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MED#1 MEDICAL PRACTICE MANAGEMENT SYSTEM Version 1.06 A full featured, simple to use, medical office practice management system for IBM-PC (and compatible) micro computers. Copyright (C) 1988, 1989, 1990 BY: MEDshare 4100 West 15th, Suite 103 Plano, Texas 75093 (214) 736-3668 ALL RIGHTS RESERVED LIMITATION OF LIABILITY THE FOREGOING WARRANTY IS IN LIEU OF ALL OTHER WARRANTIES, EXPRESSED OR IMPLIED. INCLUDING, BUT NOT LIMITED TO, THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. IN NO EVENT WILL MEDSHARE BE LIABLE FOR CONSEQUENTIAL DAMAGES EVEN IF ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. GENERAL If any of the provisions, or portions hereof, of this agreement are invalid under any applicable statute or rule of law, they are to that extent to be deemed omitted. COPYRIGHT Copyright (C) 1988, 1989, 1990 by: MEDshare 4100 West 15th, #103 Plano, Texas 75093 All rights reserved. DISCLAIMER MEDshare makes no representations or warranties with respect to the contents hereof and specifically disclaims any implied warranties of the merchantability of fitness for any particular purpose. MAILING ADDRESS MEDshare 4100 West 15th, Suite 103 Plano, Texas 75093 (214) 736-3668 USER MANUAL Introduction to MED#1....................... 1 Registering your copy of MED#1.............. 3 Features.................................... 4 System installation......................... 6 System initialization....................... 8 Keyboard usage General key usage...................... 10 'F1' HELP.............................. 11 'F2' Search............................ 11 'F3' Add new........................... 11 'F10' Memory check..................... 12 Getting Started............................. 13 Master Menu................................. 15 (P)atients Sub-Menu.................... 16 (P)atients........................ 16 Inquire...................... 16 Add new (account/patient).... 17 Change....................... 20 Delete (account/patient)..... 20 (+/-) skip and display....... 20 Notes........................ 20 Print........................ 21 (T)ransaction posting............. 22 (P)ost transactions.......... 22 Patient notes........... 22 Insurance information... 22 Multiple ICD-9 setup.... 22 Posting of charges...... 23 Posting receipts and 23 adjustments........ 23 Recalls................. 23 History................. 23 Insurance print request. 23 Print insurance claim... 24 Forms alignment.... 24 Filing address..... 24 Super Bill print request 24 Print Super Bill........ 24 (D)elete transactions........ 25 Deleting a transaction.. 25 Recall of deleted trans. 25 (L)edger.......................... 26 Account/Patient.............. 26 (D)isplay.................... 26 First page display...... 26 Full ledger display.... 26 (P)rint...................... 26 (B)ill............................ 27 (S)uper bill................. 27 Requesting a super bill. 27 Questions asked......... 27 (I)nsurance claim form....... 28 Patient setup........... 28 Transaction selection... 28 Form alignment.......... 28 Questions asked......... 28 (R)ecall.......................... 29 (D)isplay ................... 29 (P)ost updates............... 29 (A)dd new............... 29 (C)hange................ 29 (D)elete................ 29 (+/-)skip............... 29 (H)istory......................... 30 (D)isplay.................... 30 (P)ost updates to............ 30 (A)dd new............... 30 (C)hange................ 30 (D)elete................ 30 (+/-)skip............... 30 (R)eports.............................. 32 (C)harges and adjustments......... 34 by Patient................... 34 by CPT code, Patient......... 34 by Table, CPT code, Patient.. 34 by Invoice number............ 34 (R)eceipts........................ 35 by Patient................... 35 by Code, Patient............. 35 by Table, Code, Patient...... 35 (M)onth-to-Date Summary........... 36 (G)eneral Ledger.................. 37 (A)ged Accounts Receivables....... 38 (S)tatements...................... 39 (I)nsurance Forms Batch Print..... 41 (L)etters and Recalls............. 43 (P)ring recall letters....... 43 (M)ailing labels............. 43 (L)ist pending recalls....... 43 (S)pecial.................... 44 Select parameters....... 44 Labels.................. 44 Letters................. 44 Listings................ 44 (P)atient recap................... 45 (L)etters.............................. 46 Word processing keys.............. 47 (D)isplay letters................. 48 (M)aintenance..................... 48 (I)nquire.................... 48 (A)dd new.................... 48 (C)hange..................... 49 (D)elete..................... 49 (+/-)skip.................... 49 (L)ist to printer................. 49 (I)nsurance companies.................. 50 (D)isplay companies............... 50 (M)aintenance..................... 50 (I)nquire.................... 50 (A)dd new.................... 50 (C)hange..................... 50 (D)elete..................... 51 (+/-)skip.................... 51 (L)ist to printer................. 51 (D)octors.............................. 52 (D)isplay......................... 52 (M)aintenance..................... 52 (I)nquire.................... 52 (A)dd new.................... 52 (C)hange..................... 52 (D)elete..................... 53 (+/-)skip.................... 53 (L)ist to printer................. 53 (T)ables............................... 54 Alpha or Code sequence displays... 54 (D)isplay tables.................. 54 (C)harge code display............. 54 (M)aintenance..................... 55 (I)nquire.................... 55 (A)dd new.................... 55 (C)hange..................... 58 (D)elete..................... 58 (S)how....................... 58 (+/-)skip.................... 58 (L)ist to printer................. 59 (A)ll tables................. 59 (S)elected tables............ 59 (U)tilities............................ 60 (A)pplication Support............. 60 (U)pdate Practice Data....... 60 (P)urge Old Invoicing........ 60 (C)reate New Charge Table.... 60 (D)elete Existing Table...... 60 (F)inance Charges............ 60 (T)ransfer patient data...... 61 (L)edger code update posting. 