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MedBASE User's Manual

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1. Select Physician and Close Window Billing Surname First Name If the user leaves the Search Field blank and hits Return then all referring physicians in the database will be displayed in the Referring Physician Browse Window Clicking on the New button will allow you to enter a new referring physician as described on Page 10 Clicking on Cancel allows the user to exit without editing physician information After selecting a physician either through an exact match in the Physician Search routine or from the browse window the Referring Physician Information Screen will then appear allowing you to edit physician information as shown at the top of Page 10 Referring Physician Information 025991 CARSON EDWARD 825 COXWELL AVE TORONTO ONTARIO M4C3E7 Billing No Surname First Name Address Postal Code Delete Select Done Fields marked with an are required for OHIP claims Billing Enter the referring physician s 6 digit billing number If an incorrect billing number is entered a message Invalid Input will appear Surname First Name Address Required for Physician Address Labels Postal Code Format ANANAN Physician Address Labels Only referring physicians without existing claims can be deleted Clicking on the Delete button prompts the program to search the database for existing claims for this referring physician
2. Enter New Service Code Fees for 4603 in spaces below A603A asos ___ E a603C M User Defined Fees 25 non OHIP non machine readable codes are included in the MedBASE fee schedule and are numbered from I001A to 1025A The assignment and usage of these fees is at the discretion of the user Their initial value is 1 00 and this can be edited as described above These codes cannot be included with an OHIP submission but can be used in any Direct billing claim These fees can be used for services not covered by OHIP such as insurance forms administration fees and disposable items Process Menu Partial password protection limits access to the Process menu When partial password protection is active the selection of any option from the Process menu or changing providers while within a Process menu option will require entry of the appropriate password before proceeding Bill The Bill option of the Process menu is used for creating a machine readable file for submission to OHIP This option is also useful for verifying submissions and for reprinting billing summaries and unsubmitting OHIP submissions After selecting Bill the OHIP Submission screen will appear OHIP Submission Choose Provider DR J ALLISON 0000 224840 60 Submit Date dd mm yy 19 08 93 Preparing Submission Please Wait Verity Bill Options Done Choose Provider
3. occcocccncccncccnooos 15 MedBASE User s Manual Page 31 Service Code Info SCreen ccoconnoonccccnccnonnnannnos 15 Service Code screen for Direct Billing 14 Service Codes Menu Option ccccceeeeeeeees 15 Service Date ooccccooncccncnnncccnnonaconnns 12 13 14 20 Set Preferences SCIeel ooccnnncccnnnccnonoccninicnns 13 20 Setting default values oooo 4 5 12 13 20 Special visit TEES ia ie 12 Specialty Lodi 2 Starting the Program essecceeeseneeeeeeseneeees 1 Status DE A ese 2 8 16 18 Submission number rindo iso 17 SUD DA 16 Summary Menu Option Patient eee 7 Summary Menu Option Claim oomnooncinnn 15 Summary of Claim Items Not Found 19 System requirements sai Sheree settee acess 1 Technical advice and support c ocoooooocccncccccnnnnnnnns 22 A O otenaes 18 Unsubmitting ClalMS oocccccnnnnnonnnccnnnnnnnnnnnnnns 17 A A eee erie ewe EOE 12 User Defined Ferias 16 Verification Of claims ooccccnnnnnnnncccnnnnnnno 14 16 Verify Menu Options c c cdcancsdvesseasacendeandeens 14 Verification SEEN is ain austin see 14 Version Numbet cccceeeee 3 5 9 13 14 19 WCB billing cards A eae aes 13 AAA entanas 13 14 16 Workman s Compensation Board oooocccnnonccccnnnn 13 Write Off Susini dd dd 17 MedBASE User s Manual Page 32
4. 30 days past due Print Accounts Receivable list as of To change the provider the current provider is the default click the Choose Provider button The Provider Browse Window will appear and the desired provider can be selected full or partial MedBASE User s Manual Page 22 password protection will require entry of the appropriate password The default date is the current date and this is the date generally used for generating a list of Outstanding Transactions ie current Accounts Receivable When a prior listing of Accounts Receivable is required usually for Financial Statements at fiscal year end the desired All claims 30 days past due 60 days past due date can be entered in this field Use the adjacent Pop up menu to select the desired date threshold for the 90 days past due 120 days past due Accounts Receivable list To print the Accounts Receivable report click the Print button Click the Done button to exit Reconcile The Reconcile option of the Process menu is used to reconcile previously billed claims from a OHIP Remittance Advice RA Diskette After selecting Reconcile the file selection window will appear Insert the OHIP RA diskette and select the RA file should begin with a P as per the new OHIP format Click Open to continue or Cancel to abort the reconciliation If you select a file which is not an OHIP remittance advice file an error message will appear I
5. informing the operator as described in the New menu option section Information from the magnetic strip will be used to update the database only if the date of the card is newer than the date of previous cards used with MedBASE for this patient If the card is from a new patient a new Patient Information Screen appears displaying the Health Version patient surname first name and initial date of birth and sex as read from the magnetic strip as well as the default values for City Province and Area Code The remaining patient data can then be entered on the Patient Information screen as described for the Select menu option Physician Menu Physician MedBASE User s Manual Page 11 The Select option allows you to select a referring physician for editing of physician information Upon selecting Select the Physician Search screen will appear as shown below Physician Search Search List by Surname First Mame MM OR Physician Awaiting Search Criteria New Cancel By typing in either a the referring physician s surname first name or any portion thereof or b the Physician the corresponding physician will be found almost immediately If more than 1 physician matches the search criteria as when a partial name is entered eg M then these referring physicians will be displayed in a Referring Physician Browse Window as shown below
6. If any are found a warning message will appear Cannot delete physician due to existing claims If there are no existing claims a message will appear asking to confirm if you want to delete the physician Click Yes to delete the patient or No to cancel Clicking the Select button will bring up the Physician Search screen as described on Page 9 allowing the user to either edit or view the information of another physician or to enter a new physician as described in the New menu option section below Done Click the Done button to leave the Referring Physician Information screen Any changes will be saved Required for MedBASE User s Manual Page 12 New New referring physicians can be entered either by clicking the New button on the Physician Search screen or by selecting the New menu option from the Physician menu After selecting the New menu option a blank Referring Physician Information screen will appear Enter the referring physician s OHIP billing number If this field is left blank and Return is hit a new referring physician is not entered and the screen is exited If an entry is made the program will then search for this number in the Referring Physician database If one already exists a message indicating this will appear and the screen is exited If this is a new and valid number the remaining referring physician data can then be entered on the Referring Physician Information screen a
7. Provider Dr J Allison 0000 224840 60 Fee Fee Date Service Billed Paid 23 08 90 AOZA y 23 08790 C101A 7 70 7 70 427 OHIP 20 07 91 G401A 21 07 91 G401A Status Reconci led Reconci led Submitted Submitted Acct 000167 000167 004292 004292 Inpt Inpt Inpt Inpt 95 85 were billed If there are claims entered the Review Claims screen will appear with a scrollable list of claim information for the selected patient as shown at the bottom of the previous column You may choose another patient for claims review by clicking the Choose button which will again bring up the Patient Search screen When printing the user can choose Print All Claims Print Past 3 Years Only to print all claims or only the most recent ones as shown on the pop up menu The default is Print Past 2 Years Only Click the Print button to print the claim review Click the Done button to exit this screen Import The Import menu option allows you to import a group of patients from a file created by another MedBASE program This menu option can also be used for importing patients from the Patient Set Up File supplied by OHIP disk must first be sent to MedBASE Software Inc for preparation Print Past 2 Years Only Print Past Year Onl After selecting Import a file selection window will appear prompting you to choose the Patient Import file as shown below Only files created by MedBASE using
8. another discrepant claim To exit click on the Done button Archive The Archive option of the Process menu is used to remove a batch of claims patients and appointment records from their active databases In general this feature is useful only after a provider has been using the program for an extended period of time ie 2 years or more and wishes to remove records to optimize program speed and performance We would recommend the following guidelines for archiving 1 Keep claim records from the current and previous fiscal year in the active database to maintain accuracy of accounting functions Claims older than this can be archived if necessary For example if the current date is September 1 1993 and the provider s fiscal year runs from February 1 January 31 then an archive date of January 31 1992 can be used 2 Use the same archive date for claims and patients Hence using the above archive date only patients whose last visit was before January 31 1992 will be archived If a different archive date is used for patients then many of the patient records will not be removed because of existing active claims 3 Patient records can be individually restored at any time Claims and appointment records cannot be easily restored Be absolutely certain before proceeding with archiving MedBASE User s Manual Page 24 4 Past appointment records are of little use for most users To optimize appointment proc
