green when settled Published 1 6 2009 Page 201 of 248 Reference Manual Unapplied Checks Unapplied checks are checks that have been entered into the system and have not been fully applied Unapplied checks can also consist of checks that have had payments unapplied and not reapplied The applied portion of a check does NOT move to the patient s ledger until the check has been fully applied To view checks that have not been applied follow the instructions below e Click Billing Billing Utilities i hres e Click Unapplied Checks Unapplied Checks e Select the check from the list that needs to be applied Check IDF Master Carrier Carrier Date Method Ref Ma Amount Posted Unapplied Motes e Click the OK button The screen then takes you back to the posting screen for th
275. ny notes as you want Notes are seen throughout the system if they are marked as a pop up Active Pe aed Type aLL ointernal Only Billing Popups Schedule Popups C Non internal Only Al C All CIA Search a Dall Tener Tse acne ra son iron ie tring ofl Bo a Memo 10 copayvistt 2 0923200 traing m E Hl If Gilling Hardship case they are only to be billed 35 00 for appointment Notes are Active or Inactive Each note can be set for internal use only meaning that it will never print out on an Encounter Form or any other piece of printed material that the patient might see e Click on Add New Note to create a new note The option is available for making the note a Scheduler pop up note and or a Billing pop up note If the note is marked as a Scheduler pop up it will appear on the schedule for a patient If the note is marked as a Billing pop up it will appear on the CEW for the patient when charges are being entered Scheduler pop ups appear on the Today tab and on the Scheduler screen when booking an appointment for the patient Billing pop ups appear on the Charge Entry Wizard s first screen If you enter a note while entering a new patient the note will automatically be entered into the notes tab and will be marked as a Scheduler pop up The Patient Notes tab is available from the Magic Wand OB04 2008 syyiliams Like Dr Ackerman ta adjust Missed last Co pay 15 Anyplace there is a sticky no
276. o US Virgin Islands http www triples med org webmedicare Palmetto GBA Ohio South Carolina West Virginia http Awww palmettogba com DMERC Providers Health Now Region A http www umd nycpic com Adminastar Federal Region B http www adminastar com Palmetto GBA Region C http www palmettogba com Cigna Medicare Region D http www palmettogba com 19 MEDICARE SECONDARY amp CROSSOVER CLAIMS Information regarding Medicare Secondary claim submission and crossover information can be obtained at http www cms hhs gov medicare cob This site is a valuable resource to you as it contains newsletters fact sheets and instructions for Medicare secondary submissions including contact information for any direct inquiries Proprietary Information 76 CLAIMS FAQS Q How do do Name Matching A Go to Professional Institutional Claims Name Matching Highlight the name on the right that you wish to name match search for payer by name or payer id in Name Contains box click in circle next to the payer you choose on the left then click the Match to Selected Payer button on bottom right Q How do I fix something that has Name Matched incorrectly A Go to Professional Institutional Claims Name Matching and go to the appropriate sub tab Then check the box in the lower left corner Show Matched Names Then click UnMatch button on the right side of the screen Then slide the slide bar on the right
277. on Charge Entry Today s Payment for SN3 HOLLY MARTIN Sandusky Today s Charges J el ie i ii a 1 ca bon oon ason ca oon oon 50 ca oon oon ara ca on on as eee on oof a0 Ad AN p iee sof sso oof sso p jee so sjon e E E EE afa E E E 1700 Ral A Ral A nan nnn nnn nnn Patient Payment recommended Payment 300 00 Copay 0 00 Patient Products 300 00 Today s Charges Total Applied Today s Balance Patient Credits 1 25200 300 00 952 00 ephled Bee aa Tendered Applied Adjustments Applied Prey Credits Applied 300 00 oo oo o oofosnzeoos fca E e r fee A iian en eje e Adjustment Apply to Today Apply To Mew Credit 0 00 300 00 0 00 Amount 10 00 Apply Unapply Tend Method CA Y Change Due me Total 4 ied 0 00 Unapply All Payment Date 100672008 0 00 k BP D Ret Mo Motes Copay Mote ao Reset X Cancel q Back W Erisnea Published 1 6 2009 Page 153 of 248 Reference Manual Today s Charges Section This is the section of the screen where the charges for today s date of service are listed The details of the charges cannot be edited from this screen they can only be viewed However you can change if the charge is billable to insurance from this screen by checking and un checking the Ins Box Today s Charges Tee Ta E oo oo 500 oof om p ifen eoj sajon af o oan
278. on condition for the case In the drop down there are Routine Acute and other standardized ser east ou os rongng BA Lookup descriptions eee mene Onset Date This is the date of Manifestation Accident or Injury This is the Last X Ray Date Jos22r2008 Gi Lookup information that prints in box eee rf Lookup 14 on HCFA form Initial Date of Treatment This is the date that patient was first treated If this is not entered when the case was created search by clicking the Lookup button This is the information that prints in box 15 on a HCFA form Levels of Subluxation i a Js Onset Date Box 14 109222008 Date of Acute Manifestation Like an onset date for a re examination Last X Ray Date This is the date that the last x ray was taken for the patient If this was not entered when the case was created click on the lookup button to search for the last x ray code in the charges database Last Exam Date This is the date of the last exam If this was not entered when the case was created click on the lookup button to search for the last exam code in the charges database Levels of Subluxation Select the levels from the drop down list Published 1 6 2009 Page 89 of 248 Reference Manual en Accident Information This is where you select the accident information for the case Employment Related Checkbox If this Accident Information case is an accident and is employ
279. or Providers ah a IE aini rA Click on the Provider in the list rarr AvALASue starr D e Make sure the check box Active for Scheduling is checked Options Active for Scheduling e Published 1 6 2009 Page 75 of 248 Reference Manual e Uncheck the override color to allow visit colors to show Override Color e Select the days of the week to schedule by clicking boxes M tio M Tu i we ff Th i Fr f Sa e Select the time blocks for the time block that the provider will work e Click fill e Click Save Published 1 6 2009 Page 76 of 248 Reference Manual Utilities Scheduler When you click on the Scheduler button from the Utilities menu the scheduler is displayed in a different view The purpose of this screen is to give you a different view of the schedule The tabs at the top of the screen allow you to choose the view for your scheduler data Day View Displays the Day View week View Month view View appointments for the day 2 5i wokwes ae a en Provider STAFF v that you have selected on Saturday September 20 Over coe ST 6am the calendar a on 4 September 2008 gt MT WTFSS 25 26 27 28 29 30 31 1234567 8 91011 1213 14 15 16 17 18 1960 21 22 23 24 25 26 27 28 29 30 October 2008 MT WTFSS 12345 m Dam Nee BHE a N o
280. or incomplete codes too Proprietary Information 58 f 2irMed Training Account 5076 training account Log Off ZirMed Account Prof Claims Inst Claims Remits Eligibility Print Services Patient Statements Pay F Poy Help Contact Us Customer Support Center Survey Claims Batches Mame Watching Providers Reports Enrolment Payers Coding Tools Settings Exceptions Procedure Code Search ICD 9 Search Reports Uncheck if you don t want ICD 9 Code Search alicik incomplete codes to list Search for Type code or keyword Service Date 08 01 2007 Search wl Include Incomplete C Janly search my codes List My Codes Displaying 1 10 of 12 Codes 10125150 Page aj GO Code Description My Codes 003 OTHER SALMONELLA INFECTIONS Incomplete E 003 0 SALMONELLA GASTROENTERITIS 0034 SALMONELLA SEPTICEMIA aT 003 2 LOCALIZED SALMONELLA INFECTIONS Incomplete E 003 20 LOCALIZED SALMONELLA INFECTION UNSPECIFIED 003 21 SALMONELLA MENINGITIS 003 22 SALMONELLA PNEUMONIA E 003 23 SALMONELLA ARTHRITIS E 003 24 SALMONELLA OSTEOMYELITIS E 003 29 OTHER LOCALIZED SALMONELLA INFECTIONS E Displaying 1 10 of 12 Codes 10125150 Page of2 GO Proprietary Information 59 CODING REPORTS Coding ee Billing Report fi d Demo Medical Practice Demo Medical Practice 729 w Karen Craigmyle Log Off ZirMe Account Prof Claims Inet Claims Remit Eligibility Print Services Patient Statements Pay Leads Admin f mma Contact Pay
281. or the patient by typing the first three letters of the last name hitting the space bar and typing the first three letters of the first name For example SMI lt space gt JOH for John Smith If there is only one patient who meets the search criteria that patient s name will be automatically placed in the box Otherwise a grid of patients who meet the criteria will be displayed so you can choose the correct patient from the list Employment Status The default is Employed This can be changed to Unemployed or Student Marital Status The default 1s Married This can be changed to Child Other Widowed Divorced or Single When finished click Save and Schedule or Save and Edit If you need to cancel your work click cancel x Cancel gal Save and Schedule Save and Edit Cancel removes all data as though the entry never happened Published 1 6 2009 Page 80 of 248 Reference Manual Save and Schedule This immediately takes you T Schedule Appts HS10207 WILLIAM MARTIN Sandusky9 5 Close Patient Search Pp ip Scheduler Settings F to the scheduling screen where it will default to ele ee E a NP for a new patient exam preteens AN OOOO O OP Future Appointments Save and Edit This immediately takes you to the Patient Edit Information screen to enter the demographic information set up the cases insurance and diagnosis codes Adding a New Patient e Click the New Patient or F4 on the menu E
282. ot a reschedule or a no show If a patient calls prior to the date of their appointment and cancels and does not reschedule mark them as a cancellation To mark them as a cancellation follow the below instructions e Find the appointment that you need to mark as cancelled e Click on the wand e Click Cancellation This will mark the appointment as a cancellation Printing a Daily Schedule There are a few different daily schedule reports that you can run in the system Choose the format that you like the best All daily reports can be set up to be scheduled to show up in your email That way you do not have to remember to print the reports daily they will just show up in your email e Open the Account Assistant e Click on Reports e Click on the Report Generator e Click on Daily Reports e Click on the Daily Schedule Report e Select the report options that you want e Click view report Published 1 6 2009 Page 140 of 248 Reference Manual Charge Entry Wizard CEW F7 The Charge Entry Wizard is the module that is used to enter charges into the database Charges consist of products and services The CEW gives you the ability to enter all charges at one time whether it 1s a Service or a product To open the CEW click F7 on your keyboard or click the CEW on the menu at the Ear top of the Screen CEW F7 Once the CEW button has been selected the Patient Search screen will appear Enter the patient s last name and hit enter
283. ote 5 EE Patient Information iy Case Information la Insurance Diagnosis Codes FP Motes Ledger Weight Loss e Refresh Caze aLL Charges Payments Balance Totals and Aging Voided Charges Voided Payments Claims Charge Date between 1401 2008 and 11nsn2008 Month to Date 55 144 pat H A 1107005 Pl 2 PAT Wo 98941 ADJUSTMENT THREE TO FOUR REGIONS 65 00 0 00 z Payment Metroa Amount Ref No Notes Date Applied a A 205 cK 65 00 34255235235 1197 2008 05 04 PM Date case charge t voice jou To Status Hold term Description Total Balance H fpi 11412005 FI 261 147 FRI pre Woo 97140 MANUAL THERAPY TECHNIQUES 54 00 0 00 H pz 1141120085 FI 262 146 FRI pre WoO 98945 EXTRASPINAL 45 00 0 00 Fa fe 114112005 FI 263 148 FRI pre WoO 97012 MECHANICAL TRACTION 42 00 0 00 H pi 114112005 Pl 264 146 PAT pat Mo 59 ADJUSTMENT THREE TO FOUR REGIONS 65 00 0 00 Patient Ledger Charges Tab w charge detail expanded e The Charges tab shows every single line item that has ever been charged to the account e The dates can be adjusted for the charges that are being displayed e All or Specific Case Types can be displayed e Sorting Click on any of the column headers in the grid and it will sort the information being displayed by the column that was selected e At the bottom of the screen the Total Charges and the Total Charge Balance are shown Count 71 Total 4903 55 Charge Balance 708 0
284. ou to start over Create Schedule Settings for Visit Types Click on Utilities Utilities Calculator F6 Support Log Of ae i Setup i User Manager gt Inventory fos Schedule Settings For visit Types izi Schedule Settings For Providers H Scheduler F Open Today Tab Schedule Appts Restart Account Assistant Click on Schedule Settings for Visit Types Published 1 6 2009 Page 68 of 248 Reference Manual o wf Utilities Calculator F6 Support Log Of Ae System Setup pa User Manager W Products and Services Goa Schedule Settings For visit Types e Click the arrow next to Default Visit Type e Go to Time Blocks and enter the office hours of operation Example from 8 00am to 12 00pm Time Blocks rn Jo7 00 AM To Jo7 00 Phi OO p ed e Select days of the week by checking days boxes Check the days of the week that the clinic is open M tito W Tu fw we M Th iw Fr if Sa e Click Fill e Go back to Time Blocks and enter From 2 00pm to 6 00pm e Click fill e Go to top of page and click SAVE A box will appear stating The current settings have been changed Do you want to save these settings before loading a new visit type e Click yes A box will appear saying lt Default gt was saved successfully e Click OK Published 1 6 2009 Page 69 of 248 Reference Manual Once the default hours have been setup they can
285. ow scheduled Deleting an Appointment Appointments should not be deleted unless they are appointments that have been scheduled in the future You never want to delete an appointment on the day of the appointment You should always re schedule the appointment or cancel the appointment If the appointment is deleted your stats can will be off on your EZ Report To delete an appointment follow the below steps e Locate the appointment that needs to be deleted e Click on the pencil icon on the left hand side e Click the delete button e Click yes to delete the appointment Editing an Appointment Appointments can be edited so an appointment can always be force booked If the clinic only takes new patients at certain times during the day but a new patient comes in off the street and needs to be treated immediately you can schedule the appointment at any time a New Patient appointment is allowed Then you can edit the appointment and schedule it for whatever time you want To edit an appointment follow the below instructions e Locate the appointment that you want to edit e Click on the pencil to the left of the appointment e Change the appointment date and or time e Click the save button Signing in a Patient All patients need to be signed in Once the patient has signed the sign in sheet it is imperative that you mark them as signed in All patients that have signed the sign in sheet need to be marked as signed in on the schedule To mark a p
286. p efe soj anf oa arz00 o Ww Pl 4 97140 54 00 216 00 000 216 00 0 00 0 00 800 sso eso e ooj aam 0 00 216 00 INS If this box is checked it means that the product or service is set to bill to insurance Ifa charge has been entered and needs to not be billed to insurance you can uncheck the box from the Today s Charges screen Case This is the case that the charges are attached to Units How many units are being billed for this charge Item Typically the CPT code unless this is a service then it could be called a shortcut code Unit Amt The amount that the facility charges per unit SubTotal The subtotal for the charge Tax How much tax will be billed for the charge if the item is taxable Total The total amount for the charge Applied The amount of money applied to this charge Adjustment The adjustment amount applied to this charge Credits The amount of monies from credits being applied to this charge Balance The balance left on the charge Published 1 6 2009 Page 154 of 248 Reference Manual Patient Payment Screen This is the screen that is used to tender the payment for today There is also a sub section in this screen that will appear if a patient has credit on their account that can be applied to today s charges Patient Payment Recommended Payment 300 00 Copay 0 00 Patient Products 300 00 Today s Charges Total Applied Today s Balance Patient