61 (S)ystem Support.................. 61 (R)e-index data files........ 61 (P)rint Registration Form.... 61 (M)onographice color......... 61 (C)hange printer codes....... 62 GLOSSARY.................................... 63 DATA FILES.................................. 64 OTHER Service/support........................ 67 Upgrades............................... 68 New releases........................... 70 INTRODUCTION MED#1 is a new medical office management system that will increase efficiency in the daily administration of the business side of your medical practice. It is designed with special features unavailable in other medical systems and is very 'user friendly'. We're confident you will find MED#1 one of the easiest systems to use, especially if you are already acquainted with computer operations. But even if you aren't, MED#1 will take you through operations with simple one-key functions that follow the logical progression of your normal routine. With an awareness of the spiraling costs of office administration, MEDshare has developed its marketing concept to deliver the best possible product at a price far below existing medical systems. MED#1 WILL OPERATE ON MOST POPULAR MICRO COMPUTERS, ALLOWING YOU TO TAKE ADVANTAGE OF A LOCAL COMPUTER STORE FOR HARDWARE SUPPORT. MED#1 IS SO EASY TO USE YOU DON'T HAVE TO SPEND THOUSANDS OF DOLLARS TO TRAIN OFFICE PERSONNEL. And of course the best advantage of MED#1 is this opportunity to fully test the system in this un- registered package. While you are limited to 100 patients in the un-registered version, that is the only limitation. You can take those 100 patients through every function of recording, posting transactions and billing, allowing you to test to the full extent of the system. No other software company gives you that kind of opportunity, and we encourage you to copy your unregistered disk and share it with a colleague who might be interested. To operate the MED#1 system, you need a computer with MS-DOS 2.0 (or greater), 640 K of memory, and the following: (1) floppy disk drive (for loading software) (either 5 1/4" or 3 1/2" floppy disk) (1) hard disk drive (for program and data files) (1) printer (any dot matrix) (Note: MED#1 is not qualified as a multi-user system and it does not support lazer printers.) Page 1 No special forms are required for printing. All reports will be printed on 8 1/2" by 11" standard stock paper. Custom statement forms, and the standard insurance HCFA-1500, are available through MEDshare, but the system will print without them. Copies of these forms will be sent to you upon request. For your special custom forms please let us know so that we can program software for you (small charge for customization). Now, more than ever, computerization is a part of every medical practice. It's faster, more accurate and opens you up to the opportunities of future technical advances. MEDshare is committed to making that a reality, especially for the single doctor practice where cost factors and limited personnel made it impractical in the past. We are also committed to a 'stand by you' philosophy of business, offering a sales and phone support team to provide assistance as needed. MEDshare will also keep you updated on advancements that will enhance or improve your existing system. FEATURES OF MED#1 THAT WILL SAVE YOU TIME & MONEY * Statements can be printed for all accounts with a balance due on your schedule. * Patient ledgers are automatically updated at time of transaction posting - no need to maintain a manual ledgers. * Superbill and/or Insurance claim form can be printed as patient checks out or any time needed. * Standard Insurance form HCFA-1500 can be printed automatically for insurance assignment with less mistakes, less manual re-input, saving time. (Contact MEDshare for the name of the manufacture of the HCFA-1500 form used by MED#1. While this is a standard form there can be as much as three print positions variance in the alignment of other suppliers forms.) * Instant access to account/patient ledger information to help collect at time of office visit. * Reporting to help you run your practice: A) Daily charges and receipts recap. B) Month-to-date summary recap. C) Aged accounts receivables. D) Statements. E) Recall letters. F) Special Recall selection that will help you keep in touch with your patients. G) Insurance claim forms. Page 2 REGISTERING After you've worked with the un-registered package of MED#1, and decide you want full access to the system, follow these simple steps to register: 1. Enter the (A)pplication support section of the UTILITIES sub-menu, select '(U)pdate practice data' and verify that the information displayed is correct and entered exactly as you want it to be displayed in all usages. YOUR UNIQUE REGISTRATION NUMBER IS CONTROLLED BY HOW YOU SETUP YOUR PRACTICE NAME. PLEASE TAKE THE TIME TO INSURE THAT YOUR PRACTICE NAME IS EXACTLY AS YOU PLAN TO USE IT. 2. Enter the (S)ystem support section of the UTILITIES sub-menu, select '(P)rint registration form, and print out a copy of the REGISTRATION FORM. 3. Finally, mail the form and a check to cover the REQUIRED registration fee to MEDshare. You will then receive: A. A REGISTRATION NUMBER that will unlock you from the 100 patient limits of the system. B. A phone number you can call for support (you will be billed for this support at $60.00 per hr in 1/4 hr units). C. A printed copy of the user's manual. D. A copy of the newest version of MED#1 (if your un-registered copy is not the latest). E. Newsletter informing you of other programs that complement MED#1. (Sorry but we can only offer this support to registered users.) Page 3 FEATURES Speed and efficiency are the most important qualities of any medical office management system, and the features of MED#1 were designed to provide time saving factors. The following list describes some of those features as well as providing other helpful information. ---------------------------------- 1. 'FLAGS' used in one function will access another function directly, eliminating the need to manually move from function to function. 2. If you're updating a file and change your mind or make a mistake, pressing <ESC> will cancel the new information and leave the previous record intact. 