9. mssaca Pay Provider O Pay Subscriber 0000 District Code N_ 100008 Specialty No First Name Title Address Postal Code Pay Type Group No Billing No Change Password Surname First Name Title Needed for direct billing letters ie Yours sincerely J Allison MD FRCP C Upper or lower case allowed BSc PhD etc Address Needed for printing claim cards Postal Code Format ANANAN Group No Enter the provider s 4 digit group number or 0000 Billing No Enter the provider s 6 digit billing number If an incorrect billing number is entered a message Invalid Input will appear District Code Enter the District Code for the provider as outlined by OHIP y Specialty Code Enter either the specialty code 2 digit number or for general practitioners enter 00 Change Password If you click on the Change Password button the password edit screen will appear displaying the password status and the current password Password Off Using the Password Pop Up menu you have 3 choices If password protection is not desired choose the Password Off option To restrict access to the Process menu only choose the Partial Protection option To completely restrict access to a provider choose the Full Protection option Partial Protection Full Protection You may edit the password by typing in the password edit boxes The password ma
10. Click this button to change the provider for whom you wish to bill the current provider is the default The Provider Browse Window will appear and the desired provider can be selected full or partial password protection will require entry of the appropriate password The current provider in the Status Bar will not be changed Submit Date The current date will appear as the default in this field To change this date simply enter a different date This date will entered on the submission diskette For convenience submissions can be verified for errors from either the OHIP Submission screen by clicking on the Verify button or by selecting the Verify menu option from the Claim menu See the section describing the Verify menu option on Page 14 for further details about verification of claims With group submissions all of the group providers can be verified with one click when done from the OHIP Submission screen When verification is done from the Claim menu only claims for the Current Provider are checked regardless of whether the provider is part of a group or not If errors are found during verification they should be corrected before proceeding with the submission Click Done to return to the OHIP Submission screen Click on the Bill button when you are satisfied that the OHIP submission is error free All unsubmitted OHIP Reciprocal and WCB claims belonging to the MedBASE User s Manual Page 20 a
11. February 26 1992 Change Patient Mr F Berger 000007 12 00 Description CONSULTATION Time Similarly to edit an appointment click on the Edit button on the Daily Appointments screen This will also bring up the Add Edit Appointment screen and allow the user to change the patient by clicking on the Change Patient button or change the time or description as described above If no more further appointments or bookings are desired for that day then click on No More Bookings When searching for the next available appointment then days flagged as such will be omitted To print a summary of the daily appointments click on the Print button of the Daily Appointments screen When the entries or changes for that day are complete click on the Done button to return to the previous screen Find Next Booking screen or Monthly Appointments screen Click on the Done button on the previous screen to complete appointment processing Summary Selecting the Summary menu option from the Patient menu brings up the Patient List Export screen as illustrated below This screen allows the user to browse print or export a summary for a subset of patients by specifying any or each of 4 parameters Sex Age date of Last Visit and Identifier A summary of J8 patients can also be generated see Page 19 for details Patient List Export List Patients with the Following Characteristics se Male p
12. OK to confirm and continue MedBASE User s Manual Page 18 Service Code A605 Enter a description for this service code All unsubmitted directly billed claim items will be included on the statement and may come from several claim accounts The Direct billing statement of account will then be printed It may be advisable to use the provider s letterhead for this report After the statement is printed a message will appear asking if you wish to change the status for these claims to submitted It may be useful to do this to mark that these accounts have been invoiced However 1f the user wishes to send another statement for the same claim accounts it will be necessary to revert the claim status back to Saved using Adjust see Page 13 Summary The Summary option of the claim menu is used for printing a summary for a defined subset of claims for a particular provider These claims can be defined by a date range or account range The date range can be used for detailed daily weekly or monthly claim summaries The account range is useful for verifying entered data against original data keeping track of the accounts entered in a given time period The summary can be limited to any or all statuses of claims ie Unsubmitted Submitted Discrepant Reconciled and can be limited to claims with a specific Service Code or Claim ID see Page 12 The generated report details all of th
13. Pop Up menu to change the claim status for all of the items in the claim If discrepancy is chosen a warning message will appear asking if you status of all claim items to Discrepancy Reconciled want to change the Discrepancy OHIP Reciprocal You can use this Pop Up menu to change the billing type for all of the items in the claim WCB Direct Clicking the Choose button will bring up the Claim Adjust screen allowing you to select another claim for adjustment Click the Done button to exit Verify The Verify option of the Claim menu is used to check all unsubmitted OHIP Reciprocal and WCB claims belonging to the current provider for errors The errors checked for include Service code excluded from machine readable input Diagnosis code required for this service code Referring physician required for this service code Hospital number required Admission date required Service date is after submission date Service date is more than 6 months old Service date is after admission date Missing Health number for this patient Missing date of birth for this patient Account Provider DR J ALLISON 0000 224840 60 4292 Patient 322 MR ANTHONY SPENCER MedBASE User s Manual Page 17 Reciprocal Claims require a specified province Reg for lt province gt must be __ digits Manual review required for this claim If errors are found an error report window will appear as shown
14. and commercially available since January 1991 A PC based version of MedBASE was developed and released in January 1992 possessing the same features and look and feel as the Macintosh version These programs are intended specifically for Ontario physicians and other health professionals who submit patient billings to OHIP The MedBASE program makes full use of many of the intuitive tools characteristic of the Macintosh with the aim of providing a user friendly environment for the operator As with many Macintosh applications a minimum of operator training is necessary for using the application and the layout is designed to maximize efficiency and minimize operator error The program can be used in conjunction with many of the available MACRO programs such as Macromaker or AutoMac for executing repetitive tasks This manual assumes that you are familiar with the Macintosh operating environment and are acquainted with the use of the mouse Macintosh windows and menu driven commands For new Macintosh users unfamiliar with this environment we recommend reviewing the Macintosh Owner s Manual Proper operation of the program requires that MedBASE be properly installed as described below Desk accessories are fully operational in conjunction with MedBASE and the application is compatible with both Systems 6 0 and 7 0 Because of the potential memory demands of a large database system we recommend at least 2 MBytes of RAM with S
15. as shown at the top of the next column Patient Search Search List by Surname First Mame MOM Patient oR Awaiting search criteria 10 Digit Health New Cancel By typing in either a the Patient s surname first name or any portion thereof b the Patient or c the 10 Digit Health the corresponding patient will be found almost immediately If more than 1 patient matches the search criteria as when a partial name is entered eg FR then these patients will be displayed in a Patient Browse Window as shown below Ed Select Patient and Close Window N First Name Patient Health Q If the user leaves the Search Field blank and hits Return then all patients in the database will be displayed in the Patient Browse Window Clicking on the New button will allow you to enter a new patient as described on Page 5 Clicking on Cancel allows the user to exit without editing patient information After selecting a patient either through an exact match in the Patient Search routine or from the browse window the Patient Information Screen will then appear allowing you to edit patient information This screen is shown at the top of the next page Fields marked with an are required for OHIP claims Patient Assigned by the program when a new patient is entered It cannot be edited Health Enter the patient s 10 digit Health Numb
16. below Click Print to print a report of these errors Errors can then be corrected by selecting the corresponding claim accounts using the Select menu option on the Claim menu Click Done to exit Verification Complete 6 errors found 13 04 91 19 04 91 25 04 91 04 05 91 09 11 90 09 04 91 Diagnosis code required Diagnosis code required Service date after admission date Referring physician required Service date more than 6 months old Missing OHIP amp Health number Print NOTE Only one error is reported for any claim item Itis advisable to reverify after correcting the first batch of errors before proceeding with billing to ensure that a second unrecognized error was not present Direct Use the Direct option of the claim menu to print an invoice or statement of account for patients who are billed directly If no unsubmitted Direct claims are available a message will appear alerting you to this Otherwise the Patient Browse Window will appear showing only patients with unsubmitted Direct claims by the current provider Select the patient for whom you wish to print a Direct billing invoice and close the window When preparing an invoice it is important to have an explanation for each Service Code so that the patient understands what he is being billed for For all service codes with blank description fields a Service Code screen will appear as shown below Enter a description and click