287. patient walks into the clinic and the referral Published 1 6 2009 Page 48 of 248 Reference Manual source has not been entered the front desk has the ability to create a referral source rapidly Remember that new patients CANNOT be saved in the system without a referral source Adding a Referral Source through system setup e Click Utilities S Utilities Calculator F6 Support Log Of P 5 m Setup z User Manager Inventory oR Schedule Settings For Visit Types Schedule Settings for Providers f Scheduler Open Today Tab Schedule Appts D Restart Account Assistant e Click System Setup So F Utilities re F6 Support Log Of Ae System Setup i Us Manager gt Inventory e Click the referral source tab Sroups Referral So Ferral Smirre Fie e Click add new referral da Add ai Source Published 1 6 2009 Page 49 of 248 Reference Manual e Select a referral source group from the drop down Ref Source Group Uncategorized Code PAT e Code Enter a code The code is a short identifier that is used for the referral source Ref Source Group Uncategorized Code PAT ete ed m TIFRIT See sl e Description Enter a description This is the Description of the code Code PAT Description PATIENT REFERRAL Active PS e Active Check the active box if this is an active referral source Code PAT Description PATIENT R
288. porting tools to make sure that your office is running efficiently and you are avoiding trouble If you know that claims should be paid in 22 days and you have claims over 30 days with NO NOTES then find out why Published 1 6 2009 Page 207 of 248 Reference Manual The Quick Checklists The following checklists repeat information from the rest of the manuals that you have read and training that you have had but it s important that you keep them foremost in your mind Any failure in these steps will impact A R The Mandatory Daily Items to keep your office running Collect Co Pays and Deductible Amounts at Checkout Bill Daily Check ZirMed Daily Enter in Payments and EOBs Daily Resubmit claims as needed Daily Balance your desk and back office Daily The Weekly Items to keep your office running Work your Carrier Non Payment Report Check your A R Reports for Paid PIs and WC The Monthly Items to keep your office running Statements to Patients Work your A R Published 1 6 2009 Page 208 of 248 Reference Manual Reviewing the Scheduler Reconciliation Referral Source EVERY account should have a referral source even on established patients take the time to ask what originally brought them into your care Remember for patient referrals the referral source should be PTREF or similar for patient referral then the account number should be entered in the referral account number in the Account Assistant Patien
289. priate for Phunkey reports o Log out of Phunkey o Goto the Control Panel o Run the Print IT Client applet o Click the View Property Cache button o Click the Update Cache button o Upon completion click the Close button to close the Property Cache window and click OK to close the Print IT Client window o Reconnect to Phunkey and run a report Published 1 6 2009 Page 18 of 248 Reference Manual e The report is being formatted for A4 paper instead of Letter o This situation is usually seen with Brother printers To have the report formatted to print to letter instead of A4 paper install the Brother Generic PCL5e driver Please see the Brother Generic Printer whitepaper for information on this If the issue persists please contact Customer Support Helpful Tips Save Paper Preview before printing A very helpful feature of the Print IT Client is its ability to Preview job before printing This feature is turned on from the client when you are connected to the Phunkey server Simply right click on the Print IT icon in the system tray the area next to the clock in the lower right hand corner of the screen and select Preview job before printing Print IT POF publisher options v Preview before printing Apphy additional printer properties SJ dy 10 24AM Published 1 6 2009 Page 19 of 248 Reference Manual Published 1 6 2009 Page 20 of 248 Reference Manual Quick Reference Codes Mandatory Sc
290. ption screen display is comprised of seven columns Coding Compliance Exceptions Entries on this screen will be excluded tram Coding Compliance validations Payer i os service Date Procedure Code Dx Code Modifier Displaying 1 3 of 3 Exceptions Proprietary Information 02 New Except Procedure Service Date Type Code s Du Code s Modifier From To Medicare 4 Indiana Adminastar IMINO ACD ape Pb BOO Medicare 4 Kentucky Adminastar MK 0 LCD f1020 i242 Medicare B Kentucky Adminastar SME YO Cll 97116 OF S30 Page 1 e The payer associated with the exception will be displayed in the first column If the payer name is too long for the allotted space it will be truncated which is indicated by three periods When this is the case you may place your cursor over the payer name and a hover over box will appear and display the complete payer name e Type The type of exception will display e Procedure Code s The procedure code s associated with the exception will display Dx Codes The diagnosis code associated with the exception will display Modifier The modifier with the exception will display service Date From and To Any service date with the exception will display Actions Links that when click will allow you to o Copy an exception o Edit an exception o Remove an exception Remove an Exception From time to time you may find it necessary for sp
291. r ID for each Up to tive can be entered ciamare shown OOOO M at the top COB Referring Provider DR DOCTOR view always Other Referring Provider Numbers Select a type and enter the provider ID for each Up to tive can be entered Fee destination eet renee tick Claim Level Coordination of Benetits this payer assumed to have adjudicated this claim k STEP 5 This is a re adjudicated claim claim was adjudicated previously by the above payer Click on a line at Claim Paid Date top to views and Coordination of Benefits Other Payer Amounts 4 5 edit that insurance Payer Paid Approved Amt Allowed Amt Patient Resp Covered Amt b Discount Per Day Limit Patient Paid Tax Amt Pre Tax Total sequence Use the Add and Delete aT inke ta add ancd Medicare Outpatient Adjudication Information deletean Reimbursement Rate HCPCS Payable Amount ESRD Paid Amount insurance Non Payable Professional Component Billed Amount Sequence when Remittance Remark Codes TE neepea The Claim Level COB Adjustment Group 1 Adel Another Adjustment Group destination insurance Adjustment Group Sequence cannot Reason Code Amour Cuantity i Units STEP 6 eh ae Control Number Service Date Procedure Charges Units Motes COR e alan 2 22 2005 99303 130 00 1 CLICK add primary claims Ii ae 2 2 25 2005 99315 66 00 il Aad we Proprietary Informa
292. r Manager Inventory T fmd hd vi Schedule Settings For Visit Types Schedule Settings For Providers Scheduler Open Today Tab Schedule Appts TNF Restart Account Assistant e Click System Setup Calculator F6 Support Log Of PA System Setup ez ust Qtanager gt Inventory e Click the Providers tab s EDI Settings e Click the Add Provider Button at the top of the screen Published 1 6 2009 Page 39 of 248 Reference Manual gt boa Settings 5 de Add Provider C e Select the entity that the doctor is associated with from the drop down menu Entity in MOTION CHIROPRACTIC Ih WOT y MOTION CHROPRACTIC Code e Create a code All physicians must have a code Make sure that the code is a portion of the doctor s last name and not numeric This way it can be easily identified when scheduling an appointment or running a report e Fill out all of the information e Enter the Provider s ID numbers these are not the group numbers for the entity these are individual provider s number o UPIN Number o NPI Number o Taxonomy Code o Tax Id number Remember do not enter dashes OFI MPI 42345678910 Taxonomy lode 10xxx000081 2 Tax ID 123456789 e Check the appropriate boxes for the provider o Referring Provider Check this box if the provider is a referring provider o Rendering Provider Check this box if the provider is a
293. r all charges in grid Set Charge Date Can change charge dates for all charges in grid Set Case Can set the case type for all charges in grid Ei Charge Edits fA Commit C Set Rendering Provider Set Referring Provider Set Treating Provider Edit Diagnosis Codes Set Modi Set Mod Set Mod Set Mod4 Set Local Use Box 19 mH Set Charge Date FT Set ase Published 1 6 2009 Page 193 of 248 Reference Manual The status of the charges can also be updated Click the Status Edits button and this screen will appear Ei Status Edits Ei Charge g All charges ON hold all charges OFF hold All Charges ON Hold This places all charges in the grid on hold All Charges OFF Hold This places all charges in the grid off hold All Charges HCFA Sets all charges to bill on a Paper HCFA All Charges EDI Sets all charges to bill electronically All Charges STMT Sets all charges to bill on a statement ea All charges HCFA ci All charges EDT All charges STMT Once the changes have been made to the charges and everything can be updated click Commit Changes A box will pop up asking if you are sure this is what you want to do Click yes and the changes will be made to all of the charges in the grid Published 1 6 2009 Page 194 of 248 Reference Manual Billing Menu Payments Carrier Payments Understanding and Entering Carrier Payment
294. r higher to be only 10 a month well worth it Do NOT be talked into a dedicated T 1 line or any option over 150 a month Printers You must be printing through the ChiroMagic Demo system before going live Take a look at the http www printershowcase com Ricoh SP C420DNV Value Bundle 1 635 with toner A duplex laser that prints on both sides is very nice for printing Encounter Forms with the super bill on the back for less wasted paper Always get the DN at the end for duplex network Your ChiroMagic Website is www chiromagic com The Client Login to the support area is chiromagic and password is magic123 at http www chiromagic com Published 1 6 2009 Page 9 of 248 Reference Manual You will find training videos important instructions and materials here Thank you for your time Please do not hesitate to contact our ChiroMagic division leader Carrie Barnett if you have any questions Carrie Barnett 307 275 1022 x116 carrie phunkey com Support Email is support phunkey com Your Support Phone is 307 275 1022 Yours Very Truly Phunkey Incorporated Steven C Williams Chairman Published 1 6 2009 Page 10 of 248 Reference Manual Installing ChiroMagic Windows XP You MUST have high speed Internet Connectivity to utilize CHIROMAGIC Instructions for Installing Remote Desktop on your Computer Please make sure that you follow the instructions below to get Remote Desktop Protocol RDP
295. r the carrier that is displayed Voided Checks on Ledger List of payments that have been voided for the carrier that is displayed Claims tab on Ledger List of claims that have been billed for the carrier that is displayed Published 1 6 2009 Page 189 of 248 Reference Manual Totals at Bottom of Screen At the bottom of the screen you will always see the totals for that screen In the case of the Checks screen you will see the total Paid Applied Adjusted and Total Credit Total Paid 18445 47 Total Applied 18445 47 Total Adj 29574 75 Total Credit 0 00 Charge Review Using and Understanding the Charge Review The charge review is a utility that is given to all users to query and update data in mass Bill to Values All charges Account Assistant Charge Review el ES have a bill to value This is eee E la x a z E the place where the char ge CEW F7 New Pat F4 Reports Biling Utilities Calculator F6 Support Log Off will be billed to next a Close Reset Filters Run Query Status Values All ae Charge Dates Case Type lt AllCaseTypes gt gt F Charges have a status ar i 0912112008 i ia 082112008 ix Tey E pat PX value This 1S the place paras Last Billed Carrier Type ea Carrier Types j Never Billed Billed Use Date Range All cnie X where the charge was Status Values Sn one ill l La z eC SA Treating
296. r the claims EDI Type The EDI type typically will read Default EDI Setup Claim Count How many claims total are in the batch Total Total dollar amount of the file Last File This is the name of the last file number that went to the clearing house Notice the green arrow to the left This allows you to select which batch needs to be sent to the clearing house or printed Once a batch is highlighted in yellow the details of the batch are listed in the bottom portion of the window Claim Batch Detail p 6292 TEST4 JONAH WALLIAMS ey CHIR 31 MICHAELDI BAR 1124060017 204139137 1r4666570 3 1174666570 adil Notice that the important information of entity facility and boxes 32 and 33 are present for review along with box 24 and 17 These are the primary fields used to make sure the right provider numbers and NPI numbers are printing for that Ccaim This is the 1 problem for rejected claims The Magic Wand is available for each patient Published 1 6 2009 Page 181 of 248 Reference Manual Claim Functions Flag a The claim functions flag represents the functions for claims that are about to be printed or transmitted Claim Functions ae view HCFA 3E Delete Claim and Rollback Charges af View in Patent Ledger View HCFA This will display the claims on a HCFA form so you can confirm that the information is accurate Delete Claim and Rollback Charges This will delete the claim and roll the cha
297. r wao S Remittance Remark Codes TTT sending this claim to another payer Claim Level COB Adjustment Group 1 Add Another Adjustment Grou Providers in a Adjustment Group provider to payer Reason Code Amount eaka f Units COB situation da not ul i Control Number Service Date Procedure Charges Units Motes L C9 usually complete this information but may 2 22 2005 99303 130 00 1 STEP 6 ep do o if the 2 2 23 2005 99313 88 00 1 roe TEI aS i Line Level COB Data VWaApproved Amount Add Another COB Section Line Level COB insurance sequence 1 line 1 Bundled Line Number has Adjudication or Payment Date Le Procedure Type Code Moditiers ES anne Procedure Description Paid Units of Service Paid Amount Referral Number eer Prior Authorization Number Se Line Level COB Adjustment Group insurance line 1 Add Another Adjustment Group Adjustment Group Reason Code Amount Quantity t Units T The approved amount equals the amount for the service line that was approved by the payer sending this oar to another payer ES Repeat Step 6 for each additional service line on the claim After you have entered all Claim level and Line level COB information for the secondary claim you should be ready to submit your claim 10 If you will be using your Providers screens click in the box next to Overrides On prior to clicking Save amp Resubmit
298. ractice 729 ZirMed Demo Log Off irMe Account Prof Claims Inst Claims Remta Eligibility Print Services lt Pay F Poy Help Contact Us Customer Support Center Survey Claims Batches Mame Matching Providers Reports Enrollment Payers Coding Tools Settings Search Claims Rejected Claims Dashboard Old Claims Screen User Preferences Specify Claim Claim Prefix a Displaying 1 2 of 2 Claims Fage of 1 0 Claim Number Patient Name Trans Date Rendering Provider ZirMed Payer Charges Seq Status 0061 78 00 FRANCIS FRANCES F O3 02405 Medicare B Kentucky 43 00 1 Received by Payer Edit Mote O2 25s0F DOCTORIMA Adminastar SMK YO 094729 00 FRANCIS FRANCIS F 0222 05 Humana and subsidiaries 216 00 1 Received by Payer Edit Mote More O2 25 07 DOCTORDR claims 61101 Check All Clear All Selected Claims More Actions Page of 4 0 fi Z d Demo Medical Practice 729 ZirMed Demo Log Off irMe Account Prof Claims Inst Claims Femits Eligibility Print Services lt Pay 4Poy Help ContactUs Customer Support Center Survey Claims Batches Mame Matching Providers Reports Enrollment Payers Coding Tools Settings Search Claims Rejected Claims Dashboard Old Claims Screen User Preferences Specify Claim ZirMed Payer Claim Number C Rejected Only im Prefi Displaying 1 2 of 2 Claims Claim Number Patient Name Trans Date Rendering Provider ZirMed Payer Charges Seq F 0017