3. Use of the 'F1' hot key on all input fields during operation will provide a pop-up help screen. 4. The 'F2' hot key allows you to do patient search/select. It also allows for insurance company search/select. 5. The 'F3' hot key allows you to (A)dd a new insurance company at the time of transaction. 6. Your disk capacity is your only true file size limit. Up to 99,999 accounts can be set up with MED#1. 7. Accounts can have up to 100 patients with automatic patient numbering within that account. Each patient can have his own doctor assigned. 8. Rates can fluctuate within the accounting functions allowing you to accommodate variances without altering your tables. 9. Statements, letters, and insurance forms can be batch printed or selectively printed. 10. Patients can have unlimited notes and history with a patient profile recap at any time. 11. Up to 100 doctors can be set up per practice, each with a unique charge table. 12. Up to 99 standard recall letter formats can be setup and attached to specific charge codes. Page 4 13. Recall letters can be scheduled during patient transaction posting, and each request can be maintained individually. A special recall feature allows you to produce listings, labels, and letters for patients based upon various select parameters such as age, sex, date last seen, and other information in the patient master record. 14. Up to 99 (00-98) unique charge code (CPT) tables can be set up. Tables can be copied to create a new table. There is not limit on the number of codes per table. 15. A separate table for ICD-9 codes (table 99). 16. Each charge (CPT) code can be flagged for history, recall, or insurance. 17. You can search both CPT and ICD-9 tables by either code or alpha description sequence starting with a specific value. This search ability is available while within the transaction posting cycle and the table maintenance function. You can associate up to four ICD-9 codes to the CPT codes being posted for a given patient posting cycle. 18. During individual transaction posting changes can be made to charge tables, doctors can be re-assigned and charge rates can be changed. 19. Daily charge and adjustments recap can be listed in four formats: by: patient by: charge code and patient by: charge table, charge code and patient. by: invoice number 20. Daily receipts recap can be listed in three formats: by: patient by: charge code and patient by: charge table, charge code and patient. 21. Monthly Summary of all postings can be ran any time and will recap by each day of the month total charges, adjustments, and receipts. 22. Aged Accounts receivable can be run by account number or account last name. You also have the option of not printing zero balance accounts. 23. Statements can run for any given period and can contain a printed message. It also carries the option of printing zero balance accounts, credit balances accounts, and only debit balance accounts over a given minimum balance. Page 5 SYSTEM INSTALLATION REQUIREMENTS: MS-DOS 2.0 (or greater) 640 K memory (1) Floppy disk (to load program with) (1) Hard disk (for program and data files) Monochrome or Color Monitor Printer (any dot matrix) (Note: MED#1 - Version 1.06 is only certified as a single user system. A multi-user version is currently being tested and should be available soon.) INSTALLATION: Installing the MED#1 system is not complicated, nor will it take much time. The first thing to do is make a back up of the MED#1 distribution disks, and store the originals in a safe place. Your instructions manual for your computer should tell you how to do this. Use the new BACKUP disks for the rest of the installation instructions: 1. Check to insure you have a 'CONFIG.SYS' file in your root directory with the following minimum values: FILES = 20 BUFFERS = 8 (WITHOUT THESE MINIMUM VALUES BEING SET YOUR MED#1 SYSTEM WILL NOT RUN!) If you don't have a 'CONFIG.SYS' file, or it doesn't contain these minimum values, consult your DOS manual on how to create or modify your 'CONFIG.SYS' file. (NOTE: MED#1 will not operate properly, and may crash, if your 'CONFIG.SYS' file doesn't exist and have these minimum values. If you need to create or modify your 'CONFIG.SYS' file, be sure to 'reboot' your system before you continue.) From your root directory, create a sub-directory for your MED#1 program and data files by entering the following DOS command: C>MD\MED1 <return> Now you can select the new sub-directory by entering: C>CD\MED1 <return> Page 6 Insert the MED#1 distribution disk labeled #1 into drive A on your computer. Copy the contents of that disk into the newly created MED1 sub-directory by entering: C>COPY A:*.* <return> (NOTE: ALL ENTRIES must be typed in exactly as displayed in these examples, including 'spaces' between characters or letters.) REMOVE DISK FROM DRIVE A UPON COMPLETION OF COPY PROCEDURE AND REPEAT PROCEDURE WITH EACH OF THE REMAINING DISTRIBUTION DISKS YOU RECEIVED. If you do not have a printed copy of the MED#1 user manual you should print a copy of the one provided to you, on disk, with your system. To PRINT your copy of the MED#1 user manual: 1. turn on your printer 2. enter: C>MANUAL <return> This is a full copy of the printed user manual less graphics and file layouts. This manual is also about 100 pages long so be sure that you have enough paper in your printer before initiating this request. Page 7 SYSTEM INITIALIZATION MED#1 initialization is an automatic process performed at the time of initial loading of MED#1 program. (If you have been testing a prior release of MED#1 and are attempting to use the data files built by this earlier release, you will be requested to run program 'MED_UPDT.EXE' before you can use your new system. This program is supplied to all REGISTERED users and will perform all file conversions for you.) This initialization process will create your data files and your personalization file.: MEDMVBLS.MEM This file contains your practice personalization information as well as other information needed by MED#1. The following files will be created during system initialization: 1. PATIENT.DBF = Account/patient master file 2. COMMENT.DBF = Account/patient notes file 3. HISTORY.DBF = Account/patient