17. the Export option can be imported Choosing a non MedBASE file will result in a warning message and the file will not be imported MedBASE User s Manual Page 10 Choose Patient Import File E MeaBill 2 D Patients1 c up O All Files After selecting a valid Import file the Importing Patients screen will appear with a status bar indicating progress Importing Patients Total Patients In File 57 Total Patients Imported 46 Duplicate patients will not be imported and the screen will indicate the total patients in the Import file and the total imported Click the Done button to exit Card Reader New patient information can be entered and the information of existing patients can be updated with the use of a Magnetic Card Reader Select the Card Reader menu option from the Patient menu After selecting the Card Reader menu option a Magnetic Card Reader dialogue screen will appear as shown below Magnetic Card Reader Sweep Health Card through reader now To cancel press any key To cancel press any key To enter the patient information run the Health Card through the card reader magnetic strip down and back As with new patients entered via the New menu option the program will search for a patient with a Health or name matching that read from the magnetic strip of the Health Card If an existing patient matches these parameters then a message will appear
18. 4 15 17 19 Adjust Claim screen Adi 14 Claim Summary SEEN ii 15 Admission date ooocccnnncc 4 12 13 14 20 21 Control Panel uso mer ernieren nnes 21 Analyzing patterns of practice oooooccccnnnnccnccnnnns 15 Daily Appointments screen 6 7 Anesthetists e sS ocooocccnncccnnnccnnnoconanicnnas 12 15 Date threshold ooccnncccnnioccnunicnnnuconanicnnnocos 18 ADPOINtMENSS ococcnnnnnnocccnnnnnnnnnnnnnanacancnonnnnos 5 6 7 Default date oooccnncccnnnccnnnoccnnnuocnnnnes 12 18 20 Appointments Menu Option cccnoooccccnnnnnncnnnnannnos 6 Default date Tan sess yics e cds 18 Appointments SCreen eee eeeeseeeeeeeeneeeeeees 5 6 Deleting a Provider tesina 3 Archive dali 19 20 Deleting a Patitos 5 Archive Menu OptiON cccccccccnnnnoonccnnnnnnononananos 19 Deleting a Referring PhysSiciaN cooonnnnnnccnnncno 10 Archive Restore screen ccvccivosnciaconapoiononsaniansad n 20 Deleting a Claim TteM oooooooocccccccccnnnncoonancnnncnonn 12 Archiving appointments 19 20 Desk Accessories cutis 21 Archiving claims oooooncccuunncnnnnnnnnonccnnnnnnnnoos 19 20 Diagnosis codes cccccccccononononnncnnnnn ns 4 12 13 14 Archiving patients coooooocccnnnoncncnonanoncnnnnnnnass 19 20 Diagnosis Code Browse Window 4 12 Assistants fees ocoooccnnncccnunconunccnanoconanicnnnos 12 15 Direct billing Statement of Account 14 15 AMOMACO oi id 1 Direct claim bil
19. 4 Find Again Command cooccccnnoncnncnnnonanononanncninnnnnnss 4 Find Next Booking screen oooooooccccccccccnnnnnnns 6 7 First Available Booking ccssecccceeeeeeeenteeees 6 Font DA Mov siii 21 Getting started A encee oer eave ees 1 Good faith payments cccooooccccnnonoccninnnonnncnonannnos 19 Group NUMBER siii 2 Ha Card a Ta 9 Health Number 3 5 9 13 14 16 19 Health Number invalid o nnn 3 16 19 Help Menu Option aida 21 Help SEMEEM sens inniennunn in asan Zi Hospital number rta idas 12 14 d ntifier iii cities 4 7 20 Import Menu Option oocccccnnnncnninnnonancnonanancninonnnass 8 Importing Patients sereen cconnonccncnnoncncnnnnnnnnss 8 Installing the ProgramM ooooocccnnnonncnnnnnnonnnnnnnnnnnos 1 Introducir is 1 JS DAM A aes 7 19 Keyboard equivalents 2 3 5 11 13 22 Labels malalignment OL oooonoocccnnnnnccccnnnonannnnnnns 21 Labels Menu Option Patient ooooooccnnnnnncccnnnnnnns 7 Labels Menu Option Physician ooonnnnncccnnnn 10 ASE VISA 1 A adi 4 7 19 License Agreement ii 23 List of Discrepancies Reconciliation report 19 Machine readable input excluded from 14 MACRO progralMWS oooococcccccnnnonononcnnnnonnnnnnonanananenos 1 MacromakerO ii is 1 Magnetic Card Reader 6 cassssastascctiseaseaiceasscenss 9 Manual reconciliatiON occcccnnnnonoconnnininnnnnnnnns 13 Manual Review AA 13 14 Max F
20. 93 Service Code C603A C602A Adjust of Services 1 Fee 52 40 16 70 Explanatory Code Admission assessment claimed by another HA physician Status Discrepancy If you do not wish to challenge OHIP and decide to accept the lesser amount paid simply click the Reconcile button This will change the status of the claim to Reconciled as shown in the next illustration below Clicking on the Unreconcile button will revert the status back to Discrepancy If you decide to dispute the fee paid with OHIP you will be required to submit on paper a Remittance Enquiry form with a written explanation Leave the information on the Discrepancy Audit screen unchanged for now Later after you have received additional fees for the disputed claim you will want to edit the fee paid on this claim Simply click on the Adjust button This will allow you to edit the fee paid field as shown below Then enter the new fee and hit Return Click the Reconcile button to reconcile the claim saving the new fee paid Discrepancy Audit Account 4292 Patient SPENCER ANTHONY Patient 322 Service Date 17 07 93 17 07 93 Service Code C603A C602A Adjust of Services 1 Admission assessment claimed by another physician Explanatory Code Status Reconciled Clicking the Choose button brings up the Claim Browse Window again allowing you to select
21. DIS Occasionally the user may wish to restore a previously archived patient back to the active patient database This can be done by clicking on the Restore button This will bring up a Patient Browse Window as shown at the bottom of the previous column Select the patient to be restored and close the window If the patient has already been re entered into the active patient database the archived record will not be restored to avoid duplicate entries Otherwise a message will appear indicating that the patient has been restored as shown below Archive Restore Provider DR J ALLISON 0000 224840 60 Archive Date 31 12 91 XX Claims Reconciled as of Archive Date XX Patients Inactive as of Archive Date O Appointments Booked before Archive Date Restrict to Patients with Identifier Patient restored to active database Name ALEXIS MARCO l Restore Patient Archive Done Click the Done button to exit Preferences Selecting the Preferences option of the Process menu will bring up the Set Preferences Screen as illustrated below Set Preferences Choose Provider DR J ALLISON 0000 224640 60 Patient Claim Screen Screen City Hospital gt Province Automatically Enter Area Code 416 X Service Date Male O Female Default Date J Referring Physician K Admission Date K P
22. M edB A SE U ser s M anual M ac Table of Contents EOC TONS sata e E A OERS 1 Getting Started innon Gran e aie A AEE E AE dao as 1 Installina the Prostar iodo liinda 1 Starting the Pr graM acarrear inn dni dla 1 Provider Mente cesos le dorados 2 E 2 A a a A 2 NA A OO 3 Patient Meni AAA A O A O 3 A A 3 A E A AR 5 APDO MES ss 6 A E EET EPEE ESEE ENT RTE EEEE 7 Fabels inneoin A EN 7 Review Claims areno aee ote aaa ana eE onc an E R R 8 A 8 A A O E 9 Physician MU E E satay ooo eel So ead ea E cueas 9 soc Co GEREN NEA reer ote RESIN ERNE GEE CSR EMR E UEC ee N IA 9 INOW rset Sian Ss tote irea eee ia alas eet eae ea ed aan ee eee eaka 10 A aa a aaa EAE 10 Clair Me ta ADA a a lad aeies 11 SS O EP 11 NEAR A O eco hahaha 13 O O A A IA 13 O 14 Direct A E A E A A AA 14 A Sh os cas gia eae ae Pain eae sae een ees Sanaa E 15 Service COUES ult iii E a lato 15 Process Meninas AA 16 A en ence TETEE EA 16 PONG sriseacanoniert nein iat kia A ee ee 17 A A A e ge Lagu asda ante pad editeoaaoia sh Lawes aaa tans aed aoe 17 Accounts R ceivabl ais coins andadas 18 Recon ll babosa 18 Discrepancy iese eneste EEEa aa RE E Lays AIEEE EEEIEE 19 Preferences ADOUL MEdBASE acid 21 A LS 21 DESK ACCESOS a a aaa lacio tinc E ENEE 21 File Meni cnoe A A AA a a a 22 MedBASE LOSA EASTER O da A Masao oes 23 Introduction MedBASE is a versatile and powerful billing and office management database system originally designed for the Macintosh
23. Submission 22 Submitted on 17 09 91 When OHIP submission files are created by MedBASE they are assigned sequential numbers 001 002 003 etc as required by OHIP These submission s are also the last 3 characters of the submission filename When a valid submission is entered the date of submission will be displayed on the screen and this becomes the active submission If for some reason the user has made an error in the OHIP submission and wishes to undo the submission this can be done by clicking on the Unsubmit Claims button The status of all the claims from the active submission will be changed to Saved Unsubmitted These claims can be submitted again later using the Bill button as described in the previous section Clicking on the Reprint Summary button will produce an OHIP Billing Summary for the active submission This is useful when during the actual submission procedure the user failed to turn the printer on or had printer related problems If any claims from the active submission were later resubmitted in a different batch then claim or record counts may be inaccurate Click on Done to exit and return to the OHIP Submission screen MedBASE User s Manual Page 21 Done Click on this button to exit the OHIP Submission screen Profile Selecting the Profile option of the Process menu will allow you to print a detailed summary or practice pr
24. atients only age Age greater than 70 On or after Jan 1 1991 Includes CHF Browse Print Export Done Click the Browse button to view the patients who match the chosen criteria as shown below Ed scroll to view Matching Patients First Name Date of Birth Identifier Surname Click the Print button to print the patient summary Click the Export button to export the patient information to a text file This file can be used for importing patients into another MedBASE program or into other programs which accept a tab delimited text file such as Microsoft Excel or most word processing applications The File Save dialogue window will appear prompting the user to Insert Export Diskette After the file has been successfully written the diskette will be automatically ejected Click the Done button to exit this screen Labels MedBASE User s Manual Page 9 Patient labels can be printed using Avery AL 120 label sheets 14 labels per page with a laser printer or with a non laser printer equipped with a sheet feeder After selecting the Labels menu option the Print Patient Labels screen will appear as shown at the top of Page 8 Print Patient Labels O Address Labels Chart Labels Remove Clear O Start Position Print List 83 ANDERSON DIANE 91 AUSTIN FRANK 74 BROWN DAVID O Number of La