299. raining Cast Hire hills tra account trainingaccount New User Page of Go E Mail indicates the Domain Administrator Optional if you enter one please make sure that it is valid Active Force user to Change Password Primary Account ZirMed Training Account S076 E want this user to be able to add users delete users and change user information as well as have automatic access to all functions for all accounts within my domain Unlock Accou This account has been locked due to 3 consecutive failed logins Check this box to re activate the account Update User Proprietary Information 6 WELCOME Go to Account Welcome screen The Welcome screen is the first screen after logging into the system zirMed Training Account S076 training account Log Off Account Prof Claims Inst Claims Remit Eligibility Friot Services Patient Statements lt Pay Fd Poy f ZirMed Help Contact Us Customer Support Center Survey Welcome UmMmary Account Protile hy Profile Users Reports Enrolment Providers Enrollment Records Preferences Downloads Action Items Alerts Professional claims currently rejected 13 Rejected Claims Dashboard General Alerts 10 Payer Updates 846 Institutional claims currently rejected 9 Rejected Claims Dashboard a The Welcome screen will display links to other information on the ZirMed Web site Look for updates in this area for the latest information on
300. rch the following e Which payers can accept electronically filed claims through ZirMed com e Which payers require enrollment before accepting electronically filed claims e Payer IDs used for Name Matching All information on this screen is maintained by ZirMed Under Search For you have the capability to search for a payer by using either the Name or Payer ID Number The Type category also allows you to narrow the search by choosing the payer type from the drop down box e g Commercial Medicare Medicaid Blue Cross Blue Shield etc If you cannot locate a payer on this list the Payer may still be able to accept electronic claims You can verify this by contacting the Payer directly and asking if they accept electronic claims If they do ask them for their Electronic Payer ID For those payers who cannot accept an electronic claim ZirMed can create a paper claim and mail it to the Payer on your behalf this is done in Name Matching f 7i d zZirMed Training Account S076 training account Log Off irMe Account Prof Claims Inst Claims Remit Eligibility Print Services Patient Statements lt Pay FaPoy Help Contact Us Customer Support Center Survey Claims Batches Mame Matching Providers Reports Enrollment Coding Tools Settings Printable Updates Payer Search kentucky Enroll Reg Ext PayerID Search Payer Name or ID Displaying 1 4 of 4 Payers Page of 1 GO External Enroll Payer
301. re Appts 360 00 1 467 00 533 00 KAISER 0 00 2 OS S0 2008 traing 10 copays visit 09 22 2008 traing Hardship case they are Authorizations only to be billed 35 00 for appointment 5 episodes of 11 used Expires 12 51 2006 Began 14 2008 Edit Auth In Fast visits Number of visits 10 Last visit By DOS al Last Visits by DOS Entered gt Er Copy Selected i Odd Hew Ta Charge Group Menu Bar E Charge Entry for SN3 HOLLY MARTIN Sandusky a Close PP Patient Search g Today s Patients a P Miti rmt On the top of the CEW there is a menu bar which allows you to perform various functions once the CEW is open Close The close button will close the CEW Patient Search This button allows you to search for any patient in the database Published 1 6 2009 Page 143 of 248 Reference Manual Today s Patients This button allows you to search for any patient who is on the schedule for today that has not had a charge entered into the database Magic Wand This button allows you to open and perform any functions that are accessible from the magic Patient Section The patient section allows you to see what patient and case they will be working with and also some additional basic information for the patient Patient ne ee Current Case MANOSI Patient Balance Total Balance Avail Credit Pri Carrier Pri copay Future Appts 390 00 1 467 00 o33 00 KAISER 0 0
302. red into the computer E Charges Report Options Ot x 5 Close Run Report C Clear show 7 Clear Criteria Show Field Criteria P Patient a iV AcctNo E W LastName r Vo FirstName r W Charge r Entity E M Facilty r V Case E IM Service Type C V Charge Date a T Entry Date E M tem E tem Type a CPTCode a 7 ChargeDese E Units YF UntPrice p M SubTotal E Vo Tax C A Total M Pad E F Ad oi MM Writeott E V Balance Ci V BilTo E F Status a x Remember that the show field will display the information on the report if the show field is not checked then the information will NOT be displayed on the report The Criteria field allows the user to select specific information for that field It is important to remember that on the charges report the total payments are the payments that have been applied against the charges that are being displayed Charges 301 records th AcciNo LastName FirstName Charge Case Charge Date tem Units UnitPrice SubTotal Tax Total d Adj VvrteOft Balance BE To Status Hold RespParty RendProy TreatProv Modi Mod2 Mod3 Mod4 Resp Carrier SNoo0o2 TON AMBER 3 E CHRO 10 15 2007 97012 1 42 00 4200 0 00 42 00 0 00 0 00 38 00 PAT pr iv ee HHM lt none 59 ANBCBS Snooo04 MILLER PAMELA 1 gt CHRO 1017 2007 98941 1 65 00 6500 000 6500 0 00 0 00 0 00 PAT pri G 3 HHM HHM 0 SNO0006 pea BEND
303. rendering provider o Treating Provider Check this box if the provider is a treating provider Published 1 6 2009 Page 40 of 248 Reference Manual o Can Schedule Check this box if you need to schedule appointments for the doctor Referring Provider Rendering Provider Treating Provider a 1 41 4 Can Schedule Payment Methods Understanding and Setting up Payment Methods Payment Methods are used to define how payments are collected for your clinic They ft Add Method JG Delete Method Y X Code PRI are also used to sort and group your collections B Code Description fz Desecration PRIMARY Insurance PAYMENT by payment method on reports Payment sas SOUFCE Primary Methods give you the ability to break down a i Type ayme where your collections are coming from REFNS REFUNDINSF PRID Primary Adjustm Payment Methods help in the automatic and intelligent entry of payments Each payment has a source and a type These cannot be altered Code This is the code that is used when entering in a payment in the CEW and Payment screens CASH for example Description This is the description of the Code Source Primary Secondary Patient or Other No other choices Type Payment Adjustment Refund Write Off What is a Payment A payment is money that has been received and put into the bank account in exchange for products or services What is an Adjustment
304. report is displayed by carrier Clicking on the bubble will display the names of the patients that are attached to the insurance carrier Published 1 6 2009 Page 231 of 248 Reference Manual AR by Carrier 3 records Carrier Company Phone Resp Party Last Billed Total Paid QUALCH SS QUALCHOICE HEALTH PL 440 460 3498 094 6 2008 1 208 00 10 00 MEDICA MEDICAL MUTUAL OF OHIO 800 362 1279 1149 2008 1 212 00 270 00 0 00 UNITD1 UNITED HEALTH CARE 800 225 7951 1147 2008 726 00 445 00 0 00 Clicking on the bubble will display this information Drag a column header here to group by that column Email Spreadsheet ey Print Charges 10 records Drag a column header here to group by that column AcctNo LastName FirstName Charge Case Charge Date UnitPrice SNOOOO4 Mig MILLER PAMELA 23 FatcHIRO 09272008 71100 1 90 00 SNO0004 yr MILLER PAMELA 20 j CHIRO 09 12 2008 98941 3 1 65 00 SNO0004 5e MILLER PAMELA 22 pz CHIRO 09 12 2008 98943 1 45 00 SNO0004 yr MILLER PAMELA 21 fe CHIRO 09 12 2008 97012 1 42 00 SNOOo004 yr MILLER PAMELA 44 pe CHIRO 09 15 2008 97140 4 54 00 SNO0004 gt MILLER PAMELA 32 JM CHRO 09 5 2008 97140 4 54 00 SNO0004 5e MILLER PAMELA 33 Ab CHIRO 09 15 2008 97110 4 53 00 SNOO004 5e MILLER PAMELA 45 pa CHRO 09 15 2008 97110 4 53 00 SNOO0O4 yr MILLER PAMELA 43 Ab CHIRO 09 15 2008 98940 1 55 00 SNOo004 5e MILLER PAMELA 31 i CHRO 09 15 2008 98940 1 55 00 Over30 Over6
305. rges back so you can re bill them Ms Goto camer KAISER zP View Claim History View in Patient Ledger This will take you directly to the l Enter Claim Mena patient s ledger Go to Carrier Ledger This will take you directly to the carrier ledger View Claim History This will take you to the history of the claim Enter Claim Memo This will allow you to enter a memo for the claim Sending Claims Electronically and Printing HCFA Forms Once the charges and batches have been approved and are ready to be processed it is time to transmit the electronic claims and print the paper HCFA On the charges tab notice the batches that are listed have a type of EDI or HCFA 1500 form If the type is EDI then that batch needs to be sent electronically If the type ready HCFA 1500 then that batch needs to be printed to paper e Click on the HCFA form to the left e If sending electronically then select Send EDI file Billing Functions mi Send EDI File e If printing claims for a batch select Print HCFA 1500 forms Published 1 6 2009 Page 182 of 248 Reference Manual Print HCFA Bulk Billing History Tab Once the HCFA s have been printed and the files sent the batch will be moved to the History tab Bulk Billing 0 EN Close me Refresh fa Charges b Claims mB History J sunknown MICHAELDOIH HEF Detant EDI Setup 351 40 a a 6151 180 RORY SAMPAR SAP CHRO PRI 27 MICHAELDIX 4124060017 204139137
306. rid Start Time Jo7 00 AM im peu visit TYPE air J 182 192 192 gt aches A Grid End Time Jor 00 Pi ie Allowed Providers and Max Bookings Hourly Start Time e Allow All Prov A Disallow All Prov CI Pr fe erar avane starr Ce it ren ROLLY Mare SPINAL DECOMP SPECIAL CONSULT E z a E 30 MINUTE MASSAGE E E Time Blocks From Jor 00 AM To Jor 00 Pri Clear All IY fio W Tu I vie M Th Iw fr Sa Eil Clear a Fill Min to Max a5 Reset Visit Types Section Show All Types If this box is checked the list of visit types below all active and inactive visit types will be displayed Published 1 6 2009 Page 66 of 248 Reference Manual Visit Types These are the different visit types that the clinic offers Notice the green arrow Whichever visit code has the green arrow next to it is the visit code that populates all of the settings to the right In the example above the green arrow is next to the 60 Minute Massage meaning that the details to right are for the 60 Minute Massage Settings Section Notice the header says Settings for MA60 this is because the visit code to the left is the 60 Minute Massage Settings for MA60 Code This is the code for the i waco Minutes feo visit type Description 60 MINUTE MASSAGE Grid Start Time 07 00 am H Description This is the Color J 182 192 192 Active M Grid End Time 07 00 pm descr iption of the code Allowed Prov
307. rned Telephone Support can be reached at 307 275 1022 If you do not get a representative directly please leave a message and detail about the issue or problem You will probably receive a return email rather than a phone call Describing the Problem or Issue This cannot be stressed enough Detail Detail Detail Please make sure that if you have an issue to give the account number patient name what you were doing and the exact error message We receive too often the scheduler isn t working PatientCall didn t call a patient and without the detail there is no way to check into the issue Published 1 6 2009 Page 241 of 248 Reference Manual Turn Around Time You can expect to receive a response in 6 business hours Many times you will receive responses quicker than that We strive to respond as fast as possible and are adding staff when needed to accommodate call volume Please remember that on www ChiroMagic com you have ALL the training sessions recorded sessions and solutions USE THESE they are FREE Development Software Problems or Errors Please report errors in the software or reports immediately to support phunkey com We attempt to correct all bugs and errors within 24 hours of receipt You will receive a case notification for opening and closing these reports just like regular support There is never a charge for error fixes Development Cycle New Features Phunkey releases three
308. rols to set the quantity received of each item In the Notes field you can put in a purchase order number or any other pertinent information about receipt of the item This is a great place to notate missing inventory items from an order Published 1 6 2009 Page 61 of 248 Reference Manual When you are finished with the inventory receipt you can Clear items Select more items or Add the quantities that you just entered to inventory You can also adjust a single inventory item quickly from the Items menu After you click Add to Inventory you can go to another tab or print out the Inventory Received Report Services and Products Received Progress Report The following screen will appear with choices You can filter by User Category Item or a From or To date INVENTORY RECEIVED Category a SO i tem Ea E From RH To RH View Data xX Cancel E cee e Click the View Data Button when the filter criterion has been selected You will see the inventory received items with all related information Entry Date User Category Lode Description aty Motes i 024 2 2008 07 16 PM NONE NUTR415 COLD DRINKS MILDBERRY PASSION 6 PO 123 4 i z prow 024 2 2008 07 16 PM NONE Pe PHASE Il START NEVY PATIENT PO 123 4 Published 1 6 2009 Page 62 of 248 Reference Manual Set up Pricing for Products and Services Once the item has been added into the system it needs to be added to a fee schedule
309. roup By Billing Mame ClaimiD Billing Name Service DT Charges ACORDIA HATIONAL 29993409 DOEJOHM JACK JIM JACKSON EFS D6 26 2003 655 00 PAYER MAME MATCHING REQUIRED MAME M amp TCHED AND CLAIM RESUBMITTED BY KAREN PAYER MAME MATCHING REQUIRED RENDERING MAME MATCHING REQUIRED REFERRING MAME MATCHING RESUIRED CLAIM EDITED AND RESUBMITTED ZIRMED PAYER MAME MATCHING REQUIRED RENDERING MAME MATCHING REQUIRED BILLING MAME MATCHING RESUIRED FACILITY MAME MATCHING REQUIRED REFERRING MAME MATCHING RESUIRED CLAIM LOADED FOR PROCESSING ACORDIA HWATIONAL 87815 30r 4022 DOEJOHM BOMET BILL WY JACKSON Sa ORG 20035 E5500 REMDERING NAME MATCHING REQUIRED BILLING MAME MATCHING REGUIRED CLAIM EDITED AND RESUBMITTED TRAINING A RENDERING MAME MATCHING REQUIRED Payers Matched to Paper This report displays all Payers you currently have payer name matched to paper within the ZirMed system This report should be reviewed periodically to ensure Payers who can accept electronically submitted claims are updated Use the Name Matching for Payers screens to enter these updates Payers Matched to Paper By Account Payer Hame Address CIGNA HEALTHCARE MEDICARE KENTUCKY Proprietary Information 40 Detail Reports The Detail Report feature allows you to choose a number of report options in order to create a report that best suits your current needs From the Detail Report screen you can select the sort sequence and date ran
310. rrier ONLY THOSE ITEMS that are billed to a carrier will appear on the claim You do not have to put charges on hold and then take them off of hold and move them to the patients A claim will not have more than one invoice on a claim A claim will normally not have more than one date of service on a claim unless you edited one of the invoice charge s date of service Published 1 6 2009 Page 128 of 248 Reference Manual How to Enter in Charges Open the Account Assistant Click the Charge Entry Wizard or hit the F7 key on your keyboard Hitting F7 on the keyboard will bring up a list of patients This is a list of patients who had an appointment today whose appointment time has passed and for whom a claim has not yet been entered If you want to enter a claim for one of these patients highlight their name and click enter Or if the doctor who you want to enter a charge for is not on the list click cancel and you will be prompted with a search screen to look up their name Notice at the top of the screen you have the patient s name and account number Patient Balance The patient s balance Total Balance The total balance including the insurance and the patient balance Avail Credit Available credit on the account PRI Carrier The primary carrier for this patient PRI Co Pay The primary co pay for this patient Future Appointments Number of future appointments for the patient Should be 12 You also hav