history file 4. RECALL.DBF = Patient recall note file. 5. INSCO.DBF = Insurance company master file 6. DOCTOR.DBF = Doctor master file 7. CHGTABLE.DBF = Charge table (s) master file 8. LETTER.DBF = Recall letter master file LETTER.DBT = Recall letter formats 9. TRAN.DBF = Transaction posting data file These 'data base files' (DBF's and DBT) receive and store information that will be accessed during the functions of the MED#1 system. These are the only files you really need to backup in order to restore your system from any major fault that corrupts your current database, or makes it inaccessible for use. __________________ (Note: The file 'MEDMVBLS.MEM' existence signifies that your system has been initialized. If this file is deleted you will repeat the initialization cycle upon loading MED#1. If your data files still exist you will be given the opportunity to either leave them as they currently exist - or delete and replace them with blank data files. Please take care during this cycle so that you do not lose any critical data.) _________________________ Page 8 After you've initialized your data files, you'll be asked to enter your 'practice' information. This is your personal practice data, ie. name, address etc. Enter all requested information in the exact format you wish it to be displayed/listed. YOUR REGISTRATION NUMBER IS DEPENDENT UPON THE PRACTICE NAME YOU ENTER. PLEASE TAKE THE TIME TO INSURE THAT YOUR PRACTICE NAME IS EXACTLY AS YOU WISH TO USE IT. ONCE REGISTERED ANY CHANGE TO THIS NAME WILL REQUIRE YOU TO RE-REGISTER YOUR SYSTEM. When you finish entering the information, your system initialization will terminate and the MED#1 - MASTER MENU will be displayed. Page 9 GENERAL KEY USAGE The following key, and key combinations, can be used by the operator in the posting of data in all screens. FULL SCREEN NAVIGATION KEYS: ---------------------------- KEY PURPOSE -------------------------------------------------------- Left arrow, Character left. Does not move the Ctrl-S cursor to previous input field. Right arrow, Character right. At end of input the Ctrl-D, cursor moves to the next input field. Ctrl-Left arrow, Word left. Ctrl-A Ctrl-Right arrow, Previous word. Ctrl-F Up arrow, Previous input field. Ctrl-E Down arrow, Next input field. Ctrl-X, Return, Ctrl-M Home Beginning of input field. End Last character of input field. Ctrl-Home Beginning of first input field. Ctrl-End Beginning of last input field. FULL SCREEN EDITING KEYS: ------------------------- KEY PURPOSE -------------------------------------------------------- Del, Delete character at cursor position. Ctrl-G Backspace, Destructive backspace (deletes the Ctrl-H character left of cursor. Ctrl-T Delete work right of cursor. Ctrl-Y Delete from cursor position to the end of the current input field. Ctrl-U Restore current input field to original value. Page 10 HOT KEYS F1 - The use of the 'F1' key (for all data input fields) will display a brief informative message concerning the field you are currently ready to enter data into. Press the 'F1 key whenever you need more information concerning the field you are in. F2 & F3 Hot keys: These hot keys are only activated while in the 'PATIENT' functions. A message indicating that the 'F2' or 'F3' key has been activated will be displayed for those fields that utilize these hot keys. F2 - The use of the 'F2' key varies depending upon the field you are currently in. ACCOUNT/PATIENT ID. field - Pressing the F2 key will allow you to search/display/select a listing of accounts/patients in one of three sequences starting with a specific reference. The search/display/select sequences are: by ACCOUNT/PATIENT number, by last name, and by first name. You can select the desired account/patient by highlighting the desired record and pressing the <RETURN> key. INSURANCE COMPANY ID. field - Pressing the 'F2' key will allow you to search/display/select insurance company records already setup. These records will be displayed in ID. sequence. From the displayed listing of insurance companies you can select the one you wish to bring into your current display by highlighting the desired company and pressing the <RETURN> key. CHARGE CODE field - Pressing the F2 key while in this field will display all the codes in your currently selected charge table. You select the desired code by highlighting the desired code and pressing the <RETURN> key. DIAGNOSTIC CODE field - Pressing the F2 key while in this filed will display the codes you have setup in table '99' (your ICD-9 table). You can select the desired DIAGNOSTIC code by highlighting it then pressing the <RETURN> key. F3 - If you are in the INSURANCE COMPANY ID field pressing the 'F3' key will allow you to add a new insurance company to your INSURANCE COMPANY MASTER FILE. Page 11 F10 - The F10 hot key has been installed to help you to determine if you have sufficient memory to operate the MED#1 system. This key is activated at all times the same as the F1 key. Pressing the F10 key will display the current available memory you still have after loading the MED#1 program. This memory displayed value will vary depending upon the function you are in. To insure that you have sufficient memory try to maintain at least 40 K of free memory at all times. INSUFFICIENT MEMORY WILL RESULT IN THE CRASHING OF THE MED#1 SOFTWARE. Page 12 GETTING STARTED The first thing to do when you are ready to start using the MED#1 system is to set up the files you will be accessing. (The initialization process merely created the files. Here you will be entering the information to make the system work for you.) 1. DOCTOR - in this file you enter the information needed to identify the doctors that operate in your practice. 2. LETTERS - in this file you create letter formats for all patient recalls. For this function, the MED#1 system works as a word processor to create the 'body' of the letter. This file MUST be set up before any CHARGE TABLE CODES can be set up to request a patient recall. 