25. bels 1 Print Choose chart labels or address labels by clicking the appropriate radio buttons Chart labels are useful both for patient charts and lab requisitions and contain detailed patient information Clicking the Add button brings up the Patient Search screen as described on Page 3 The selected patient is added to the print list To remove a patient from the print list highlight the patient in the print list and click the Remove button To remove all names from the the print list click the Clear button The Start Position allows you to use a label sheet which has been partially used For example if the first 3 labels have been previously used set the start position to 4 to use the remainder of the sheet If more than 1 label per patient is desired then set the Number of Labels accordingly Click the Print button to print labels for patients in the print list Click the Done button to exit Review Claims The Review Claims menu option of the patient menu allows you to review all claim information for a particular patient When a claim is open selecting Review Claims will generate a claims review for the active patient only Otherwise the Patient Search screen will appear and any patient can be selected If there are no claims for this patient under the current provider a message will appear stating that no claims Review Claims Mr A Spencer 000322 CHF CABG
26. click the Ref Phys button Clicking on the Ref Phys button will bring up the Physician Search screen as described on Page 9 The user may select a referring physician from the database or enter a new physician for the claim If automatic referring physician entry is activated see Preferences section on Pages 20 21 then the default referring physician see Page 4 will be automatically entered when a new claim is created For patients with previous billings the patient s most recent diagnosis code will already be entered as the default The diagnosis code can be entered or changed by typing in the 3 digit diagnosis code or by clicking the Diag Code button Clicking the Diag Code button will bring up the Diagnosis Code Browse Window Ed Select Diagnosis and Close Window HS Code Diagnosis Description See Page 4 in the Patient Select section for more information on diagnosis code entry Claim ID An optional field claim ID can be useful for identifying or separating groups of claims ie different clinics office vs hospital practice etc When printing claim summaries claim ID can be used to identify groups of claims see Page 15 If not needed simply leave the field blank Hospital You must enter the hospital or facility number as necessary See Preferences section on Pages 20 21 for information about setting default values for Hospital Admit Date An admission date must be entered for ho
27. ctive provider will be processed OHIP claims without a valid Health will not be submitted If the provider belongs to a group ie Group not 0000 then the user is given the option of billing all providers from that group Alternatively each provider in the group can be billed separately and multiple diskettes submitted Click on Yes or No as desired After processing is complete a machine readable ASCII file will be created and a file save window will appear with a prompt to insert the OHIP submission diskette Insert the diskette and click Save The file will be saved on the diskette and a duplicate copy will also be saved in the MedBASE Submissions folder on the hard disk The diskette will be ejected and a prompt will then appear asking whether you wish to print a Billing Summary Click Yes or No as desired Be sure to record the number of Claims and Records The OHIP Submission screen will then be exited It is advisable to check all submission diskettes to ensure that a submission file is present Duplicates from the MedBASE Submissions folder can be copied onto a new diskette if necessary Clicking on the Options button will bring up the Billing Options screen as shown below This screen is useful for reprinting previous billing summaries and unsubmitting previously submitted OHIP submissions Billing Options Provider DR J ALLISON 9000 224640 50 Unsubmit Claims Reprint Summary Enter
28. der is displayed at the bottom of the screen in the status bar as shown below BAIE Current Provider Dr J Allison 0000 100008 13 April 7 1992 Provider Menu File 35 EAA Patient Physician Claim Process Choose D Edit MedBASE User s Manual Page 2 The Choose option allows you to change the active or Current Provider Upon selecting Choose or the keyboard equivalent Command D the Provider Browse Window will again appear similar to Startup The desired provider can then be selected and the window closed If full password protection is active the operator will be prompted with the Password Window After choosing the new provider the status bar will be updated at the bottom of the screen Edit The Edit option allows you to enter or change the information associated with each provider If partial or full password protection is active the password window will appear before editing is allowed The Provider Information screen contains several fields as shown at the top of the next column Fields marked with a must be entered before any billing can be done for that provider Fields marked with a cannot be edited once saved In MedBASE type is converted automatically to UPPER CASE Exception Title see below A alpha N numeric Provider Information Surname ALLISON JAMES MD FRCP C TGH 200 ELIZABETH ST TORONTO
29. dit claim information Claim Form DR J ALLISON 0000 224840 60 Account MR W BISHOP 7000 DR F HORTON Unit Fee Service 428 Diag Code Fee Billed Date 105 40 13703793 Claim ID HOSP 13703793 Hospital 1302 Adm Date dd mm yy O Manual Review Account This is the claim account number assigned by the program This number should be recorded with any hard copy billing records or slips and is used by the program for identifying claims This field cannot be edited To change the provider for this particular claim click the Provider button This will bring up the Provider Browse Window and the desired provider can be selected full password protection will require entry of the appropriate password Close the Provider Browse Window after making the MedBASE User s Manual Page 14 selection This will change the provider on the Claim Form screen but does not change the current provider in the Status Bar To change the patient for this particular claim either enter the patient number if known or click the Patient button Clicking the Patient button will bring up the Patient Search screen as described on Page 3 The user may select another patient or enter a new patient for the claim Ref Phys To enter or change a referring physician for the claim either enter the physician number if known or
30. djacent figure to select the claim billing type OHIP is the default WCB Direct Status The claim status Not Saved or Saved is displayed at the bottom of the Claim Form screen Manual Review The Manual Review checkbox should be checked for claims designated as requiring manual review by OHIP The Print button allows you to print an OHIP card Reciprocal Billing card or Workman s Compensation Board WCB card for the current claim Before printing the user will be prompted that all changes must be saved Claims with a Direct claim billing type cannot be printed directly from the Claim Form screen See the section on Direct claims on Page 14 for details about printing invoices for directly billed patients Cancel The Cancel button allows you to leave the claim edit screen without saving any changes made A message window will appear asking you to confirm that this is what you intend to do Clicking the OK button will leave the claim edit screen and save any changes New Selecting the New menu option from the claim menu or entering the keyboard equivalent Command N brings up a screen identical to the Patient Search screen described on Page 3 but with the heading Choose Patient for New Claim as shown below Choose Patient for New Claim Search List by Surname First Name Patient oR Awaiting search criteria 10 Digit Health The user can s
31. e mandatory claim and patient data for each claim item as well as totals After selecting the Summary menu option the Claim Summary screen will appear Claim Summary Choose Provider DR J ALLISON 0000 100008 13 to 7012 29 09 93 Limit Claims By Acct Range 1 Date Range dd mm yy 01 01 93 to Include J Unsubmitted Claims Service Code 24424 XX Submitted Claims Claim ID E E Discrepant Claims EX Reconciled Claims Order By Account Alphabetically To change the provider the current provider is the default click the Choose Provider button The Provider Browse Window will appear and the desired provider can be selected full password protection will require entry of the appropriate password Click on the appropriate check boxes to include any or all claims according to claim status The user can specify a specific Service Code and or Claim ID to limit the claim summary to claims matching that code ID To print the summary click the Print button Click the Done button to exit Service Codes Selecting the Service Codes option of the claim menu will allow you to examine or edit the fees OHIP Service Code Info Choose Service Code Description Fee A 27070 Fee B 9 57 t Fee C 11 04 Edit Service Fees O Consecutive Day Billing O Manual Review Required Must Indicate In Outpatient O Non machine R
32. eadable O Referring Physician Required XX Diagnosis Required O Hospital Required Service Code Admission Date Required 3 Assistant Base Units 4 Anesthetist Base Units requirements or service description for a given service code After selecting Service Codes the Service Code Info screen will appear as shown above For anesthetists and assistants fees the appropriate base units are displayed at the bottom of the screen To examine or edit a different service code enter the first 4 characters of the service code minus the A B or C suffix The service code information will then appear for the entered service code Alternatively click the Choose Service Code button to bring up the Service Code Browse Window as shown below allowing the user to select a service code from the list Select Service Code and Close Window Service Code Description RAL REASSESSMENT RE CONSULT ATION To edit the service code fees click on the Edit Service Fees button This will bring up the Edit Service Code Fees screen as illustrated below The user will not be able to alter certain service codes because they are invalid ie A603B is initially blank MedBASE User s Manual Page 19 and a fee cannot be assigned to it In addition the base fees for assistants and anesthetists fees cannot be edited Edit Service Code Fees