311. rrier bi patient s diagnosis codes will print on page 1 of the Encounter 5 e ny Form M Show Page 2 Patient Diags M Show CPT List 2nd Page 7 W Show CPT Prices notes that are labeled as instructions will print F7 Calculate Last Exam Date Show Patient Memos If this box is checked then the patient s notes that are marked as Memos will print on the Encounter Form Show Carrier Memos If this box is checked then the insurance carrier memos will print on the Encounter Form Show Signature Line If this box is checked then the signature line for the doctor and the patient will print on the Encounter Form Show Page 2 Patient Diags If this box is checked on page 2 of the Encounter Form the patients diagnosis codes will print Show CPT List 2 Page If this box is checked then the patient will have a 2 page Encounter Form and on the second page will be a superbill for the doctor who matches the patient s fee schedule 1 Form for Each Patient If this box is checked and the patient has multiple appointments scheduled only one Encounter Form will print Calculate Last Exam Date If this box is checked then the Encounter Form will print the date of the patient s last exam based on the charges that have been entered into the computer Select the appointment date that Encounter Forms are being printed for in the calendar The date that is blue is the date that will print By default the Encounter Forms will
312. rrow to the left This allows you to select which charges need to be approved for billing Highlighting the line will then populate the Charges screen below MICHAEL HCFA Lo HCF4 1500 Form tensao E T eter Vea Al Pa a Published 1 6 2009 Page 178 of 248 Reference Manual It is also important to understand the column headers in the Charges window Charge This is the charge number for the charge Patient This 1s the patient name and ID number that will be billed Bill To Where the charge will be billed Primary or Secondary Carrier The carrier that the charge will be billed to Date Date of Service for the charge Rend The rendering doctor for the charge Refer The referring doctor for the charge CPT Code The CPT code that will be billed Modl Mod2 Mod3 Mod4 Any modifiers attached to the charge Units How many units will be billed on the charge Charges Function Flag The Blue flag represents the charge functions that are available for the charges that are about to be billed If a charge needs to be edited then it can happen directly from this screen Edit Charge This takes you to the charge detail screen where the charge can be edited for specific information such as charge date diagnosis codes and modifier information Charge Functions h Edit Charge a Place Charge on Hald A Bill ta Patient Place Charge on Hold This will place the charge on
313. rst Name Last Name E Mail e Accounts If you have multiple accounts you can limit access per user e Permissions Set permissions per user e Reset Password General To change a user s information highlight their name on the left then change the boxes on the right under the General tab To add a new user click the New User button on the left side of the screen it will give you some boxes to fill in to create the new user The password you give a new user must be at least 6 characters contain at least 1 number and is case sensitive It is a good idea to designate a Security Manager to have permissions to add users and reset passwords in the event that the Domain Administrator is not in and a user needs to reset their password To Inactivate a User highlight their name on the left uncheck the Active box then click on Update User Account ZirMed Training Account 5076 eirMed Training Account 5076 ZirMed Training Account 5076 GUT 5076 M PFC ZirMed com _ Usr karencraigmyle karen craigmyle f Z d ZirMed Training Account 5076 w Training Account ZirMed Training Account 5076 w w P irMe Account Prof Claims Inst Claims Remits Eligibility Print Services Patient Statements Pay Fd Po Help Contact Us Customer Support Center Survey Welcome SUMMAEY Account Profile hy Profile Users Reports Enrollment Providers Enrollment Records Preferences Downloads Manage Users Page 1 of 1 Go General
314. s Carrier payments are completely separate from patient payments Carrier payments are payments that come in from insurance carriers for specific patients Carrier payments are entered into the Carrier Payments module located under the Billing Menu on the main menu Carrier payments do not appear on a patient s ledger until they have been t 8 E CEW F7 New Pat F4 Reports Biling Utilities Calculator F6 Support Log Off applied Until then the carrier payment patient Seach P is held with the unapplied checks until Oal I Si aasi the whole amount has been posted It iiis made 5 r Check Information WILL report on your collections report Aamot GER er Payment Foes Unapplied 0 00 Notes Check Date 091212008 method PRIADI z So let s say the clinic received a 1000 Select Charges Ulities BCBS payment The check has been men Date Last Name FirstName Acct Total Allow Paid Adj Balance Prev Pmt Applied entered into the database but only 500 of the check has been applied toward four patient charges The collections report will show the 500 as unapplied Carrier payments and se me ee a e a e e the other 500 will appear normally as a Primary or Secondary insurance payment The collections report will reflect the entire payment even though a portion is all that is posted Each time you enter a carrier payment it will show you any
315. s Voided Checks and Claims This screen displays all of the information for the prospective location a Location Ledger Miil E S dose DateRange osi2t2008 to os072008 custom Refresh Ledger Charges Payments Checks Total and Aging Yoided Charges oided Payments Yoided Checks Date Range The date range box allows you to customize the dates for the charges that are displayed The information that will display by default will always be the last 30 days There are pre set custom date ranges in the drop down box Make sure that if the dates are changed in the Date Range box check the Refresh Ledger Charges Tab on Ledger This will display a list of charges for that carrier that fall in the date range that has been selected above By clicking the blue flag the charges can then be edited voided taken off of hold a memo entered and the history of that charge can be viewed Patient Accounts can also be accessed from this screen by clicking on the Magic Wand next to the Acct field The will show all payments adjustments and write offs Checks tab on Ledger This is a list of checks that have been posted for this carrier Clicking on the check function allows you to edit the check Remember that if a payment is unapplied the check then becomes an unapplied carrier check again since there is a portion of the check that is not applied Voided Charges on Ledger List of charges that have been voided fo
316. s Ua veisisssccssccaucccussstalenvecustinvestsbesccauctevesatelessseuaiissesrsdenecsuctansssteleseeasadiesesnclenctvccaasessnslaaeeasies 123 Published 1 6 2009 Page 3 of 248 Reference Manual Voided Payments TAD a cececesscescenseccasceeveossbaescscncevussssyeusiarcdseuceiaasieecucevecsstanss est eneciseuiionsesueauscecscessausepeesiaunets 123 Clams TA Dussier ene eee 124 Claim History Functions siisii arn R E A anna EE NRR 124 WMO ES CANIN GC ASES err 125 SCS D0 cre arnt ec testis tatenre once eons ae tecadinss E idnaleenehuanee 125 SS NS LAENE a N E E O E ENEA O AEE E 125 Diagnosis Codes Dy CASE sc san cevarisncaessneveaienensenatioesacuestnnsousteshua TEASEE EE EEr EEEE EEEa ASENA EEEE TEE 125 AA D EO NEEE NEE EENE AO N EE O E E E O O E 127 Magic Wand and Patient Functions sssssssecccccossssceccoccsssscecccoosssssccecccssssscecccossssscecoccsssssseeocossssssececosssss 127 Schedule A PpOMOMC lS orsina a E RENERE EEN a R NE aE 127 Print Future Appointments s sssssosmsrasnen n eana aE OaE Ea EAEE A EET 127 PU A E AEE E A E ENE E A A E EA A E N E E EA 127 Understanding Entering Charges sesers ae AEE Ea Er EEEa AEEA EE ENTE sat 128 Howto Pott in Cha SG eeoa er OE REE OEE EE EESE Ea A AETA 129 Oe A E EEE E E N S N E E E E N N A E E E E E 131 eS AET gt 1 E T AE O AANO N OE A A E A E EAE A 131 a TG MT E AEN A TN OAA OAE ATEA A 131 Eao oiae E ee e E EE E E EE E OEE ENEE 131 AAIE IC E i EE A AI A AAIE VA A EEA E E 131 The Today Tab and Fro
317. s already been created Delete Click this icon to delete an exception Allow This column denotes whether this exception allows appointments to be scheduled Prov This is the provider that the exception is for Visit Type This is the visit type that the exception is for From This column denotes on what date the exception starts To This column denotes on what date the exception ends Note This column show the note is attached to the exception Published 1 6 2009 Page 72 of 248 Reference Manual Adding Exceptions Click the Add button to bring up the Schedule Exception screen ta Schedule Exception A Save x Cancel Provider HOLLY H MARTIN F gt Visit Type ALL VISIT TYPES F From 14 27 2008 03 00 AM to 112772008 05 00 PM All Day Mote Thanksgiving Day office Closed If Appointments are allowed click the Allow Appointments Checkbox Select the Provider from the list by clicking the Magnifying Glass Select the visit type from the list by clicking the Magnifying Glass Set the From and To date and time or select the date and click All Day Enter a Note Click Save Setting up the provider when the provider works the Office Hours of Operation e Click on Utilities Utilities ms if User Manager gt Inventory cog Schedule Settings For Visit Types igi Schedule Settings For Providers E Scheduler E Open Today Tab fe Schedule Appts Restart Ac
318. s and Aging voided Ch Payment Date Method Amount Applied fee 132511 Josmyeona CHECK 15 00 15 00 T Charge Date term Total Applied SA 303961 05072008 9894 65 00 15 00 Fayment Date Method Amount Applied 133360 0s20r2008 PRO 20 63 20 63 ose0 2008 29 37 29 37 T cove 1356090 OB042008 CASH 15 00 15 00 COPAY 6 4 2008 h Z f ae po e veo 7301 On the payment ledger just like on the charge ledger there are function flags remember a green function flag means the payment came from the patient and the yellow function flag means the payment came from an insurance carrier The functions flags for the insurance carrier payment and the patient payment are different Both are explained below At the bottom of the tab you will see the Paid amount Adjustment amount Refund amount Write Off amount Total Amount Total Applied and the Total Credit for the patient Remember the totals that are being displayed there are in correspondence to the date range at the top of the screen Paid 2600 653 Adj 105 00 Refund 5 32 Write Off 0 00 Total Amount 2 700 51 Total Applied 2 553 51 Total Credit 347 00 Green Function Flag Patient Payment Note If the payment is a patient payment and there is available credit left on that payment then an Apply Payment function will be displayed If there is not an available credit then there will be NO Apply Credit function Published 1 6 2009 Page 10
319. s filed e Type This dropdown will default of All which includes o o LCD o NCD Or you may use the dropdown feature to choose a specific type of exception you wish to search for e Procedure Code If you would like to search for an exception for a specific procedure code then enter the code in this filed e Dx Code If you would like to search for an exception for a specific Diagnosis Code then enter the code in this filed e Modifier If you would like to search for an exception for a specific Modifier then enter the modifier in this filed You MUST click on Search to complete the filter search options Exception History From time to time you may find it necessary to add copy edit or remove an exception Once you have taken one or more of those actions you may find it necessary to know what had been done in the past To achieve this there is a link History on the Coding Tools Exception screen that when click will provide you with a history Proprietary Information 50 i Payer Specific Exception History Web Page Dialog Exception History Clase Window Date Time User Action Type O54 02007 F444 AM Zirtied Created LEO Procedure Code 71020 2nd Procedure Code fs Dx Code 7242 and Dx Code Modifier Service From Date service To Date When you click on this link a window will open and there will be a list of each payer and exception type CCI LCD or NCD you have ever tak
320. s you to enter a patient payment rapidly Patient Ledger Allows you to pull up the ledger for the patient Encounter Form Allows you to print an Encounter Form for a patient Remember if printing an Encounter Form from the Magic Wand for the patient the system will automatically print an Encounter Form for the default case for the patient Edit Information Takes you to the Patient Information tab See Basic Data Entry Section for details Published 1 6 2009 Page 131 of 248 Reference Manual The Today Tab and Front Desk and Scheduling The purpose of this section is to discuss the front desk and to teach the things that are important to this area of the clinic Here is a checklist of the basic things that need to be learned at the front desk e Scheduling an appointment e Rescheduling an appointment e Multiple booking an appointment e Deleting an appointment e Editing an appointment e Signing in a Patient e Marking a patient as a No Show e Cancelling an appointment e Printing Daily Schedule Reports e Printing Daily Encounter Forms The Today s Appointment tab is where the schedule for the day is stored When a user who works at the front desk comes in for the day this is where they will spend the majority of their time Once you is logged in the Today s Appointment tab should be opened and locked If it is not locked then the schedule will slide on and off of the screen just take the mouse and click on or
321. se of information indicator This can be controlled by our settings screen if you are not able to populate within your practice management system RESOLUTION Contact your Implementation Specialist or Support Representative to activate this setting if you are unable to populate it within your practice management system If your settings screen is completed and you are still receiving this rejection message please contact ZirMed Proprietary Information 23 MEMBER ID INVALID DOESN T EXIST 02 INVALID PROBLEM The payer is stating that the subscriber ID on the claim is not active or is invalid within their system RESOLUTION Contact patient for correct insurance information and resubmit claim if applicable If the insurance is termed you will want to hide the rejected claim on the ZirMed system To hide a claim check the box under hide on the left side of the claims screen REQ GROUP POLICY PROBLEM Payer is requiring a group policy number to be indicated in box 11 RESOLUTION You may edit the claim online and resubmit with the required information You will need to update your practice management system to prevent future rejections GH INVALID CHARACTER S FOUND IN CLAIM UB INTERMEDIARY PROBLEM Intermediary is stating that a character on the claim is invalid Typically this will involve a hyphen or asterisk on the claim RESOLUTION If you cannot locate the invalid data you will want to contact your account rep Us
322. sis codes You must of course specify diagnosis codes for all HCFA and EDI charges a afo o eT Published 1 6 2009 Page 125 of 248 Reference Manual p In the Patient Edit Information screen there is a Diagnosis Codes tab where there is a separate set of diagnosis codes for each Case When the user clicks the Diagnosis Codes tab the diagnosis codes will be displayed for the default case Simply click the key next to each case and the Diag grid will appear with the diagnosis codes for each case You can add new diagnosis codes by typing in a number or word to search the list You can also click the Function Box at the left of the diagnosis code row and select COPY from another case This will quickly copy over another case s diagnosis codes Check the Default button 1f you want those diagnosis codes to always appear checked when entering in charges for that case Current Case CHIRO i Copay Fut Code LastDOS CHIRO 6 4 2008 Chiropractic Iv Print Description Published 1 6 2009 Page 126 of 248 Reference Manual Front Desk Magic Wand and Patient Functions The Magic Wand will take you to the Patient Functions display menu for a patient Anytime you see the Magic Wand you have Patient Functions access to the patient functions Remember anytime you sees the gl Schedule Appts Magic Wand you can access any of the following patient ti Print Future Appts funct