3. CHARGE TABLES - in this file you establish all the charge tables and the charge codes necessary for posting transactions. Tables '00' - '98' are reserved for your CPT charge codes, table '99' is reserved for your ICD-9 codes. When you set up a patient/account record, you will assign one of these tables to the patient for all patient transaction posting. The use of multiple tables adds flexibility to how you define your practice. NOTE: The UTILITIES function of MED#1 contains routines that will assist you in creating a new table from an existing one. We suggest you first create a 'default' standard table containing all the codes you normally use, and then create copies of that table using the utilities. You can then modify the tables as needed. 4. INSURANCE COMPANIES - in this file you will enter all the information necessary to address a specific insurance company. If you already have a master list of insurance companies you file with, those are the ones you can set up in advance. New companies can be added later. NOW you are ready to set up your ACCOUNT/PATIENT master files. The following list contains information about how the system operates that you should find helpful in understanding the cross-referencing capabilities of MED#1. 1. ACCOUNTS are the party that will be responsible for the payment and will be listed in AGED A/R (past due bills), and on all other STATEMENTS. 2. ACCOUNTS can also be a patient. 3. ACCOUNTS will have a patient code of '00'. 4. ACCOUNTS can have up to 100 patients each. Page 13 5. ACCOUNTS can be a business or an individual. 6. PATIENTS can have a code of '00' to '99' (system assigned). 7. PATIENTS can provide insurance coverage for other patients within the same account. (Patient providing coverage must already be set up within the account.) 8. PATIENTS can be assigned to any doctor on file. 9. PATIENTS can be assigned to any charge table on file. 10. DELETING a patient will delete all related patient transactions, patient notes and patient history. 11. DELETING an account will delete all patients, patient transactions, patient notes and patient history. 12. Posting of any 'NOTES' to patient file will set up a request for the printing of a 'PATIENT RECAP' listing. Within the MED#1 system is a UTILITIES section which is provided to assist you in maintenance of your files. They should be used with great care because of their ability to modify your data files. They should ONLY be used after you've made a BACKUP of your data files (*DBF & *.DBT). With the UTILITIES function you can re-index your files which will remove all records flagged as DELETED and return the space they occupied to your system. If you restore your data files from a BACKUP, you must run the 'RE-INDEXING' function before they can be used. Failure to do this will corrupt the restored data files and you will have to re-load them from the same BACKUP and start over. Page 14 MASTER MENU The first screen that will come up when you activate the system contains a date that should be current. Beside the date is a 'Y' which is highlighted with the cursor flashing underneath it. If the date is correct, press the <ENTER> key. That will automatically call up your MASTER MENU from which you can choose the section you want to work in. The system automatically puts you at the top of the menu in the (P)atients section, and you can enter that section by pressing either the <ENTER> key or the letter <P>. NOTE: This is the section where most of your work will be done in creating patient medical and financial records. Information stored here can be flagged for use in the other sections. If you want to move to another selection, you can move the cursor by pressing the <ARROW> key. Using the different arrow keys will move you up or down the menu until the section you want to work in is highlighted. Page 15 (P)atients Sub-Menu NOTE: This is the section where most of your work will be done in creating patient medical and financial records. Information stored here can be flagged for use in the other sections. ENTERING the (P)atient section, will give you a sub- menu for all functions you can perform. Again, selection can be made by moving the cursor with the ARROW keys until you are on the section you want to work in. To enter that section, press the <ENTER> key or the letter in () preceding the name on the sub-menu. (P)atients The first time you use this part of the system, you should enter the (P)atients section first to create records for that patient. For later system use, you can enter the other options directly and pull information from the (P)atients section. Entering the first option of the sub-menu will give you a the first of three screens used to capture your patient information. Along with this screen is a sub-menu that allows you to indicate the type of maintenance you wish to perform. If you wish to locate a specific patient currently on file but you do not know that patients account number press the 'F2' key. Pressing the F2 key will call up a mini-screen with three options for searching for this patient: (A)ccount/patient ID (L)ast name (F)irst name You can 'SEARCH' in any of those categories. For example, move the cursor with the <ARROW> key until you're on (L)ast name. Press <ENTER> and type in the name. The system will display the file with the requested name at the top of the list. Press <ENTER> again, and that record will be called up and displayed on the screen. The sub-menu options displayed perform the following functions: (I)nquire (I)nquire will display information for a specific patient/account. If you want to use this option to scan information to see if it is correct, press <ENTER>. You will then get a 'prompt' asking for the ACCOUNT #. Type in the ACCOUNT # and press <ENTER>. Page 16 Pressing the <ARROW> key will take you through all the records of this 'Patient/Account'. To return to the PATIENT/ACCOUNT MAINTENANCE (Screen) press <ESC>. The first time you're using the system, you won't have any data in your files to (I)nquire about, so you will move to the second choice (A)dd new, and begin to develop your patient/account records. (A)dd new When you enter the (A)dd new section, the system will give you a mini-screen to choose whether you want to add a new ACCOUNT or PATIENT record. (Note - You must be already within an account before you can select the 'PATIENT' add new request. If you select the PATIENT add new request the next available patient