33. elect or the keyboard equivalent Command S brings up the Claim Select screen as shown below Only unsubmitted claims ie Status Saved for the active provider can be accessed Claim Select Search List by Surname First Name Unsubmitted Claims Only OR es Account Awaiting search criteria Cancel By typing in either a the patient s surname first name or any portion thereof or b the claim Account the corresponding claim will be found almost immediately Searching on Account will yield only one match if found If searching on the patient s name then often more than 1 claim will match the search criteria and these claims will be displayed in a Claim Browse Window as shown below displaying the claims in order of Account Number E select Claim and Close Window Account Patient Service Date Patient Name If the user leaves the Search Field blank and hits Return then all Unsubmitted Claims will be displayed in the Claim Browse Window for the active provider Clicking on Cancel allows the user to exit without entering the Claim Form screen Otherwise the Claim Form screen will appear as shown below A given claim account contains anywhere from 1 to 8 claim items After selecting the desired claim and closing the window the Claim Form screen will appear allowing you to e
34. elect a patient from the database or enter a new patient A new Claim Form screen will then come up for this patient with the current provider as the default provider The most recent diagnosis code of the selected patient is entered as well The default referring physician is blank Data is entered in the fields as described for the Select menu option Values for Referring Physician Hospital and Admit Date will appear as specified in the Set Preferences screen as described in the Preferences section on Pages 20 21 Details of Claim Form entry are described under the Select menu option Adjust MedBASE User s Manual Page 16 The Adjust menu option of the Claim menu is used for making changes to claims that have already been submitted To avoid conflicts with OHIP only certain fields can be edited once claims have been submitted After selecting Adjust the Claim Adjust screen will appear as shown below Unlike the Claim Select screen this screen allows you to access all claims for the active provider ie unsubmitted submitted discrepant and reconciled claims Claim Adjust All Claims Awaiting search criteria Search List by Surname First Name OR Account As with Claim Select typing in either a the patient s surname first name or any portion thereof or b the claim Account will bring up the the Claim Browse Window if m
35. ent due to existing claims If there are no existing claims a message will appear asking to confirm if you want to delete the patient Click Yes to delete the patient or No to cancel Clicking the Select button will bring up the Patient Search screen as described on Page 3 allowing the user to either edit or view the information of another patient or to enter a new patient as described in the New menu option section below Done Click the Done button to leave the Patient Information screen Any changes will be saved New New patients can be entered either by clicking the New button on the Patient Search screen by selecting the New menu option from the Patient menu or by using the keyboard equivalent Command R After selecting the New menu option a blank Patient Information screen will appear Enter the Health Version if applicable patient surname and given name The program will then search for a patient with this Health or name If one already exists a message indicating the patient Health and date of birth will appear If this is the same patient a new patient entry will not be created Otherwise a new patient will be entered into the database Default values for City Province Area Code and Patient Sex are also entered according to the Patient Preferences defined in the Preferences section as described on Pages 20 21 The remaining patient data can then be entered on the Patient Information sc
36. er If an incorrect health number is entered a message Invalid Input will appear Correct the health number or leave it blank to continue Version If applicable enter the version number 1 or 2 alphabetic characters E Patient Information Patient Health 742875848 1 Version 0 322 Surname SPENCER First ANTHONY Date of Birth dd mm yy 25 03 34 Male O Female Ref Phys 052456 DR H JACKSON Dia 428 Last Visit 21 07 91 Address 3285 ST CLAIR AVE E Admit Date 17707791 SCARBOROUGH ONTARIO Phone H 416 265 3610 Postal Code MIKILS Phone B CHF CABG Identifier MedBASE User s Manual Page 4 Surname First Name Date of Birth Enter the patients date of birth in the form dd mm yy Sex Choose male or female by clicking the appropriate radio button See Preferences section on Pages 20 21 for information about setting default values for patient sex Ref Phys For patients with previous claims the most recently entered referring physician will be indicated beside the Ref Phys button For new patients this field will be blank To enter or change the referring physician for a given patient either enter the physician number if known or click the Ref Phys button Clicking on the Ref Phys button will bring up the Physician Search screen as described on Page 9 The user may select a re
37. er Information screen ccooooocccnnnoncnccnnnns 23 Provider Men asked 2 Quit Menu Option ssseessesseessssrersssrrrrssrrerrserees 22 RA Remittance Advice file oooooooocno ooo 18 Reciprocal Claims vai 5 13 14 16 Reciprocal billing cards oooocnnnnnnncccnnnacccnnnnnnns 13 Reciprocal Medical Billing 5 13 14 16 Reconcile Discrepant Claim c ccceeeeeeeeeees 19 Reconcile Menu Option ccssccececeeeeeeeees 18 Reconciliation by diskette oooonoocccnnnnnnccccnnn 18 Reconciliation Summary reports eee 19 Reconciliation Summary screen 0 18 19 Reconciliation Totals 18 19 Referring Physician address labels 10 Referring Physician Browse Window 9 Referring Physician Information screen 9 10 Remittance EQU etica iconos 19 Reprinting a billing summary ccoooooccnnnnnoncncnnnnns 17 Restoring patient records ooooocccnnnonccccnnnoannnnnnnns 19 Resubmission in batch ooooocccnnnnonccccnnacocnnnnnnos 17 Resubmitting individual claims oooooonnnnnncccnnnn 14 Review Claims Menu OptlON ooooooocccccccccnnnncnnnnnnos 8 Review Claims Screen conoonccnccnooncnnnnnnonncnnnnannnos 8 Select Menu Option Claim eee 11 Select Menu Option Patient ooooooocnnnnnnnc 3 Select Menu Option Referring Physician 9 Service Codes cuisine 12 14 15 17 Service Code Browse WindoOW
38. essing we would advise archiving appointments booked before the current month For example if the current date is September 15 1993 choose an archive date of August 31 1993 for appointments Selecting the Archive option will bring up the Archive Restore screen as shown below Only claim and appointment records relating to the current provider can be archived Any patient can be archived as long as there are no active claims relating Archive Restore Provider DR J ALLISON 0000 224840 60 Archive Date 31 12 91 XX Claims Reconciled as of Archive Date amp Patients Inactive as of Archive Date O Appointments Booked before Archive Date Restrict to Patients with Identifier EXPIRED Archiving Patient database Restore Patient Archive Done to that patient Enter the desired archive date Click the appropriate check boxes to archive claims patients and or appointment records The user can choose to archive only a subset of patients and their corresponding claims by specifying a descriptor that must part of the patient s identifier field Click on the Archive button to begin When archiving is complete an alert message will indicate the number of patient claim or appointment records archived Select Patient to be Restored to Active Database First Name Patient Health at WILFRED Surname ABOUSSAFY ALIFERIS ALKIVIA
39. f a proper file has been selected the file will be read and the diskette ejected If the provider on the diskette is not the current provider and full or partial password protection is active for this provider then the user will be prompted for the appropriate password The Reconciliation Summary screen will appear as shown below As a default the claim item will be reconciled if the fee paid is within 1 00 of the fee billed Otherwise the claim item will be marked as a discrepancy The underpayment and overpayment limits may be edited as desired OHIP Reconciliation OHIP Reconciliation in progress Accept underpayment if within Loo Accept overpayment if within s Loo Records Reconciled Discrepancies Prev Processed Not Found Click the Continue button to proceed with the reconciliation The Reconciliation Summary screen will show the progress of the reconciliation both in the form of a status bar and in the table indicating the total of records reconciled of discrepancies previously processed and not found ie on the RA diskette but not in the database and usually the result of manual card submissions When the reconciliation is completed a prompt will appear asking whether you wish to print the Reconciliation Summary reports Click Yes or No as desired These reports include 1 Reconciliation Totals and List of Discrepancies 2 Summary of Clai
40. ferring physician from the database or enter a new physician for the claim If automatic Referring Physician entry is chosen in the Preferences section see Pages 20 21 then the referring physician on this screen will be the default entry for any new claim for this patient For patients with previous billings the patient s most recent diagnosis code will be shown beside the Diag Code button For new patients this field will be blank The diagnosis code can be entered or changed by typing in the 3 digit diagnosis code or by clicking the Diag Code button The diagnosis code on the patient screen will be the default entry for new claims for a given patient Clicking the Diag Code button will bring up the Diagnosis Code Browse Window Select Diagnosis and Close Window P Code Diagnosis Description 428 i i eneralized arteriosclerosis atherosclerosis hlebitis thrombophlebitis To search for a given diagnosis or portion thereof use the Find Command F and Find Again Command G commands under the Edit menu Once the desired Diagnosis Code is selected close the window and the correct diagnosis code is entered NOTE Find and Find Again are active whenever a browse window is open and may be used as an alternative searching tool Street Address City See Preferences section on Pages 20 21 for information about setting default values for City Province See Preferences section on Pages 20 21 for