323. slide it over the Today s Appointment tab syuawnuloddy s Aepo L Once the tab is opened click the push pin at the top of the screen and this will lock the schedule in the open position DE Published 1 6 2009 Page 132 of 248 Reference Manual This is how the schedule will look 7 ARMIN eo eENOER cRAS o 9 1 CEC ne at n an e fret fozssem vans oon e 9 fire osoon roumo vann swe 9 GIA o EE fs The search screen at the top of the screen allows you to search for appointments that are on the schedule The calendar allows you to select the day that they want to view The print button allows you to print different reports from the schedule Appointment List visit Type Schedule Provider Schedule Encounter Forms Recall List Schedule Reconciliation The appointments are displayed in time order The information that is displayed is the visit type the provider appointment time patient name sticky note 1f there is a note attached to the appointment and the patient account number and the Magic Wand In the example below notice how there is an appointment without a clock next to it This means that the appointment time has passed the patient was not checked in and charge has not been entered into the system TX Se rin T scheduled ol addon 6 patients Z CE EE Published 1 6 2009 Page 133 of 248 Reference Manual When the patient checks in for the appointment double click on
324. sonehveudde ante Vensdadgasadeossuueduasnegensptubennaeesedonendecesbed 65 Scatching Tor EMS secsec N Ea E E EEEE EEEa 65 Utilities Schedule Settings for Visit Types cccccccccccccssssssssssssssssscccccccccccccccccccccccssssssssssscseeeeeeeeees 66 VASE VS e e LOB E E E E N E E I A E T E AE V E E 66 BC UES a OU P E N E E E N E O E A E A PE OA A O O O 67 AK Ee E E a i OAE EA EA A E O O AA P OAA O O 68 Create Schedule Settings for Visit TYPes ccccccccccccccecceeeceeeeaeessessseeeeeeeeeeeeeeeeeesaeesssseseeeeeeeeeeeeeeeeaasaaaassseseeeeeeeess 68 Utilities Schedule Settings for Provider cccccccccccccscsssssssssssssssssccccccccccccccccccccssssssssssssseseeeeceeeees 71 Provideri SCCM ONG a E E E E E O E EE A E 71 OMS SSC i esena O E O T2 Eee o KS eE R A E E A A A A E A R 72 PX CCOUIONMG SCCM OF sses EEE EEE Ea 72 Adine ECC DUONG 15 0css onesies tonsnancugaecenseiawabacetctcescatcaceetanaecaedancead aeons Ea 73 DV PUN upa FO VICE sesane E E E EEE 75 CUS O COAUTOR 77 ONES OCI Today TAD sisrorrrsiroreitrror srst or nreo ENE EEEE NENE EE EEEE EERENS 78 Published 1 6 2009 Page 2 of 248 Reference Manual Utilities Schedule APPTS ssivissiscrisscascdccsscnessdsdvccvoniessaddesivnsdocdassevciadeisevcdaseeddesavasdosieavasdasdecssesseeseesdss 78 Utilities Restart Account ASSISIOHL sesssessssssseeeeesssssseeeeeccossseeeecccccssseseeeecccosseeeecccssssseeeeeccsssesseeeeeeso 78 Basic Data Entry Patient IN
325. ssssssscccccccssssscsccccsscsssssssssccoees 164 Understanding Master ait s 525 5 2cacscanas cnararctceutasancs danasuantonia Matures i E a A aae aeaa eaaa 164 Adding New Master CaArrief os caces tenes carceacecturondacaatesenitesmses abeceadeabucaaaidencadantanal CanceGsnchurond idea ia Nanaia toned 164 Understandine Caprice siccsticsscsassccustavaeinsbesssancectsssapsssecuadaiawenstowsstuccetevauslusvecetiveecuatiiavsucdonesaseaateseessesasauass 166 B TATION EAD aer E E I EE TOET OCEANON ET ECE OOOO EOE OEE OOE 166 E a a E i AT A E E ETE EA 167 TI TNO o T N A 169 B 5 CU e EE E EE 169 POB SE a E E E E E 171 Adding an TAS UE AOS Carrilet soprcsrrnnono eodein aaa gaon eaaa aa aai 171 Adding EOB Settings toa C ante srrsimirocri isori tenanan o aa aa ra eain aaia 173 Guarantors Understanding and Setting Up GuarantorS sssssssseccccosssssececocossseccccocssssseecoceossssssseeesoo 175 Addin a New GU ar anit OF seisoessaan EN E ERES E EE 176 Buk BUDO sorsien E EEE EEA EE S 177 Understanding Charges Invoices and Claims ccccccccccccccccceeeeeseeeseseeecceeeeeeeeeeeaaeeeaaaaesssseeeeeeeeeeseeeeeeeaaaaaeseasees 177 Charn e TaD a E E E E E 178 Cr E A e E TE E R E E E E E E 179 Cra AE ea E EE EE E E E E 180 Ca MAD earar E E E E E E E E E E E E E 181 amw Ba KEE E E E E 181 Sending Claims Electronically and Printing HCFA Forms cccccsssssssesseseeeececeeeeeeeeeeaaaasaseeeeseeeeeeeeeeeeeeeaaas 182 Buk Billins History VA i aes eten ota ci
326. st DO NOT PRINT THIS LIST Just download it to your desktop and open the report and you can click on the binoculars and look for the payer id number If it is on the list make sure that you set the carrier to go electronically inside of the software Problem Resolution Guide for Medicare When you move to ZirMed Clearing House getting your approval switched from your existing clearing house to Medicare will take the longest of all your carriers Usually 2 7 weeks depending on your Medicare carrier Medicare has a DIFFERENT set of requirements for EVERY STATE and in some states like California SEVERAL different formats 90 of all out billing issues are with Medicare For New Offices e Make sure the paperwork is filled out perfectly double check for transposed numbers or letters e Do NOT go live until you have approval from all carriers including Medicare This means the previous two points are critical e Once you have approval for all carriers you MUST GO LIVE otherwise you will NOT be able to transmit claims out of your old system Published 1 6 2009 Page 245 of 248 Reference Manual e Noridian Medicare takes the longest amount of time and WPS Medicare takes the shortest e If you SUBMIT claims to ZirMed prior to approval they will get rejected because your enrollment is not complete Do you have a New Corporation ID If you are changing your business structure especially from Sole Proprietorship to Corporation
327. stName FirstName have not been printed yet P Patient Case EI Patient Case p Detaut view Patient Form o View Forms for 10 2008 View Patient Form Published 1 6 2009 Page 220 of 248 Reference Manual Encounter forms can be printed for a single patient through this screen by typing in the patient s name in the Specific Patient box Select the Patient Case from the drop down list and the Encounter Form will print for this particular case Remember when printing an Encounter Form from the Magic Wand that the Encounter Form will print for the default case If a patient is a walk in and an Encounter Form needs to be printed HS10205 HOLLY MARTIN Sandusky rapidly for the default case click on the Magic Wand and select print Patient Functions 6 Schedule Appts P Print Future Appts Enter Charges Charge Review Enter Payment Patient Ledger Encounter Form when scheduling the appointment 4 Edit Information Statement Notes a Log Measurement Published 1 6 2009 Page 221 of 248 Reference Manual e Snap Shot Report This report has been designed to produce all of the critical weekly and monthly statistics to help monitor your practice NOTE to Doctors Access to the Snapshot Report is given to users based upon how your Setup Sheet is filled out It is imperative that we know which users need access to the report If there are emplo
328. swsts lt s Csi i i S nnee CLEVELAND sss sSOSOSSSSSSCi oH vr s lt sS Ju2sase 7e900 Ju2aase 7e900 123654789 s sSSCSCisw 10xx88811112 12345678910 0 vrerock rock com Person Reference Manual e Click on the button at the top of the screen that says ID Numbers J System Setup E Save and Close as ather System Setup Lists fe Patient Status E Referral Source Groups E tE Settings IS Service Types E Case Types dP Add Entity x Delete Entity ad ID Numbers a cool e Enter the ID numbers for your facility What are these ID numbers These are ID numbers that are attached to your entity that could be required by an insurance carrier When sending a claim electronically some insurance carriers require ID numbers to be attached to qualifiers If you have a legacy ID number that still has to be transmitted for Blue Cross or Blue Shield this is where you enter that information Every clinic is required to enter the NPI number the Tax ID number and also the doctor s Taxonomy Code The qualifiers that are required are highlighted in the illustration below Note A Phunkey representative will also meet with the staff and assist in setting up the Entities in the Setup one on one tutorial Published 1 6 2009 Page 34 of 248 1 ZE MEDICAID PROVIDER NUMBER CHAMPUS IDENTIFICATION NUMBER FACILITY ID NUMBER PREFERRED PROVIDER ORGANIZATION NUMBER HEALT
329. t PVA Chiro Patient Visits divided by Converted New Patients this gives you your Patient Visit Average New Patient Conversion Ratio Chiro This is the Converted New Patients divided by the Prospects The closer to 100 the better New Patient Referral Chiro The percentage of converted patients who came from patient referral divided by the total number of new patients In order to activate this feature you MUST be entering the referring account number in the Account Assistant Patient Window this is the only place to enter this number No Show This is the percentage of patients who are true No Shows and do not reschedule In order to make this function work you MUST check the No Show box on the appointment or use a NS status code If they called in and rescheduled you would us a Reschedule Visit code and not mark it as a No Show Average Visits per Patient For the period this is the Average Visits per patient The total Patient Visits divided by the total of the individual patients that made up those visits So if you have 600 patient visits for the month and that was represented by 200 individual patients then your Average Visits per Patient is 3 0 Average Future Appointments per Patient The total future appointments for the patients you saw during that time period divided by the number of individual patients Published 1 6 2009 Page 225 of 248 Reference Manual Average Future Appointments per Convert
330. t Rejection Message V Rejected Group By Rejection Message a Choose Group By aan y Days Include Mame Matching Rejections mE Then Click Go 2 claims remain rejected from 58 days ago on D June 04 2007 SLL SLU Total Charges Rejection Message i ED 1 950 00 CLAIM REJECTED BY FIRST EDITS lt BR gt AS OF OCTOBER 1 2003 ANTHEM WILL HO Batch loo Resubmit E LONGER ACCEPT THIS INVALID PROVIDER NUMBER PLEASE USE YOUR 12 DIGIT Click number to go FACETS PROVIDER NUMBER TO OBTAIN YOUR PROVIDER NUMBER PLEASE l 7 ss ia CONTACT ANTHEM PROVIDER RELATIONS RENDERING PROVIDER NUMBER Select drill down amp click Go VALUE RECEIVED 1352 3344 1 200 00 CLAM REJECTED BY FIRST EDITS lt BR EMROLLMENT FOR PROVIDER NUMBER 113444 FOR PAYER ID TRICS TRICARE SOUTH REGION HAS NOT BEEN COMPLETED 100 00 CLAIM REJECTED BY FIRST EDITS lt BR gt ENROLLMENT FOR PROVIDER NUMBER 113750 FOR PAYER ID TRICS TRICARE SOUTH REGION HAS NOT BEEN COMPLETED 600 00 CLAM REJECTED BY FIRST EDITS lt BR gt ENROLLMENT FOR PROVIDER NUMBER 114440 FOR PAYER ID TRICS TRICARE SOUTH REGION HAS NOT BEEN COMPLETED 4 2 850 00 Results do not include Hidden Claims Resubmit Resubmit Resubmit This report should be reviewed immediately when you see you have rejected claims Proprietary Information 35 This is the same report you see when you click Rejected Claims Dashboard
331. t This is done from the print menu on the schedule Click the print button and select schedule reconciliation Cross reference the sign in sheet with this report Everyone who is on the sign in sheet should be on the reconciliation report If they are on the sign in sheet and not on the reconciliation report then that means the charge has NOT been entered into the system If a patient is not on the reconciliation report but they are on the sign in sheet locate the DC Note and enter the claim Re Run the reconciliation report and all of the information should now match Reviewing the Scheduler Reconciliation Referral Source EVERY account should have a referral source even on established patients take the time to ask what originally brought them into your care Remember for patient referrals the referral source should be entered and the account number should be entered in the referral account number in the Account Assistant Patient Info Screen No Show if there is No Claim listed the word NO SHOW should be in big bold letters like this NO SHOW If the patient is not marked as a No Show then reference the sign in sheet and make sure that the patient did not sign in If they are not on the sign in sheet then make sure you go into Published 1 6 2009 Page 159 of 248 Reference Manual the schedule and mark that appointment as a No Show If this is not done then the Snapshot Report will be inaccurate The following is a list of st
332. t Info Screen No Show if there is No Claim listed then the No Show box should be filled out and the Status box The following are agreed upon status codes RS Rescheduled for future appointment NS No Show no communication SI Signed in CW Cancelled Will Call If the Visit was rescheduled then it is not a No Show A No Show is for a visit that the person did NOT show up and did not call to reschedule Co Pay 100 in Co pay means Cash patient Co pay s are entered into the patient screen in either SA or AP There should be a payment 99 means Personal Injury 98 means Work Comp 97 means Trade out You are welcome to create your own co pay codes but you should have something The Co pay should NEVER be 0 00 it might also be a percentage meaning that the patient owes a of the bill Cross reference the Co pay with the Payment Field this is critical if there is a co pay listed and no payment then that money was not collected not entered or stolen If they did not collect the co pay then there should be a notation in the Special Instructions field in the patient screen so that the next time Encounter Forms print the front desk will know Charges look at the charges you normally perform similar services for each client it should be noticeable if there are missing charges B should know the special nuances about what can be billed to the different carriers You may need to cross refer
333. t of all of the charges for the day Total Applied This will default to the amount of the recommended payment Today s Balance This is the charge minus the applied amount Tendered Applied This will default to the amount of the recommended payment Adjustments Applied Defaults to 0 00 PREV Credits applied Defaults to 0 00 Amount to Tender Amount of money you are taking in today If the amount that you are taking in today is more than the co pay the system will automatically apply it to credit so that the next time the patient comes in you can take the money from there and apply it against that DOS Published 1 6 2009 Page 130 of 248 Reference Manual e Adjustment Amount you need to adjust off for the day e Apply to Today This will default to the recommended payment If you need to change that amount you can override it here e Apply to new credit This is the difference between the Amount to Tender and the Apply to New Credit amount e Method How the patient is paying the money e Payment date the date of the payment always defaults to today s date e REF No This is for the Check Number or the CC Authorization number e Click Finish e Your receipt will appear on the screen summarizing today s charges Charge Review Takes you to the Charge Review for the patient s charges See the section of the manual on Using and Understanding the Charge Review Enter Payment Allow
334. t t A Patient Ledger Payments i Account Ledgers are reports that staff members can give to patients to let them know there account Status fy Account Ledgers Report Options yl Close o gt Run Report C Clear Show C Clear Criteria Patient fi Px Criteria Charge Date between i1252008 and 112572008 Today Patient Charge Date Show Carrier Infa D Financial Class E el Pri Carr Sec Carr Show Paid amp Adj M Guarantor l Show Diagnosis D Case Type Show Carrier Info DOS Summary Format show Guarantor Show Paid amp Adj Show Diagnosis DoS Summary Format q A A A AO T T T Remember that all reports have a list of fields to select from Once a field has been selected the criteria will then show up in the left hand side of the screen for the user to select what they want from the list Appointment Reports Appointment reports are used to generate lists of appointments for certain criterion Remember there are fields that can be shown on the report and then also criteria that can be selected to narrow down the results that are displayed Published 1 6 2009 Page 227 of 248 Reference Manual Appointments Report Options Mel x Close o gt Run Report C clear show _ Clear criteria Appt Date Time between qone200e and 1oNoeoo0s custom Appt Status PatientiD E Appt Date Time ra 5 j Wo vist Type E EUSA Rescheduled W Provider C a Cc lled FO ieda gt ancell