number within the current account will automatically be assigned for you. If you select the ACCOUNT add new request the next available account number will be returned to you. You can override this with any other unused number by simply typing over the returned number.) Choosing either the (A)ccount or (P)atient option will activate the screens needed for the display and/or entry of the fields required. As you enter the information, the cursor moves automatically from FIELD to FIELD and SCREEN to SCREEN. (A FIELD is the space designated for a specific piece of information such as name, address etc.) The information you enter in the BILLING INFORMATION SCREEN is only available for use depending upon how you process your Aged Accounts Receivables and Statements. If you process by Account then this screen information is only valid if this patient is also the account master (patient number '00'). If you process your Aged Receivables and Statements by patient then this screen is valid for all patients. A. All FIELDS for dates are set up for double digits so all single digit months and days should be preceded by a 0. B. The 'CODE' field is a free-form field for use if you have some sort of coding system for patient filing. One use of this field is to identify BAD DEBT account/patient's. This field is displayed next to the account/patient ID. when you use the F2 search/display/select function. If you don't, or don't want to use it, you can skip this field by pressing <ENTER>. (Note: You can use this code field to sub-group your patients. You can then use the 'Special Recall' report feature to select these patients for letters, labels, and listings.) Page 17 C. The 'SALUT' field is provided to enter the salutation you want to use in recall letters. An example of this field usage is: Dear Mr. Ed Jones D. If you leave a field before you're ready, press the <ARROW> key and it will take you back. E. If you make a typing error, move the cursor with the <ARROW> keys to the mistake and press <DELETE> or <BACKSPACE>. Either one will remove the error. F. The system automatically capitalizes the first letter in a field containing a word that is not preceded by numbers. Example: LAST NAME - Doe. In the address field the street name will not be automatically capitalized. (Insurance information.) When you've finished the patient information section, the system automatically moves you to the 'Financial/Insurance' patient information screen. Your first function here is to assign a 'code table' number to this patient. We highly encourage you to assign DEFAULT 00 by pressing the <ENTER> key. What this means is that 99% of the time this will be the table you want to use. This code table you assign to the patient is the STANDARD table that other sections of the system will access for functions associated to this patient. You can also make modifications to the STANDARD table to create other tables. A. The doctor assigned to patient is designated by a number which you set up in your DOCTOR FILE. This is the doctor that normally sees this patient. B. Referring doctor field contains the identification number that relates to a specific doctor you have setup in your doctor master file that provided this patient referral to you. This doctor must already be setup in your doctor master file before you can enter this number. This referring doctors name, and medicare id number, will be printed on all HCFA-1500 forms you print for this patient. The other field for referrals is for you to enter comments for other types of patient referral were used to encourage this patient to use your services. B. In the 'insurance provider' field you can designate the person within this account that has the insurance policies that cover this patient 'X = self, S = spouse, P = parent, and O = other' by entering the patient ID. for the current patient Page 18 record being processed. If someone else is the 'insurance provider' enter the patient number for that person (must be a patient within this account and must be currently on file). To fill in the field for #1 Insurance carrier, type in the abbreviation for the appropriate insurance company as set up in your (T)ables. Example - Blue Cross can be abbreviated as BX. If you don't remember the abbreviation, type in an approximation. You will then receive a 'prompt' if not found: 'F2' SEARCH - 'F3' TO ADD Press the <F2> key which will access your insurance (T)able and give you the proper abbreviation. Press the <ENTER> key to return to your previous function. Then you can type in the correct abbreviation for that insurance company. C. If this patient has no secondary insurance carrier, press the <ENTER> key and move on. At the bottom of this section is a line: Assigned (Y/N): N Ins. Co.: % This is asking if payment is assigned directly to the doctor from the insurance company. The percent sign (%) in that same line is for what percentage that insurance company pays. The insurance form number currently defaults to '1 = HCFA-1500' only. Later as MED#1 is expanded this form number will be identify the specific insurance form to use for this patient. (Billing information screen) This is the third of three screens used to setup information relative to this patient. KEEP IN MIND THAT THE INFORMATION YOU ENTER INTO THIS SCREEN IS DEPENDENT UPON THE MODE OF AGED RECEIVABLES AND STATEMENT PROCESSING YOU ARE USING. IF YOU ARE LISTING YOUR RECEIVABLES BY PATIENT THEN THIS INFORMATION IS USED FOR EACH PATIENT YOU SETUP. IF YOU ARE LISTING YOUR RECEIVABLES BY ACCOUNT THEN THIS INFORMATION IS USED ONLY IF THE PATIENT NUMBER IS '00'. After entering the all of the required account/patient information the system will ask you if you want to SAVE. A 'Y' will be highlighted on your screen. Press <ENTER> Page 19 for YES and the entered information will be saved to the hard disk. If you do not wish to save the entered information PRESS <ESC> TO EXIT and you will be returned to the sub-menu. (C)hange. Selecting that function will initiate a 'prompt' for the ACCOUNT/PATIENT #. Type in the # of the account you wish to change. The sequence of screens in this function is the same as in (I)nquire and (A)dd new. (D)elete. You will use this function as your practice