41. information about setting default values for Province Postal Code Format ANANAN Phone Home Enter the patient s area code and home phone number See Preferences section on Pages 20 21 for information about setting default values for area code Phone Work Enter the patient s area code and work phone number Identifier Optional field 60 alphanumeric characters used for indexing patients ie by diagnosis or other variable Used as a marker for patient summaries and archiving For newly entered patients or those without billed claims the message No Claims Entered will be present in the information box Otherwise the Last Visit will be shown Last Visit is useful for generating Patient Summaries see Page 7 and for archiving see Pages 19 20 MedBASE User s Manual Page 5 For patients whose last encounter was as an inpatient the Admit Date will be shown If the last encounter was as an outpatient Outpatient will be shown These fields cannot be edited Reciproca Clicking this button brings up the Out of Province screen as shown below Used for billing out of province patients this information is mandatory for all Reciprocal claims see Pages 13 amp 14 Out of Province MS T MCCONNELL 34687964354 Province Enter registration number Enter the appropriate registration number and select the correct province using the province Pop Up menu Click OK to continue C
42. l i ERG sacs 21 MedBASE Databases folder 1 MedBASE Submissions folder 1 16 17 Memory requirements ccccccccnnnonononnnnnnnnnnnnnnananonos 1 Message from the Ministry of Health 19 Microsoft Excel iniciacion iria diiniita 7 Monthly Appointments screen oooooocccnnoocncnnnnnnnnss 6 MedBASE User s Manual Page 30 New claim creating A ooooooocccnncccnnnonanannnononcn n 5 13 New Menu Option Claim 0 0 eee 13 New Menu Option Patient occonnnnnnncccnnccnnn 5 New Menu Option Provider cccceeeees 3 New Menu Option Referring Physician 10 Next BOOKING ie 6 7 A 18 Not found claims summary Of coooocnncccncccccccnn n 19 Number Of services iieciiacioticii ainia 12 A 6 OHIP billing Cards i 13 OHIP Error Report visi 13 OHIP RA diskette riisiin iaa 18 OHIP Remittance AdVICe cee eeeeeeeeeeeeees 18 OHIP Service codes ocooccnccccnnoccnnns 12 14 15 16 OHIP Submission diskette 16 17 OHIP Submission file o oooccnnncccnnoccnn 16 17 OHIP Submission file duplicate 16 17 OHIP Submission Screen cccocccnnncccnnnccnnns 16 17 Optimizing performance ccooooocccnnnoocnnnnnnonnnnnnnnns 19 Out of Province SCTEEN cece eeeceeeeeeeeeeeeeeeeeeees 5 Outstanding transactions cooooocccnnnoocnccnnnnnss 18 19 MA sesia teir tss 17 18 Password Protection full ooooccn
43. lecting Accounting the Accounting Summary screen will appear as shown at the top of the next page To change the provider the current provider is the default click the Choose Provider button The Accounting Summary Choose Provider DR J ALLISON 0000 100008 13 Acct Range 1 to 211 Date Range dd mm yy 01 02 90 to 31 01 91 Provider Browse Window will then appear and the desired provider can be selected full or partial password protection will require entry of the appropriate password The accounting summary can be defined according to an account range and a date range The default account range includes the entire range of claim accounts in the database This can changed as is desired More commonly the date range is used to delimit the accounting summary ie for monthly statements or year end statements The default date range is from the first to the last day of the previous month This can be edited as desired To print the Accounting Summary report click the Print button Click the Done button to exit Accts Receivable Selecting the Accts Receivable option of the claim menu will allow you to print an Accounts Receivable list as of any specified date broken down according to of days past due After selecting Accts Receivable the Accounts Receivable screen will appear as shown below Accounts Receivable Choose Provider DR J ALLISON 0000 100006 13
44. licking on the Appointments button will bring up a scrollable list of the active patient s appointments If no appointments have been entered a message will appear alerting the user to this Otherwise the Patient Patient Appointments For Mr F Berger 27 02 92 13 00 09 03 92 09 00 CONSULTAT ION EXERCISE TEST Remove Unmark El E Process Appointments Print Done Appointments screen will appear displaying a scrollable list of the appointments for that patient in chronological order An appointment can be highlighted by clicking on it and can be deleted marked ie when confirming an appointment or unmarked by clicking on the Remove Mark and Unmark buttons respectively To add new appointments or edit existing appointments click on the Process Appointments button The Patient Appointments screen and Patient Information screen will be closed and the Appointments screen will MedBASE User s Manual Page 6 appear see Page 6 To print the appointment list for this patient click on the Print button Click on the Done button to exit Clicking on the New Claim button brings up a new Claim Form screen for the active patient see Page 11 Only patients without existing claims can be deleted Clicking on the Delete button prompts the program to search the database for existing claims for this patient If any are found a warning message will appear Cannot delete pati
45. ling 2 13 14 15 16 Automatic Date Entry cccccccnnnnnonacaccninnnnn 12 20 Direct Menu Option cccooococooooacnncccncnnnnnanannnnnnncn n 14 BASE UMSS AAA AAA 12 15 Disabling Password ii 2 BUll Code herrin onene areeiro 12 Discrepancy Menu OptiON ccccccccnnnnconcccnnnnnnnn 19 Billins Number de 2 10 Discrepancies tdci 14 15 18 19 Billing Options sereen coooooccccnnooncncnnnanannnnnnnns 17 Discrepancy Audit screen 19 Billing Summary coooonoonccccnncccnnnnnonnacnnnnoninnno 16 17 Discrepancy Summary isis cars 15 Billing Summary reprinting of eee 17 District Codes A A 2 Billing typ sra 13 14 Edit Menu Option Provider oooooccnnnnnccncnnn 2 Bill Menu Option ooocccccccnnnnnnnononcnononinonanannns 16 Edit Menu Find Find Again 4 Calc a eee ee ee ae 21 Edit Service Code Fees screen 0645 15 16 Card Reader Menu Option 0 0 0 eeeeeeeeeees 9 Edit Service Fees cocooocccnncccnonccnnnoconanccnnnonos 15 16 Changing Pass WO siii inicia elas 2 Editing Provider Information s e 2 Changing Billing type ccooooocccnnnnoncnnnnnnnannnnnnnns 14 Expandable codes cccociinionianidcanicataidinas 12 Changing Claim StatUS ocoooocccnnnnnncnninnnnnoss 13 14 Exporting Patient data ocaci n adds 7 8 Changing Fee Pald ooooonoccccncccnnnnnnonannnnnos 13 14 19 Fee WNC EA 12 17 18 POC Padua conato 13 14 17 18 19 A ect a eaii iA 22 Find Conadi ds titi
46. m Items Not Found if applicable 3 Message from the Ministry of Health includes OHIP Threshold Summary The of outstanding claim items and J8 payments will be shown at the bottom of the first report J8 refers to good faith payments made by OHIP for patients with incorrect Version s or expired Health Fs J8 will be added to the patient s identifier field allowing a printout of these patients using the Summary option of the Patient menu see Page 7 Click Done to exit the Reconciliation Summary Discrepancy Selecting the Discrepancy option of the Process menu will allow you to edit any discrepant claims for the current provider An alert message will appear informing the user of the number of discrepant claims if any If discrepant claims exist then the Claim Browse Window will appear displaying all discrepant claims for the current provider MedBASE User s Manual Page 23 Selecting the desired claim and closing the window brings up the Discrepancy Audit screen as illustrated below An explanatory code is displayed in the lower portion of the Discrepancy Audit screen giving the reason for the discrepancy and below this the current status of this claim is shown initially will be Discrepancy as shown in the figure below Discrepancy Audit Account 4292 Patient 322 Patient SPENCER ANTHONY Service Date 17 07 93 17 07
47. m Menu Adjust tf Starting the Program Claim Menu Verify Provider Menu Choose Claim Menu Direct Provider Menu Edit Claim Menu Summary Provider Menu New Claim Menu Service Codes Patient Menu Select Process Menu Patient Menu New Process Menu Bill Patient Menu Appointments Process Menu Profile Patient Menu Summary Process Menu Accounting Patient Menu Labels Process Menu Aocts Receivable Patient Menu Review Claims Process Menu Reconcile Patient Menu Import Process Menu Discrepancy Patient Menu Card Reader Process Menu Archive Physician Menu Select Process Menu Preferences Physician Menu New Apple Menu Help Physician Menu Labels Apple Menu Desk Accessories Claim Menu Select File Menu Claim Menu New Desk Accessories The desk accessories are files that are installed within the operating system of the Macintosh These files reside in the Apple Menu Items Folder in System 7 0 or are installed into the system with the Font DA Mover in System 6 0 or less The Calculator can be useful when entering claims The Control Panel can contain any number of devices such as screen savers font managers as well as the basic control files for general Macintosh functions mouse keyboard monitors etc The Chooser is used to select the output device generally the printer ie LaserWriter or StyleWriter For those with System 6 0 a shareware Con
48. ncccnnnccnnno 1 2 3 11 15 16 17 18 21 Password Protection partlal oooonnnnnnnnccnnnnnonnnnnnn 2 3 15 16 17 18 21 Password Protection setting ooonnnnnnncccnncnc 2 3 Patient Information screen 3 4 5 9 21 Patient Browse WiNdOW oocccccnnnnnnnnnnnoo0 3 14 20 Patient Appointments screen oococccnoooccnnnnnonnnnnnnnns 5 Patient Import files united 8 Patient Gabel s iectcivctseect nnna aaen aa 7 8 Patient List Export screen ooooccccnnooocnccnnnonnnnnnnnns 7 Patient MET A o 3 Patient Search screen 3 5 6 7 8 11 13 Patient Set Up File iii 8 PC based VETO ab 1 NA A 9 Physician Search screen 4 9 10 12 Postscript printing cooooooooccncccnononnnonnancnnnnnonnnannns 21 Practice Profile report oocccnnnononcccnnnnnnnnnnnnns 17 Practice Profile screen cid 17 Prefere Seenaa 4 5 12 13 20 Preferences Menu Option cooonnoocccccccccnnnnnnnnns 20 Previously processed claims ooonoonnccnnnnoocnccnnnns 18 Printing direct invoices 14 Printing OHIP billing CardS ooooooonccnnnnnncncnnnnns 13 Printing Reciprocal billing cards ee 13 Printing WCB billing cards ooonnnnncccnnnnnncncnnnnns 13 Print Patient Labels screen ooonnooccccnnooocccnnnnnnnos 8 Print Physician Labels screen 10 Process IM Stat d do 16 Profile Menu Option arroces ist 17 Provider Browse Window oooccccooooccccononanccnnannnnnons 1 2 11 15 16 17 18 21 Provid