335. t the Providers names will be displayed The displayed names are pulled from information entered in ZirMed s provider screen 2 Inthe section on the right Held My Un matched Providers will display Inquiries for a given Provider will be grouped together allowing you to match the Provider Name assigned by your PM System with the corresponding information entered in ZirMed s provider screen 3 Below the Un Matched Providers section are the buttons you will use to tell the system how to match the inquiry To Name Match the inquiry 1 Highlight the Un matched Provider name in the section on the right 2 Search for the correct Provider in the section on the left In order for a name to appear in this section you will have to enter the information in the provider screen 3 Click in the circle next to the Provider name fA 7ZirMed 4 Click Match to Selected Name located on the right below the list of Un matched names lf the Provider name appearing in the Un Matched provider section Payers name does not appear in the section on the left you have the option of Do Not Process Inquiries For This Provider WARNING Anything you match to this option will be discarded and will not be processed in any way by the ZirMed system Only use this if your PM System does not have the ability to exclude a particular payer s inquiries from going to ZirMed lf the correct name is in the inquiry and it had not been previously
336. t there is available credit left on this payment that can be applied to any DOS Understanding Credits and Unapplied Payments AN UNAPPLIED PAYMENT IS A CREDIT Note If there is a payment that has not been applied it needs to be applied to a charge Use this function to keep patient statements up to date Otherwise charges can appear even when the patient is paid in full Published 1 6 2009 Page 109 of 248 Reference Manual How Do I Apply Credit to a charge To apply a credit to a charge then follow the instructions below e Click the Apply Credit from the green function flag y Applying Credit from Payment 60 for SN3 HOLLY MARTIN Sandusky9 h Apply Credit x Cancel Credit Application Patient F E dit Fayment SN3 HOLLY MARTIN Patient Balance Total Balance Avail Credit Next Appt ee Unapply Payment 54 99 663 01 905 00 16 Apply Credit credits 2e Void Payment Paice Payment Date Amount to Tender Unapplied Ref No SSS ss Josizar2008 Er 8 Ss 188 00 Notes Method Date Description Total Balance Select e The applying credit detail screen 10 01 2008 ADJUSTMENT ONE TO TWO 45 00 T 10 16 2008 ADJUSTMENT ONE TO TWO 45 00 E appe ars 178 109 PI 10 23 2008 98943 EXTRASPINAL 45 00 oo 0 00 179 109 PI 10 23 2008 97012 MECHANICAL TRACTION 42 00 oo f 0 00 e 205 119 PI 10 29 2008 98940 ADJUSTMENT ONE TO TWO 45 00 oo 0 00 Click the Select button next to the 206 119 PI 10 29 2008 97
337. t this person to be a security manager or if you will set the permissions for this user If you click the circle that says I will set permissions then after clicking Add User at the bottom you will click the Permissions button to the top right then check all the boxes of the rights that you want to grant this user Then just click to the Welcome tab You will want the new users to login sometime in the next 24 hours to activate their login password so it will not expire Q How do set permissions for a user A After adding a new user or if you want to change the permissions of an existing user just go to Account Users then click the user s name on the left side of the screen Then click the Permissions button to the top right Then check all the boxes of the rights that you want to grant this user Then just click to the Welcome tab Q How do check the status of enrollment A Go to Professional Claims then the Enrollment tab This screen will tell you if any payers are waiting on enrollment to be completed It will tell you the Status of a payer s enrollment and the Phase Proprietary Information 78 QUICK REFERENCE TO CMS WEBSITES Topic Where to Find CMS Manuals http www cms hhs gov manuals Coordination of Benefits http www cms hhs gov medicare cob Coverage http www cms hhs gov coverage Enrollment http www cms hhs gov States 10 Enrollmentl nformation asp HI PAA http www cms hhs gov hipaa hipaa2
338. tats from the box that says run new Stats If you put today s date in the As of field it will give you up to the Published 1 6 2009 Page 222 of 248 Reference Manual minute stats Remember this will take a longer amount of time to run since the computer is calculating them right then Service Type The Service Type drop down box gives you the ability to run stats for all Service Types or just one Service Type ChiroMagic has two main service types CHIRO and WL These are your two main business types for which revenues and patient visits are tracked Service Type for lt All Service Types gt Remember that ALL of these statistics are dependent upon entry of charges into CHIROMAGIC If you are behind in claim entry your numbers will NOT be accurate Main Snapshot ReportScreen At the top of the Snapshot Report you see the calculation field day numbers for the date of report WTD for the entire week MTD for month to date YTD for year to date 12 Mo Total for this month plus the previous 11 this report was for July 31 2008 so 12 Mo Total takes August 1 2007 to July 31 2008 and 12 Month Average giving you the previous 11 months plus this month divided by 12 This provides you with an excellent moving average rather than looking at YTD mid year SnapShot Report for All Service Types Gl Close E7 Email Spreadsheet z Printable Report g Show Previous 12 Months Calculation fy pav AAT A MTO
339. te while scheduling the Today Tab or the Charge Entry Wizard moving the mouse over the sticky note will bring up the note Published 1 6 2009 Page 95 of 248 Reference Manual 3 How do I add a new note to a patients account e Click the Add note button on the command bar at the top of the screen e Select the note type from the drop down Lo op AddNote e Click Save r e Mark the note with the appropriate pop up from the list Ledger Tab The Ledger tab is the heart of the patient screen From the ledger there are the Charges screen Payments screen Balance screen Totals and Aging Voided Charges Voided Payments and Claims Enter Charges The Ledger tab is accessible while having the Patient Information window A Enter Payment open or you can click the Patient Ledger from the Magic Wand Patient Ledger E Encounter Forms At the top there is the option to Close Refresh the Ledger Select the Case gt Edit Information Type Note that ALL is defaulted or specify the date range 2s Refreshing the ledger is useful if you have added charges or payments while working in the account Clicking refresh will update all the screens in the ledger Codes ID Notes 2 Ledger Jann Weight Loss Last 30 Days Case lt ALL gt LastDOS Description isDefault e sided Charges voided Pay L a EEO enon ene E with the act v ty that Was just a Refresh Ledg
340. te is the date the case is created On the tab under cases you will be able to see the date of the case and description Case Description Each case has a description When you first create a case it will default to a main description PERSONAL INJURY for example You have the ability to change the description to something more descriptive like Truck Accident You could have five different PI cases When you see the case tabs it will show CHIRO Default 4 20 2005 and PI 5 28 08 Active Inactive Each Case can be Active or Inactive Charges cannot be added to an inactive case Default Only ONE case can be the default case It will automatically be the CHIRO case when you have been converted to the new system When you create a new patient record the CHIRO case will be automatically created and set as the default case The default case is the case that the CEW will automatically open to when searching for a patient So if a patient has been in an auto accident and you create a new Auto Accident PI case you might set it as the default until the case is closed This way when the CEW is opened it will default to the PI case and all charges will be entered for the PI case So es Diag Codes aoo ap Diagnosis Codes by Case When you change the case when entering charges the diagnosis codes will also change For most Services and Products or items that are billed directly to the patient statement you are not required to use diagno
341. the history will display as blank If the change recorded is the addition of a date then the date will display LCD and NCD Exceptions Procedure Code If the change recorded is the deletion of a code then the history will display as blank If the change recorded is the addition of a code then the code will display 2 Procedure Code If the change recorded is the deletion of a code then the history will display as blank If the change recorded is the addition of a code then the code will display Dx Code If the change recorded is the deletion of a code then the history will display as blank If the change recorded is the addition of a code then the code will display 2 Dx Code If the change recorded is the deletion of a code then the history will display as blank If the change recorded is the addition of a code then the code will display Modifier If the change recorded is the deletion of a code then the history will display as blank If the change recorded is the addition of a code then the code will display Service From Date If the change recorded is the deletion of a date then the history will display as blank If the change recorded is the addition of a date then the date will display service To Date If the change recorded is the deletion of a date then the history will display as blank If the change recorded is the addition of a date then the date will display Exception Screen Record Display The exce
342. the A R broken down by A AJR by Patient insurance carrier a R by Referral Source E AIR by Referral Source Group e A R By Case Type Allows the users to see the A R broken down amp AIR by Rendering Provider by case type J collections e A R By Patient Allows the users to see the A R broken down by patient e A R by Referral Source and Referral Source Group Allows the users to see the A R broken down by Referral sources and groups e A R By Rendering Provider Allows the user to see the breakdown of AR by the rendering provider The formats for all of the A R reports are the same The below steps are the most common way to pull a working A R Report If there are additional questions email support phunkey com This is the A R by Carrier report This is the report that is used by most clinics to work there A R This is the easiest way to mee Pear generate and use this report C cteerstow 1 cearcitera MORS e Click A R by Carrier e Once the criterion is displayed select the over 60 box or the over 30 box Most likely a user will NOT want to work current A R so that is why the user should select over 60 This will display all charges that are over 60 days old Iw E Iv O Iv O Iw O Vv O V Total C v O Iv O Iv E v O Iw O x a9 Als 992 26 OO e Click Run Report e Once the report is displayed the user will then click on the bubble under the column that they want Notice that the
343. the charge that is being entered This information comes from the default information for the case Billing Rendering Prov This is the billing provider for the charge that is being entered This information comes from the default information for the case Referring Prov This is the referring provider for the charge that is being entered This information comes from the default information for the case Case This is the case that the charges will be linked to Modifiers These are any modifiers that will be billed on the HCFA for this charge Local Use Box 19 This is the Information that will print in Box 19 on a HCFA Sublux If you click this button the date of subluxation will appear in the box Chronic This will put the word CHRONIC in box 19 Last Xray The date of the last x ray for the patient based upon the x ray charges that have been entered into the system Pay or Deny This will put the words Pay or Deny in 30 Days in box 19 Published 1 6 2009 Page 151 of 248 Reference Manual Clear This will clear box 19 from any information that has been typed in the box Bill to Insurance When checked the item will go onto a claim for the insurance carrier If not checked it is assumed to be paid by the patient On Hold This will put the charge on hold so it will not be billed to insurance or the patient Employment Related If this box 1s checked then box 10A will be checked on the HCFA form
344. the clock or in the white box and the icon will then be changed to a green check mark f scheduled appointments 6 patients v 0 ossoam sewer E yr Once the charge has been entered for the patient the green check mark changes to a dollar sign denoting that a charge has been entered Z p HH os30aM BENDER CRaIG G SNo0008 b Additional icons that appear next to an appointment and what they mean Blue Dollar Sign Patient charge has been entered Green Check Mark Patient has been signed in for appointment Blue backwards arrow Appointment has been rescheduled Red X Patient Cancelled appointment Red X In Circle Patient was a No Show Clock Appointment is pending The goal at the end of the day is to have an icon next to every appointment on the schedule NO APPOINTMENTS should have a blank box The Pencil icon next to the visit type allows you to edit an appointment If you click on the pencil next to an appointment the edit appointment window will open allowing you to edit the appointment F Published 1 6 2009 Page 134 of 248 Reference Manual Editing an Appointment This is what the edit appointment window looks like ea Edit Appt SNOOO06 CRAIG BENDER Sandusky4 gt A Save and Close Delete Seer 7 sa EEN visit TYRE OFFICE VISIT P Date Wed 10 6 2008 Start Time os 30 am Minutes 15 Mote Log f4 0704 2008 01 15 PM Createctraing 1008 2
345. the edit information button e On the Patient Information Tab at the bottom where it says marketing select the referral source from the list and click save Published 1 6 2009 Page 52 of 248 Reference Manual Marketing Categories Marketing Categories are used for an additional level of grouping for reports mailing labels and phone blasts For example in your clinic you decide to do a Thanksgiving promotion and give away a free turkey to any patient who meets the criteria you establish For tracking purposes make a Marketing Category called Turkey08 and update the patient record that code for any patient who received a free promotional turkey Then the following year when sending out mailers or doing a phone blast you can target the people who received the free turkey last year To add Marketing Categories into the system follow the instructions below e Click Utilities a Utilities Calculator F6 Support Log Of 5 m Setup ez User Manager gt Inventory gop Schedule Settings for Visit Types Schedule Settings for Providers fe Scheduler P3 Open Today Tab Schedule Appts i Restart Account Assistant e Click System Setup i Utilities Calculator F Support Log Of ie System Setup pa ust Manager gt Inventory e Click the Marketing Categories Tab eS EN entmes yor racimes e Click add Marketing Category Published 1 6 2009 Page 53 of 248 Reference Manual qP A
346. ting and analysis More claims are not paid based on wrong or missing diagnosis codes than any other reason Please note that the reconciliation report will actually show the diagnosis codes next to the CPT codes Many insurance companies and states are now expecting line level diagnosis pointing for payment Note Make sure that you highlight the Carrier Memos on the Encounter Forms that is where you put the higher level Target Coding information about what billing codes and diagnosis codes get maximum payment from the insurance carriers Published 1 6 2009 Page 160 of 248 Reference Manual Balancing the Drawer Once the Scheduler Reconciliation report is confirmed it is time to balance the incoming cash from mail and front desk To do this follow the instructions below e Click on Reports e Click Collections e Place in the criteria that you need to print the report e Remember when balancing you want the From and To date to be the same since you are balancing for one day Note Look at all of the different options that you have for printing this report This report will tell you everything that you need to know about the collections for a day Remember you want this report to match the dollar amount that is in front of you When you have balanced your charges and payments it is time to do your billing Published 1 6 2009 Page 161 of 248 Reference Manual Published 1 6 2009 Page 162 of 248 Reference Manual