grows and changes. Deleting old files makes room for new ones. Selecting the (D)elete function will again 'prompt' for the ACCOUNT/PATIENT #. If you aren't sure of the number, you can press the <F2> key. (A HELP LINE is displayed at the bottom of your screen.) As a built in safeguard, the 'prompt' at the end of this function will ask: DELETE THIS ACCOUNT (Y/N): The default will automatically be set to an 'N'. This avoids the possibility of making a mistake by hitting the wrong key at the wrong time. The system wants you to be sure you're ready to delete. Deleting is easy, restoring isn't. (+)skip/(-)skip The (+)skip and (-)skip options allow you to advance to the next (+), or previous (-), patient record within the current account. Account/patient records selected in this manner are then displayed on the screen and you are returned to the (P)atient sub-menu to select the next function. (N)otes. You enter this function the same way you entered previous functions. These 'NOTES' can consist of any information you may wish to maintain on a specific account/patient. This information differs from history in that it is not prompted for at time of transaction posting but patient notes are displayed to the operator upon initial presentation of patient information while in patient maintenance and upon initial request to post transactions to this patient. Some good possible uses of Page 20 these notes are for patient credit status and/or initial diagnosis codes used in patient transaction posting. If you are displaying an account/patient using the (I)nquire function, and that account/patient has notes on file, the notes of that account/patient will be displayed to you automatically before the first data screen. (P)rint. With this 'PRINT' option you can request a listing of a specific patients profile to the printer. You can print any or all of the records you created in the other functions. This patient profile sheet can be given to the patient each time they come into your office. In this manner the patient can mark any corrections needed to be entered. This use of this form makes it easier to update known patient data that must be changed. Page 21 TRANSACTION POST/DELETE You select and enter that option the same way you selected the (P)atients option. (P)ost Selecting this function will call up the transaction posting screen: ACCOUNT/PATIENT - TRANSACTION POST If you're ready to post transactions, press <ENTER>. Then type in the patient's account/patient number. (If you do not know the patient account/patient number press the 'F2' hot key in order to search for that patient.) Upon entering the patient account/patient number the patient's name and current insurance filling status. Upon the initial location of the patient master that you are to post transactions to you will be displayed any notes on file for that patient. (Note: Notes are only displayed if there are notes on file for this patient. This is a convenient way to notify the operator of the financial status of the patient, or to display the diagnostic codes used for last patient visit.) This display of notes can be terminated by pressing the <ESC> key. You are then displayed the screen you will be using for the posting of all patient charges, receipts, and adjustments. Before you can enter any transactions for a patient you must confirm that the patient's insurance status and information is correct. This is the same basic information you can setup using the patient maintenance function. This screen is provided to save you the effort of having to go back to the patient maintenance screen for any correction of this information. (Note: A common problem for new users of the MED#1 system is in not understanding how to post receipts and adjustments. When you setup each of your charge tables '00' - '98' you must setup codes for transaction types 'C = charges, R = receipts, and A = adjustment's'. These three types (C,A, and R) of codes must be present within each table. You post receipts and adjustments the same as you post charges. Review instructions on setting up your tables if this concept is not clear.) Before you can post any charges you must enter in the ICD-9 codes you will be using for this patient. You can enter in a maximum number of four codes for any one posting cycle. The charges you post in any one posting Page 22 cycle can only use the ICD-9 codes entered at this time. (Note: Your ICD-9 table has the ability to hold multiple descriptors for each primary ICD-9 code. These descriptors are maintained as separate records in this table by the use of a code modifier called a 'REFERENCE' code. When you setup this table you can setup multiple descriptors for the same code by using a different reference code associated with the primary ICD-9 code. To retrieve the proper descriptor to be used with the transactions you are posting use the 'F2' search and select function if you have setup multiple descriptors for a given ICD-9 code.) After you have entered the ICD-9 codes you will be using you are ready to post your charges (receipts and adjustments do not require any ICD- 9 codes). Next you can enter the invoice number for the transactions you are entering. This invoice number will remain constant for all following postings and will not be asked for again. You will remain in a transaction posting cycle until you press the <ESC> key to terminate posting. (Note: Use the <ESC> to terminate a normal transaction posting only when you are in the transaction DATE field. Pressing the <ESC> key at the end of a transaction entry will result in the last transaction not being posted. A MESSAGE STATING TRANSACTION NOT POSTED WILL BE DISPLAYED IF THIS HAPPENS.) Change the date if necessary then enter each line item of the invoice for this patient. If you are entering charges you will be stepped through all the fields displayed in this screen. If you are entering a receipt, or adjustment, you will be displayed an abbreviated screen that accepts only the information needed for such an entry. Following the last entry for each transaction the system checks to see if the CPT code entered is to be considered for setting up a 'RECALL' or 'HISTORY' entry and if it is insurance related. If the answer is 