49. ns the copyright protection of the program and documentation Under copyright laws you agree not to transfer the program and documentation in any form to any party without prior written consent of MedBASE Software Inc Further you agree that copies of the program shall be made only for backup and archival purposes These archival copies must be retained in your possession Except as provided in this Agreement you may not transfer sub license lease or rent time share or lend the program and documentation your copies of such or any or your rights under this License Agreement except by prior written consent from MedBASE Software Inc You may not alter decompile reverse engineer disassemble reverse translate or in any other way derive any source code from this program You may not remove or obscure MedBASE Software Inc s copyright notices in either hardcopy or machine readable portions of the program and documentation MedBASE Software Inc shall not be liable for any tort indirect special or consequential damages such as loss of profits or loss of goodwill that may result from improper use of this software The liabilities of MedBASE Software Inc shall be limited to a refund of the product s price The program supplied by MedBASE Software Inc may be installed and used on only one computer terminal MedBASE Software Inc agrees to provide Ongoing Support in the form of telephone assistance on site technical main
50. ofile of a particular provider s billings broken down according to specific service codes billed over a specified date range Details of the of times billed total fees billed total fees paid and last date billed will be displayed for each service code billed during the specified date range This report is useful for analyzing patterns of practice and changes thereof After selecting the Profile menu option the Practice Profile screen will appear as shown below To change the provider the current provider is the Practice Profile Choose Provider DR J ALLISON 0000 100008 13 Date Range dd mm yy 01 04 92 to 30 04 92 default click the Choose Provider button The Provider Browse Window will appear and the desired provider can be selected full or partial password protection will require entry of the appropriate password The default date range is from the first to the last day of the previous month This can be edited as desired To print the Practice Profile report click the Print button Click the Done button to exit Accounting Selecting the Accounting option of the Process menu will allow you to print a accounting summary which indicates the of services fee billed fee paid accounts receivable over payments and write offs for a particular provider over a specified date range A breakdown is also given according to claim status ie saved submitted discrepancy and reconciled After se
51. ore than claim matches the search criteria or the Adjust Claim screen if only claim matches the criteria The data that can be edited on the Adjust screen status includes Health Version Date of Birth Fee Paid Claim Status ie Saved Submitted Discrepancy or Reconciled and Billing Type ie OHIP Reciprocal WCB or Direct The Adjust Claim screen is useful for performing manual reconciliation for directly billed claims as well as for correcting and resubmitting rejected machine readable claims OHIP claims with incorrect Health Version or Date of Birth are not processed and a paper listing of these is sent back to the provider monthly on an OHIP Error Report This information can be corrected on the Adjust Claim screen and the claim can then be re submitted by simply changing the status to Saved from Submitted The claim account will be automatically included in the next billing submission The Adjust Claim screen is shown below Adjust Claim Health 7425750481 Version Q BN 2 Unit Fee Fee Service D 0 B dd mm yy Code Fee Billed Paid Date Status 25 03 34 105 40 C 17707793 17 10 J 18 07 93 17 10 J 19 07 93 7 70 19 07 93 Co re ETA EE fe Change the data for Health Version and Date of Birth as necessary Enter or change the fee paid as necessary for the appropriate claim items Saved Submitted You can use this
52. ostscript Printing Preferences can be used to set default values that are automatically entered for the specific fields shown on the screen when a new patient entry or new claim entry is created For new claims the user may also choose whether to automatically enter the service date referring physician and or admission date If a specific default date is specified this date will be automatically entered for the service date on new claims This is useful for billing a batch of claims MedBASE User s Manual Page 25 where the services were rendered on the same day If a default date is not specified then the current date will be entered for outpatients and the admission date for hospital inpatients For further details regarding automatic date entry see Service Date in the Select section of the Claim menu on Pages 11 12 If automatic referring physician entry is selected then the most recent referring physician for that patient as indicated on the Patient Information screen see Page 4 will be entered For automatic admission date entry the admission date of the previous claim for that patient will be entered These preference selections are provider specific and the values used depend on the provider that is active when a new patient or claim entry is created Editing these default values will affect only new records Previously entered information will not be affected To change the default values for another pr
53. ovider click the Choose Provider button The Provider Browse Window will appear and the desired provider can be selected full or partial password protection will require entry of the appropriate password If a Postscript or related printer is used click on the Postscript Printing checkbox Failing to do so may result in malalignment of patient or physician labels during label printing Click the Done button to exit Menu CM File is Promi About MedBAse Help 3H Calculator Chooser Control Panel Scrapbook About MedBASE About MedBASE brings up the MedBASE Billing Systems Version 3 5 The user friendly computerized medical billing system 1991 MedBASE Software Inc Programming and Design by Nick Dafopoulos amp Charles Lefkowitz MedBASE User s Manual Page 26 Help Selecting the Help menu option from the Menu brings up the on line Help Screen as illustrated below The on line Help Screen contains essentially the same information that is outlined in the MedBASE 3 5 Manual and is similarly organized according to menu items To select a topic click on the desired topic and then click on the Help button at the bottom of the screen The Next and Previous buttons bring the next and previous topics respectively Click in the close box in the top left hand corner to exit 2 Help Hz lt lt lt Introduction gt gt gt Clai
54. r An appointment can be highlighted by clicking on it and can be deleted marked ie when confirming an appointment or unmarked by clicking on the Remove Mark and Unmark buttons respectively Daily Appointments For Thursday January 9 1992 11 00 000006 ALBERTSON ECHO 11 20 000235 L FARELLI EXERCISE TEST LUNCH MEETING BOARD ROOM 13 00 000095 J CARLSON ECHO DOPPLER 13 40 000357 F NEWTON EXERCISE TEST 14 10 000119 H HUBERT HOLTER K No More Bookings To add an appointment click on the Add button This brings up a modified Patient Search MedBASE User s Manual Page 8 screen with a General button rather than a New button as shown below Patient Search Search List by Surname First Name Patient oR Awaiting search criteria 10 Digit Health Cancel General The user can search for a specific patient or click on General to enter patients not yet in the database or non patient activities such as meetings After selecting a patient or General entry the Add Edit Appointment screen will appear as illustrated below For General entries the patient field is editable Enter the time of the appointment and a brief description up to 15 characters and click on Done to complete the entry and return to the Daily Appointments screen Add Edit Appointment Wednesday
55. reen as described for the Select menu option To cancel hit Return 4 times leaving the Health Version Surname and Given Name fields blank The new Patient Screen will be exited and the new patient entry will be deleted MedBASE User s Manual Page 7 Appointments Selecting the Appointments menu option from the Patient menu brings up the Appointments screen as shown below Choose the month and year in which Appointments Provider Dr y Allison 0000 100008013 View Appointment Schedule for September 1992 Next Booking Schedule Cancel you wish to process appointments from the respective pop up menus Click on the Next Booking button to view the Find Next Booking screen as shown at the top of the next column Click on the Schedule button to bring up the Monthly Appointments screen as shown in the next column on this page Click on the Cancel button to exit The Find Next Booking screen allows you to find the next available appointment for the currently active provider for a patient appointment or general entry see Daily Appointments For a given provider bookings can be restricted to specific days of the week ie office days as shown on the left half of the screen Find Next Booking Provider Dr J Allison 0000 100008 13 Find First Available Booking on or after 27 09 92 Restrict bookings to following days O Sunda
56. s described for the Select menu option Labels Referring physician address labels can also be printed using Avery AL 120 label sheets with a laser printer or a non laser printer equipped with a sheet feeder After selecting the Labels menu option the Print Physician Labels screen will appear as shown at the top of the next column Print Physician Labels Print List 288357 CHARLTON PETER 028894 FRANCIS EDWARD 231142 MUSTER JONATHON Remove Clear Start Position Print Done Clicking the Add button brings up the Physician Search screen as described on Page 9 After selecting the desired physician the physician is added to the print list To remove a physician from the print list highlight the physician in the print list and click the Remove button To remove all names from the the print list click the Clear button The start position allows you to use a label sheet which has been partially used as described in the Patient Labels section on Pages 7 8 Click the Print button to print address labels for physicians in the print list Click the Done button to exit MedBASE User s Manual Page 13 Claim Menu File 3 Provider Patient Physician MENTON Process The Select menu option allows the user to select a claim for editing of claim information If there are no unsubmitted claims for the current provider a alert message will appear indicating this Otherwise choosing S