347. tion n Eaito Patient FRANCIS F FRANCIS Rejection Message Time amp Date Secondary Claim Y ie N STEP 4 Sorry no history exists for claim 68923876 65 STEP 6 Below the Claim Level COB Adjustment Group s there is a section containing all the service lines for the claim Click on the ADD link located to the right of the service line After clicking on the ADD link new sections will open Here you will enter the Line Level COB Data 1 Approved Amount 2 Adjudication or Payment Date the date the primary payer paid the claim 3 Procedure Type Code Modifiers if needed 4 Paid Units of Service 5 Paid Amount Next is the Line Level COB Adjustment Group insurance sequence 1 line 1 Here you will be entering the following Adjustment Group examples of adjustment groups are patient co pays deductibles or contractual obligations Select the adjustment group type from the drop down box by clicking on the arrow then select the adjustment type 6 Adjustment Group 7 Reason Code os Fes oe er Fd oe ENT bees 7 a pepo code To view code 1A list vist Washington Coordination of Benefits 1 Add Another COB Section Ali Publishing Company Payer F CIGNA MEDICARE SECONDARY Fi i Bundled Line Number Sao Adjudication or Payment Date i Procedure Type Code Modifiers CPT HCPCS Codes 39213 I a ProcedureDescriionf OOO Paid Units of Service i Paid Amount f Referral Number e Prior Authoriza
348. tion Amount Unapplied 0 00 Check Date 09 21 2008 Select Charges ep Utilities v Charges Date Last Name First Name Acct Total Allow Paid Adj Balance Prev Pmt Applied Totals Billed 0 00 Allowed 0 00 Paid 0 00 Adj 0 00 Balance 0 00 Notes Any note that you would like to appear later on the Carrier Ledger Published 1 6 2009 Page 196 of 248 Reference Manual e Click Save Check Editing Check 9 for ANTHEM BLUE CROSS BL BA close New H Save check Apply check ga Refresh ME void check e Click Select Charges EE Select Charges Charges a The outstanding charges screen will appear showing every outstanding charge for that carrier ee Outstanding Charges for ANTHEM BLUE CROSS BL yl Close DOS Range osm22008 to oa M008 Last 30 Days Find SLL carrier charges for the Run Guer Patient Mame W x E date range regardless of status a i Select All E O94 F2008 DICK SOM GREG SMOOO08 5 CHRD 65 00 10 00 55 00 ee eee i fal esnszo0s rove ameer swo _ge crIRo morao sooo morao SEN E worm woo sn w Ba jos 22008 MARTIN HOLLY an 55 00 0 00 55 00 DOS Range The DOS Range box will always open with the date AI Dates OOO criteria of the last 30 days as the default This date can be changed to iis Last 30 Days one of the pre set defaults from the drop down or the dates can be set
349. tion Number a ai COB Adjustment Group 1 Add Another Adjustment Grou r Contractual Obligations CO Quanity i J ww Reason Code amot outy Standardized reason codes can be found on the Washington Publishing Company at hiip w wpc edi com custom _himkclaimadusiment htm 8 Amount 9 Quantity Units lf you need to enter more than one adjustment group click on the Add Another Adjustment Group link on the right Proprietary Information 66 Claim Editor Patient FRANCIS F FRANCIS Rejection Message Time amp Date Secondary Claim Secondary Claim Payer MEDICARE SMKY0 Sorry no history exists for claim 63923876 Help Settings Provider XYZ MEDICAL PA 10 Joverrideson Charges 218 00 My Claim ID 094729 00 firMed Claim ID 68923876 Instance ID 7671 3821 Simple Views Claim Detail wiew E v Provide en Editing insurance sequence 1 Primary Delete this insurance sequence Add another insurance sequence Claim Paid Date A Insurance view Service Lines View Coordination of Benefits Other Payer Amounts Payer Paid Approved Amt Allowed Amt Patient Resp Covered Amt Tine level approved Discount Fer Day Limit Fatient Paid Tax Amt Pre Tax Total amount Used Medicare Outpatient Adjudication Information primarily in payer to ReimbursementRate HCPCS Payable Amount J ESRD Paid Amount payer COB situations Mon Payable Professional Component Billed Amount py ne pave
350. tion of your financial data This gives Phunkey the ability to give you reports based upon service type If you want to classify and organize the data in more detail you will do that at the case level Some reports will have the ability to sort by Service type or Case type To set up Service Types follow the instructions below e Click Utilities i Utilities Calculator F6 Suppork Log Of P 5 m Setup Ez User Manager gt Inventory E Schedule Settings For visit Types Fl Schedule Settings For Providers Scheduler E Open Today Tab Schedule Appts Gc Restart Account Assistant e Click System Setup es Go M Utilities Calculator F6 Support Log Of an System Setup i Us Manager fs Inventory e Click the Service Types tab Published 1 6 2009 Page 26 of 248 Reference Manual STATUS a RETEA SOUP 1 Service Type Delete Se Tr If you try to delete a service type currently in use you will be prompted to change ALL case types under that service type to a new Service type Delete Service Type f There are 3 Case Types with the Service Type of Chiropractic Another Service Type will have to be selected to replace the one you are deleting Are you sure this is what you want to do Yes Mo Case Types Case types are additional breakdowns in service types The system will have default case types already set up they will be as follows CHIRO chiropractic PI personal
351. tional drop down box will be displayed allowing you to enter the location specific information Other Provider types are basically set up the same way as a Billing Provider One exception is the Rendering Provider where you can specify a Billing Provider Number If entered it will override anything supplied on the Billing Provider screen When you click the Save information for selected provider payer button you will get a pop up window acknowledging that you made a change to the Providers screen E Warning Web Page Dialog fx Any information entered on this screen will override data received on your claims OK to proceed Proprietary Information 30 REPORTS Go to Professional or Institutional Claims Reports screen select the report you want on the left The Reports screen gives you the opportunity to print reports as specific or as general as you may need f 7i M d ZirMed Training Account 5076 Log CHF 1r C Account Prof Claims Inet Claims Remit Eligibility Print Service Patient Statements Pay Leads Admin F Poy Help Contact Us Customer Support Center Survey Claims Batches Mame Matching Providers Reports Enrollment Payers Coding Tools Settings Professional Claims Reports Claims Billing Report Replaced the Claims Activity Report Rejected Claims Dashboard Expanded Rejection Analysis Hidden Claims Discarded Claims Claims Summary Claim Number Cross Reference R
352. to be changed then select acute or chronic from the drop down Employment Related Checkbox If this is checked it will automatically fill in Box 10a of a HCFA Worker s Comp would be an example of an employment related case Published 1 6 2009 Page 29 of 248 Reference Manual e Has Legal Representative If this box is checked then the appropriate box will be checked on the HCFA form A Personal Injury case might have the default set to Legal Representative Remember all these options can be overwritten when the case is assigned to a patient Financial Classes Financial classes are an additional way to track financial data For example if you have a patient who is a cash doctor who comes in for decompression Create a financial class for cash The patient would then have a service type of chiropractic a case type of decompression and a financial class of cash You now have the ability to track all financial information for one patient and view it any many different formats The system comes with a set of default financial classes They are CASH Cash Patients PI Personal Injury WC Workers Comp MC Medicare Other Other To create additional financial classes follow the instructions below e Click on Utilities Utilities Calculator F6 Support Log Of ys g Setup G User Manager gt Inventory it Schedule Settings for Visit Types Schedule Settings for Providers fea
353. ttaching a patient to a facility Published 1 6 2009 Page 36 of 248 Reference Manual e Fill out all of the Facility information e Enter the NPI number for the facility The NPI number that should be placed in this box is the entity NPI number If in box 33 of a HCFA form the pay to box says InMotion Chiropractic then the NPI number that needs to be entered at the Facility level is the group NPI number If box 33 says pay to Holly Martin D C then the NPI number that needs to be entered is the individual NPI number e Enter the Tax ID number e Enter 11 in the POS field POS means Place of Service and 11 means office e Enter 77 in the Qual field this is a qualifier that is needed for electronic billing Published 1 6 2009 Page 37 of 248 Reference Manual 9 Providers Understanding and Setting up a Provider Providers are the doctors in the clinic who provide services If you want to have the ability to schedule an appointment under a doctor then they have to be added into the system as a provider Entity This is the entity that the provider is linked to Code This is a code that is used to identify the doctor in the database This is used when scheduling patients Last Name This is the provider s last name First Name This is the provider s first name MI This is the provider s Middle initial Address Street address for provider Address2 Suite number
354. tup properly then you will not get paid Once you have opened the carrier screen notice the tabs across the top Each tab contains detailed information about the carrier that you have highlighted in the list Read below for further details and instructions on the information that is behind the tabs Information Tab Active Check this box if the insurance carrier is active This allows you to select this carrier from the patient menu Code Code used to identify gt Insurance Carriers MEDICARE 2ND fel x the carrier 1 e BC for BlueCross Company Detailed name of the insurance carrier Address Carrier mailing address Address2 Suite number for carrier City City for carrier State State for carrier Zip Zip code for carrier Phone Phone number for insurance carrier Fax Fax number for insurance carrier H Save Hl Save and Close Lo Master Carriers seeveneeeseceneccsscesccesosesssesesed ab Add Carrier x Delete Carrier Y X Active Code Company Address Address2 Contact CarrierType Pri Bill Type Sec Bill Type FeeSched PayerlD ClaimFilingCode HCFA4Digit ear EDI Setup gt Master Carrier Contact Contact for insurance carrier v meoc MEDICARE 2m0 Po Box 182332 ee s S coumes sCS on 43218 2932 614 464 9924 Ic he JHCFA t 500 Form JHCFA t 500 Form
355. u need for the appointment e Visit Type e Treating Dr e Remember the treating doctor will default for the patient if it is set up at the patient level e Click Search e Select the appointments that you want from the list by clicking on the green check mark on the right hand side of the screen As you select appointments to schedule a count will show at the top of the page for how many appointments you have selected If you are booking 12 appointments continue to select until the number at the top reaches 12 e Click Schedule Theses Appointments e This will schedule all of the appointments for that patient e If you scheduled an appointment in error then you can reschedule the appointment directly from this screen e Click on the blue backwards arrow and it will mark the appointments for reschedule Then choose your new appointment date and time on the left e Select the appointments e Click Schedule these appointments Published 1 6 2009 Page 136 of 248 Reference Manual Rescheduling an Existing Appointment e Find the appointment that you want to reschedule If you are unaware of how to find the appointment that you want to reschedule e Click on the Calendar and ask the patient for the date of their appointment once you have selected the date of their appointment then e Click in the search screen and enter the patients last name e The appointment will be displayed in the list e Click the Magic Wand e Click the reschedul
356. ually the invalid data is occurring within the billing address or patient subscriber address Proprietary Information 24 NAME MATCHING Go to Professional or Institutional Claims Name Matching screen These screens are used to associate the names provided by your Practice Management PM System with a standard Payer Identification number Payer ID that will be uniformly recognized by the ZirMed System To access Payer Name Matching go to the Professional or Institutional Claims Name Matching tab Normally you will match the Payer name with an ID only one time All subsequent submissions will automatically go to the correctly matched Payer Unless the spelling of the name generated by your PM System changes you will not need to do this again The Name Matching screen is divided into three sections 1 On the left is the Payers Search List section It is here that the Payers names their corresponding Ids and Delivery Method electronic or paper will be displayed You can search through this ID in the Name Contains box or by specifying the starting letter in the Starts With box In the section on the right claims with Un Matched Payers or with Payers Matched to Paper will display Claims for a given spelling of a Payer s name will be grouped together allowing you to match the Payer Name assigned by your PM System with the corresponding ZirMed Payer ID one time for all occurrences e g Aetna Aetna5 and Aetna PPO would
357. ul Entities le Facilities z Providers Ps dP Add Entity Delete Entity ID Numbers K 0 Address This is the Pay To TY ca monone SS address for the entity Gove company f Convery IN MOTION CHIROPRACTIC gt LastName JHUNTER FirstName HOLY hil Hi Suffix fo Address iz stret o Address2 FO TaxID This is the tax id number for the entity TaxIDType This is where you indicate if you are billing a C with an EIN number or a SSN 5 j _ Phone 2aase 7e90 000 Fax a2s456 7850 00 EntityType The type can be 1 for person or 2 for a non person entity For example if you have 2 tax id numbers in your clinic and one is for Martin Chiropractic then the SEs Person E entity type will be set to 2 and A if the other tax id number is for Holly Martin then the entity type will be set to 1 This will print the appropriate information in box 33 of a HCFA form Tax ID 123654759 Taxonomy code 10xxx00011112 MPI 12345678910 Contact i Email werock rock com TaxonomyCode This is the taxonomy code for the entity NPI This is the NPI number for the entity Published 1 6 2009 Page 32 of 248 Reference Manual Setting up the entity is the most important thing when setting up CHIROMAGIC It is imperative that you set the entity file up properly If the entity file is not set up properly bills will not be correct and the clinic will not be paid To set up an entity follow the instructions below
358. ule Appts Restart Account Assistant Published 1 6 2009 Page 78 of 248 Reference Manual Basic Data Entry Patient Information New Patient F4 Using and Understanding the New Patient Menu This menu was created so any staff member can enter a new patient rapidly The new patient menu can be added or removed for any user Account Assistant a M i Case Type Chiropractic CEW F7 New Pat F4 Re Patient Search Address 1 PO Address 2 PO New Patient Screen city stezo fo Pf Phone ko Phone Type Home gt Case Type Select the default case from the Email drop down for the new patient The default DOB is chiropractic but it can be changed by fee Male Female selecting another case type from the drop ReterralSorce iti s sS CSD down Mote pO Account This is the patient account Referring aaae Patient P number This will auto populate mployment Empioyed status Name First Name Middle Initial Last Marital Status Married Name X Cancel gel Save and Schedule Save and Edit Address I Primary street address Address 2 Suite or Apt City State Zip Enter the Zip Code and the city and state will automatically populate Phone Telephone Number Patient s phone number This is the number that is used for PatientCall New Patient Screen Phone Type This is the type of phone number for the patient Home is the default Email
359. unapplied balance from previous checks You can quickly go to Unapplied Checks from the Billing menu off of the main Account Assistant The new Carrier Payment system has been designed for speed of entry If the time has been taken to set up the EOB default Settings then posting the EOB becomes really fast Published 1 6 2009 Page 195 of 248 Reference Manual Entering a Carrier Payment e From the Billing Menu select Carrier Payments k3 Carrier Payments Unapphag Checks e Select the Carrier through the easy to use search screen Note The Codes that have the star next to them are Master Carriers i Select Carrier Enter carrier cade cr COMPANY AME S T X Put in the check information Amount dollar amount of the check Ref s The check number or some sort of reference for the check Payment Method The method of payment from the check These payment methods cannot be edited Adjustment Method Select the adjustment method from the drop down These cannot be edited Check Date Date of check pe pee O T W AMNBCEHS ANTHEM BLUE CROSSAL PO BOX 37180 LOUIS ILLE KY d amp 18 xl A H 3 F E CEW F7 New Pat F4 Reports Biling Utilities Calculator F6 Support Log Off Patient Search P x Cancel H Save Check h Apply Check Carrier BCBS BlueCross BlueShield Payment Ret Method 1 PF ee Adjustment 7 Method Applied Check Informa
360. ur files will be automatically sent to the Clearinghouse e Paper Claims should be mailed same day for those carriers left to paper e Billing manager must check Clearing House each morning to make sure file was processed e If there are any errors fix and re submit Special Note on Staying Current with your Billing Do not sacrifice anything to stay current Especially in understaffed offices it is too easy for work on receivables and get behind on billing If your staff cannot stay current and handle receivables and other office situations then you are understaffed or under trained It is better to sacrifice working on receivables and stay current so that you know you will keep cash flow moving Then put all your efforts into collecting A R because your office is behind Published 1 6 2009 Page 210 of 248 Reference Manual Putting it All Together The Insurance Industry You need to understand that the entire insurance industry is in a state of disarray Some carriers have switched over to the new standards and some have not Some of the carriers have switched over to the new standards and got them wrong for example date formats are incorrect to the national specifications and they are rejecting claims And then most importantly you have Medicare Medicaid and Blue Cross Blue Shield who have different formats in EVERY state In some states like California there are multiple BCBS s and are all different formats Where t
361. user to view the HCFA form on the screen gt View in Carrier Ledger e Rollback Charges Allows the user to Rollback the charges ah View in Patient Ledger ab View Claim History e Go to carrier KAISER Allows the user to go directly to the Enter Claim Memo insurance carrier e View in Carrier Ledger Allows the user to view the claim in the Carrier Ledger e View in Patient Ledger Allows the user to view in the patient ledger e View Claim History Allows the user to see the history on the claim e Enter Claim Memo Allows the user to enter a memo for the claim Published 1 6 2009 Page 124 of 248 Reference Manual Understanding Cases Service Types There are two Service Types Chiropractic and Weight Loss Both of these service types are separate businesses within the business In the future there may be additional service types but for now only the two apply Case Types Are individual case types that fall under Service Types There is default information set up for case types but additional case types may be added if necessary Under the Chiropractic Service type by default there is Chiro General Chiropractic Wellness WC Worker s Comp PI Personal Injury Spinal Decompression might be an example SD of a new case type that you want to add Some offices treat Spinal Decompression as part of CHIRO and some may want SD to a major case type Case Date Each Case has a date the da
362. utomatically selected for editing Enter the needed data on the right 6 When finished filling in the override information click on Save information for selected provider payer button eS Proprietary Information 29 C4 Zi M d ZirMed Training Account S076 Log Off 1r e Account Prof Claims Inst Claims Femits Eligibility Print Services Patient Statements lt Pay Leads Admin F Poy iene Help ContactUs Customer Support Center Survey Claims Batches Mame Matching ermer I Reports Enrolment Payers Coding Toos Settings Billing Pay To Rendering Facilities Referring Supervising Ordering Primary Care Purchasing ETEen SED STOW OFFICE i IOHNATHAN MD 1c SHIN I General Information Payer Specific Information PPE BREDA Gace SUNT ING Payers Provider Number 00000002345 BC BS of Kentucky ENTER THE GROUP NUMBER TaxID amp Type Osu Oen Spec Assignment Ma SELECTION w O Organization O Individual Lastrora o address 1 s SEARCHFORPAvER mess2 __ SEARCH FOR PAYER cy AddPayer O O state z Country _ Delete Payer Specific Information TUCK SAVE Save information for selected provider payer If your practice has multiple locations and it s necessary to send different Provider information for each location you can use the override feature to enter that information ZirMed Customer Support will first need to activate this option for you Once activated an addi
363. vcescacssiveccetiecactcesusssicscencitasios saetnasscuessuencacsnasiessistoscseubesssuaasiessiesneadstceviesencteiessuaaeis 149 Modity Charses SC Fee lh a aicee cas cascycousands E E i NEO a i 151 Published 1 6 2009 Page 4 of 248 Reference Manual Charge Entry Today s Payment Tender Screen cccccccccccccccccsesssseesseeeeeeceeeeeeeeeeaaaeseessseseeeeeeeeeeeeeeceeeeaaaaaagessees 153 Today SES CS SECON esseere e a iee i Ea EEEa Ee Eanan OE ES Eni Te Rare aia e EE Taiau Re 154 Panent Payment C8 C1 tater creme deste eee iE EE E EEn TEE E EEEE E EEA Eer Erer E EE AENEA RE 155 Function Buttons at the bottom of the Tender Screen oeoooneeeeeeeeseeeeeeseeeeeeeererererererererererererererereeererereeeereeeeeeeeeees 157 Pah DaO N pn E E EEA EEE E E E E E TEO 159 ME NAIM UING r E E E E E N 159 Scheduler Reconciliation Report ssssecccccsssssceeccccssssccecocssssscecccocssssscccecosssssececoosssssssceccocsssssseossssssseeesso 159 Reviewing the Scheduler Reconciliation cccccccseeececccecceeceeceeeeeseessseesseeeeceeeeeeeeeeeeaaaassseeeeeeeeeeeeeeeeeeeeauaaaassgsnes 159 Balance he Drawer sccssssisscsc onvecscacvssicscousssnsnsvinesscepssnsseswavdsseessasesegvassesceusacsdarwsscesseussdscacossseadeusssetesveveasaess 161 DUE Ve NU asserts can E ss sascuseuetigedeassseeestaesyssees1 nei ssexavuedeesavouritenvseecs asuiaatecesosss eres 163 Carriers Understanding and Setting Up Carrrier cccccssssssscccsssssss
364. ve to be mailed to a specific address but the EOB s all come from one place then a master carrier should be created and called BC Once the Master Carrier is created then you will link the Carrier to the Master Carrier Code Code used to identify the 5 j Save and Close Master Carrier dh Add Master Carrier 4 Delete Master Carrier T E Code 5ces Code Description Z Description BlueCross BlueShield gt mr Nedcare Description Description of the code Adding a New Master Carrier e Click on Billing Sie Billing Utilities hres e Click on Carriers S ja Biling Utilities qa Carriers suitors e Click on Master Carriers Calcul Published 1 6 2009 Page 164 of 248 Reference Manual a Insurance Carriers MEDICARE 27ND La Save Hl Save and Close L Master Carriers ein Information Je Ledger MEDIC ID Mo Setup MEDIC li db Add Carrier hF Delete Carrier e Click Add New Master Carrier gp Add Master Carrier e Enter a Code e Enter a Description e Click Save Published 1 6 2009 Page 165 of 248 Reference Manual Understanding Carriers Insurance carriers are companies that you bill insurance claims to If Phunkey is doing a database conversion for your facility then the insurance carriers will be transferred from your existing Practice Management Software Setting up an insurance carrier properly is very important If the carrier is not se
365. vides electronic remittance which is integrate ZirMed offers many other optional services including On line Eligibility Electronic Remittance Statements Credentialing On line Payments and much more Published 1 6 2009 Page 203 of 248 Reference Manual About ZirMed Inc ZirMed was the first web based electronic document interchange company in the medical industry Founded in 1999 we have grown to over 12 000 healthcare providers and process millions of electronic transactions each month Our flagship offering is Revenue Cycle Management From patient scheduling insurance verification and payment processing in the front office to claims processing remittance posting and patient statements in the back office we handle the complete revenue cycle for you The end result is increased productivity from your staff and significant reductions in the cost of money personnel and supplies Being web based our non invasive minimal investment offerings provide the quickest payback periods and highest returns on investment in the industry There is absolutely no risk in trying our service yet substantial net profit improvement for your business can be gained About Healthcare Healthcare is a complex business Administrative inefficiencies and costs steal valuable resources from providers thereby limiting dollars that can be invested in patient care Our Revenue Cycle Management solutions are designed to alleviate inefficiencies
366. weeRLove PX for appointment information special l s Language JEnglish G Accepts Mailer newsletters and health tips Remember i Accepts Email Blast email marketing is the most inexpensive T nie slionePlest form of patient communication Referral Source This is a REQUIRED field This field designates how the patient heard about the clinic Select None Given if the patient refuses to share how they heard about the clinic Remember that all marketing plans and management planning are based on tracking the effectiveness of advertising It will take just as long to select NONE from the drop down as it will to select the correct referral source Published 1 6 2009 Page 84 of 248 Reference Manual Referring Patient This is where the patient who referred the new patient is linked If the new patient was referred to the clinic by an existing patient the existing patient needs to be linked to the new patient Enter the ID number for the patient who referred the new patient An example would look like this Referral Source equals PATIENT and the Referring Patient would be the referring patient s account number Search for the patient by typing in the first three letters of the last name then a space and the first three letters of the first name For example SMI lt space gt JOH for John Smith If there is only one patient in the database that meets that search criteria then field will be auto populated with the patient s
367. wever overwrite this information here if needed Modifiers You can force a modifier into the system from here if you need it It should however default based upon the fee schedule for the patient Box 19 If you need something special to print on a paper HCFA in Box 19 enter it here Diagnosis Codes If the patient has diagnosis codes check the boxes that you would like to point to If the patient does not have diagnosis codes then you need to add them into the system All patients MUST have diagnosis codes To add the diagnosis code from the Charge screen click diagnosis codes in the top left Then enter the diagnosis codes and click Save This will bring you back to the CEW screen and you can select the diagnosis codes that you would like to point to Click Save or ALT S To add an additional Charge to the same claim click the add button at the top of the screen or hit ALT A and follow the above steps Click Next This brings you to the payment screen The payment screen will display charges at the top of the screen in a grid under the heading Today s Charges Notice the boxes in green and yellow When a box is green or yellow it cannot be changed The computer is auto calculating the dollar amounts in that box Recommended Payment This is typically the co pay for the patient but it can also be the total dollar amount of the charge if the patient is defined as a cash patient Today s Charges This is the amoun
368. wo check boxes flanking the field in the middle If the Show box is checked it means that the field will be displayed on the report If Published 1 6 2009 Page 235 of 248 Reference Manual you do not want the field to be displayed on the report make sure the show box is not checked The other box is the criteria box If that box is checked you will be given the criteria on the right hand side to choose from In the example above the Appt Status criteria box is checked and the Appt Status is displaying giving you the ability to check to display all Appt statuses one appointment status or multiple Appt Statuses Patient ID Allows you the ability to choose an appointment list for one patient ID number Criteria APPT Date Time Allows you to select the date for the Bae appointments that displays l Appt Date Time a SI vos W Visit Type E Visit Type Allows you to select the visit type G Provider Provider Allows you to select the provider from the list Wo Acct C Acct Allows you to select a range of account numbers to T Last Name C i i Wo First Name E print the appointment list for WO Apet Status ra Last Name Allows you to select a last name range to print Facility the appointment list for First Name Allows you to select a first name range to print the appointment list for Appt Status Allows you to select what Appt Status to print Facility Allows you to select the facility to print for
369. y will email all users when new reports and updates are made All reports will be in a grid format You will select the criteria they want to view be able to see the detail of their selection and then with the press of a button the data will be i displayed on the screen or emailed to them in a spreadsheet allowing them to do any additional processing that they desire Se 2 Reports Billing Utilities Ca Encounter Forms Fo EZ Report Encounter Forms OF Royalties Report Encounter forms are communication tools that travel with the patient Daily Reports through the clinic The Encounter Forms are loaded with information that Marketing Reports is beneficial to all aspects of the clinic Encounter forms should be Lists d printed and attached with the super bills and sent back to the exam rooms with the patients Encounter Forms are very powerful tools and are very Management b beneficial to the organization Seen Encounter forms by default will print for the default case for the patient Eee However the ability to print an Encounter Form manually for a specific case type is an option in the software Below you will find a list of the fields that are on an Encounter Form You will never understand the power of an Encounter Form 1f you do not understand what all of the information on the Encounter Form represents e Appointment Date Time Visit Code and Dr In the top left hand corner of the Encounter Form the pati
370. yees who need access to the report or that you would like to have access removed please email support phunkey com This report is found in the Reports menu If you do not see the report listed in the menu for an authorized user please email support phunkey com It is important to understand how and when the stats are calculated for the EZ Report Notice that the screen for the Snapshot Report contains two sections The first section reads Previous Stats and the second section reads Run New Stats 0 Snapshot Report a Close Settings Previous Stats Date Ran Monday December 29 2008 2 00 AM Run New Stats Service ype As of 12 28 2008 for fan Service ypes gt J Previous Stats The previous stats section is your facility stats from a previous day Previous Stats are quick and take about 3 seconds to pull up on your screen Phunkey runs a script on your database every night that calculates these stats and then places them in memory for your facility When you come in and want to generate your facility stats in the morning for yesterday all you have to do is hit the drop down next to the window that says Date Ran and select the date This will provide the facility stats in seconds for that particular date When you are viewing stats from the Previous stats section you are looking at stats that do NOT include today s stats Run New Stats If you are looking for up to the minute stats then you want to run the s

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