57. sicians have been entered in the billing system the user will be asked to enter the new Provider Information as described on Pages 2 3 After entering the Provider Information or with subsequent program use when only one provider is in the system this provider will be selected automatically If more than one provider is present the Provider Browse Window will appear as shown below This displays a listing of each of the providers in the system Select the desired provider with the mouse Select Provider and Close Window Billing First Name and then close the window by clicking in the close box in the top left corner or by hitting the escape key If full password protection is active for the selected provider see Page 3 a window will appear prompting you for the password Enter the password in the blanked out boxes and click OK If full password protection is not active these steps are bypassed Enter Password for Provider DR JAMES ALLISON Password EY When a provider has been selected only the active claims under him her can be accessed Also provider specific are patient appointments claim reviews claim summaries billing and reconciliation functions accounting summaries accounts receivable summaries practice profiling and archiving Full patient and referring physician listings are always accessible and these are not provider specific The Current Provi
58. spital inpatients If automatic Admission Date entry is activated in the Preferences section see Pages 20 21 then the admission date of the most recent claim will be automatically entered for new claims on the same patient This is a useful feature for patients with long term hospitalizations Bill Code A valid OHIP service code format ANNNA must be entered here If an incorrect service code is entered a message Invalid Input will appear Up to 8 service codes can be entered per claim All codes must end in the suffix A B or C The entry of a claim item into the Claim database depends on the presence of a non blank Bill Code To delete a claim item simply erase the Bill Code On re opening the Claim Form Window for that account that claim item will be deleted To review billing information for a specific service code select the Service Codes option from the Claim Menu see Page 15 The number of services for each bill code are entered in this field For anesthetists C suffix and assistants B suffix fees the of base units are entered automatically For these fees the user should then add on the of time units For other fees if no entry is made 1 is assumed For expandable codes such as hospital visits a gt 1 refers to visits on consecutive days starting with the Service Date Unit Fee The unit fee for the specified billcode is entered automatically The unit fee can be changed by manuall
59. tenance as required as well as updates to the program and documentation An annual fee will be charged for this Ongoing Support as agreed upon at purchase Default of payment of annual support fee will result in suspension of all Ongoing Support This is the only agreement between you and MedBASE Software Inc It cannot and shall not be modified unless in writing and signed both by you and an authorized officer of MedBASE Software Inc You agree to be bound by this mutual agreement between you and MedBASE Software Inc MedBASE User s Manual Page 29 Index About MedBASE iii ii 21 Changing Maximum Open Files 21 Accounting Menu Option oooooccccnnnoocnninnnananinonnns 17 Chart Labels un iri ee 8 Accounting SUMMA Y cooooccccnonocncnnnanancnnnnnnnnos 17 18 Choose Menu Option Provider oo 2 Accounting Summary Screen seese 17 18 CHOOSER A A E E E Oe ey 21 Accounts Receivable 2 cacscsssasesdenesiessagseseeneeses 18 Claim Adjust Screen 13 14 Accounts Receivable report 18 Claim Browse Window cccccnonccccnonnno 11 13 19 Accounts Receivable screen s 18 Claim Form Screen cccoooocccnonnnonancnnnnns 5 11 12 13 Accts Receivable Menu Option ooooocccccnnoncnccnnnns 18 O A ui aer a Made 12 15 Add Edit Appointment screen s 7 Clam Ments att sa 11 Address LabelSunasiiaini die 8 Claim Select Seres cialis 11 Adjust Menu OptiON ccccnooocccnnnnonnnnnonanancninnnos 13 Claim Status eee 11 13 1
60. trol Panel device entitled Max Files Copyright 1990 Siemens Gammasonics Inc is automatically installed into your System Folder Use this utility to set the maximum of open files to at least 80 to ensure optimal database operations An inadequate value for maximum of open files may result in problems when printing reports particularly when working in MultiFinder The computer must be restarted for these changes to take effect For those with System 7 0 the maximum of open files are regulated automatically during computer operation MedBASE User s Manual Page 27 File Menu The File menu contains one option Quit or the keyboard equivalent Command Q This allows you to quit the program IES iit Provider Patient Physician Claim Process For technical advice and support call MedBASE Software Inc at Phone and FAX line 416 778 5852 Emergency Service 416 417 2743 MedBASE User s Manual Page 28 MedBASE LICENSE AGREEMENT MedBASE Software Inc will assume that in purchasing this software package you have agreed to be bound by the terms of this license agreement If you do not accept the terms of this license agreement you may return the package to MedBASE Software Inc within 30 days of purchase for a full refund MedBASE Software Inc grants to you and you accept a Software License to use the program and documentation delivered with this Software License Agreement MedBASE Software Inc retai
61. y X Monday KK Tuesday XK Wednesday E Thursday KK Friday O Saturday A starting date for the appointment search can be specified the current date or the last date found is the default Clicking on Find initiates the search Only office days of the week are checked and days that are flagged as No More Bookings on the Daily Appointments screen see adjacent column are ignored The Daily Appointments screen for the First Available Booking day is then displayed Exiting from the Daily Appointments screen returns the user to the Find Next Booking screen Click Done to exit The Monthly Appointments screen displays the days of the selected month in a calender format Days on which appointments have been scheduled are shown RWA Days which have been flagged as No More Bookings are underlined Clicking on the backward and forward arrows situated adjacent to the month and year brings up the previous and next months respectively Monthly Appointments January 1992 A weekly summary of appointments can be printed by clicking on the Week 1 5 buttons for each week of the month To view add edit or print the appointments for any given day of the month simply click on that day on the calender This will bring up the Daily Appointments screen as shown below This screen displays a scrollable list of the appointments for that day in chronological orde
62. y be any combination of 6 alphanumeric characters Important remember your password If either partial or full password protection is operative you will be prompted for the password before being allowed to edit provider information Enter Password for Provider DR JAMES ALLISON Password fo lo Jo fo o Jo Password Off Only providers without existing claims can be deleted Clicking on the Delete button prompts the program to search the database for existing claims for this provider If any are found a warning message will appear Cannot delete provider due to existing claims If there are no existing claims a message will appear asking to confirm if you wish to MedBASE User s Manual Page 3 delete the provider Click Yes to delete the provider or No to cancel Done Click the Done button to leave the Provider Information screen Any changes will be saved New Select the New menu option from the provider menu to enter a new provider A blank Provider Information screen will then appear Refer to the Edit menu option on Pages 2 3 for details regarding the Provider Information screen Patient Menu AU Physici Select e New ES Appointments Review Claims Import Card Reader The Select option allows you to select a patient for editing of patient information Upon selecting Select or the keyboard equivalent Command P the Patient Search screen will appear
63. y entering a fee and hitting Return MedBASE User s Manual Page 15 For special visit fees the unit fee entered will equal the greater of either the base fee or the product of the fee billed on the immediately preceding item assessment or consultation multiplied by the percentage shown below Fee Code Percentage Base Fee _991A 30 9 50 _993A 30 14 30 _995A 30 14 30 _997A 50 22 00 Fee Billed The fee billed is automatically calculated and entered equals the product of the number of services and the unit fee The fee billed can be changed by manually changing the unit fee and hitting Return Service Date The date on which the service was rendered is entered here If Automatic Date Entry is checked off in the Preferences section see Pages 20 21 and a value has been entered for the default date then this date will be automatically entered in the first date field If Automatic Date Entry is checked off but the default date has been left blank then either the admission date or the current date if admission date is blank is automatically entered for the first claim item For subsequent claims items the service date for the previous claim item is automatically entered This feature can be disabled by unchecking Automatic Date Entry in the Set Preferences screen in the Preferences section When disabled the service date must be manually entered OHIP Reciprocal Use the Pop Up menu see a
64. ystem 6 0 and preferably 4 MBytes of RAM with System 7 0 A hard disk with a capacity of at least 20 MBytes is recommended MedBASE is compatible with all Macintosh computers from the older Mac Plus and SE models to the newer PowerBook LC series Centris and Quadra systems Getting Started Installing the Program MedBASE User s Manual Page 1 To install MedBASE insert the h diskette entitled MedBASE 3 5 e Program into the floppy disk p4 qp ASE comp drive This disk contains a file of the compressed code of the MedBASE application and related files When the MedBASE comp icon is double clicked a dialogue box appears as shown at the top of the next column prompting you to select a destination for the decompressed files Click on the Drive button or Desktop button in System 7 0 to select the hard disk on your computer and then click Extract to decompress the MedBASE files When pooo Select Destination Folder Hard Disk amp Hard Disk v O MedBASE Related O System Folder Volume Eject Drive Folder Cancel Extract decompression is complete a new folder entitled Billing Folder will be present on the hard disk and will contain the MedBASE application as well as the MedBASE Databases and Submissions folders Your MedBASE program is now installed Starting the Program MedB ASE MedBASE is accessed by simply double clicking on the MedBASE icon If no providers billing phy

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