'Y' (or yes) then special screens, and messages, are displayed that will allow you the option to enter such information. The insurance print question if displayed at this time is in reference to printing this last entry on an insurance form. Answer this question with a 'N' for those entries that should not be printed on an insurance immediately following this posting cycle. These transactions will receive the proper insurance status flagging an posted to the patients transaction file as if they had already be printed on and insurance for. Upon completion of your posting cycle for the current patient you will be immediately provided to: 1) print patient insurance claim form if the patient is assigned for insurance coverage, 2) print a hard copy of the patients Super Bill. Page 23 Print insurance claim form. (This option is only presented to you if the patient you have been posting transactions to has a 'Y' status for insurance assignment and you have posted entries that are to be printed on an insurance form.) If you do not wish to print the insurance claim form at this time just enter 'N'. Insurance forms not printed at this time can be printed at the end of day through the 'REPORTS - INSURANCE BATCH PRINT' option. If you do decide to print the insurance claim form at this time the first screen presented to you will ask if you wish to use the HCFA-1500 preprinted form. If you enter 'N' you will then have the insurance claim form printed on plan paper. If you enter a 'Y' then you are next asked if you wish to line up your forms. (MEDshare will be providing other insurance print modules later to be used with the MED#1 program. These other modules will allow you to print state MEDICAID, MEDICARE, and WORKMENS COMP forms. Registered users will be notified when this feature is available.) This forms alignment request will be repeated until you enter 'N'. Finally you are asked if you wished to print the address of the insurance company you are filling this claim with on either the right, or left, top corner of the claim form. If you are using the HCFA-1500 form that has the bar code then print on the right hand corner of the form. (Before you purchase any HCFA-1500 forms to be used with the MED#1 system please call MEDshare to verify the supplier of your forms. Although this is a standard form each supplier has a form lay out that can be as much as three print positions off from what MED#1 is setup for. This could make the forms you purchase impossible to line up for the MED#1 program.) If you are not using the HCFA- 1500 form that has the bar code then print on the left hand corner of the form. You are presented with the option to print a hard copy of the posted patient Super Bill for all patients. If you do not wish to print this Super Bill just enter a 'N'. If you do wish to print the Super Bill enter a 'Y'. The Super Bill is in a format that can be used by many patients for filling their own insurance claim form. All information other that insurance company and provider is printed on this form. Following the Super Bill you will be taken back to the patient account/patient number input field for entry of the next patient number. If you have no more patients to post transactions to then press the <ESC> key to terminate the posting cycle. Page 24 (D)elete Select this option if you wish to delete specific transactions for the displayed patient. Upon selecting this function you will be displayed all transactions on file for the selected patient in date order. You can delete any of the displayed transactions. (Note - Once deleted the posted transaction can no longer be accessed. Deleting a transaction will affect the account/patient ledger and aged receivables. The only way to correct the deletion of a transaction deleted in error is to either recall the deleted transaction or post a replacement entry.) Page 25 LEDGER Ledger displays can be for the ACCOUNT or the PATIENT and you will be prompted to identify the type of ledger you wish displayed. ACCOUNT/PATIENT - LEDGER - LEDGER REQUEST (D)isplay The initial display of the ledger will consist of a display of the current aged account/patient balance and the last seven transactions for the account/patient. You are then prompted if you want a display of ALL transactions in the account/patient ledger. If you select the display of all transactions you will be presented with a clean screen and you will be displayed about 20 (or less) transactions at a time starting with the oldest transaction on file. (If you are displaying a ledger for an account the transactions are displayed in date/patient sequence with each patient's name displayed before their transactions.) (P)rint Before you can request a printed ledger for an ACCOUNT/PATIENT you must have first selected a patient for display. You are then provided the option of listing either a ledger for the ACCOUNT or PATIENT and also limiting the listing to only those transactions for a given date range. Page 26 BILLING With this sub-menu you can print either a SUPER BILL or INSURANCE CLAIM FORM for a specific patient. (S)uper bill The request for a (S)uper bill will result in the printing of an invoice of current charges and receipts to be given to the patient. Upon requesting this option you are requested to enter the date range for the transactions you wish to show on the invoice. The default date will be the current date but you can override these dates with what ever range you wish. All transactions will be listed in date order with a net total summarizing the invoice. You are also offered several print options that affect the contents and format of the Super Bill being printed. These options are: 1. The ability to NOT print NON-Insurance items. This feature allows you to print a Super Bill showing only those charges and receipts that are insurance related. You will want to use this feature to print Super Bill's that are to be filled with the insurance company for payment. In this manner the patient's co-pay amount, which is not insurance related, is not shown on the bill and the insurance company payment is based on total charges that are insurance related. This means that the patients co-pay is not applied to the insurance related charges before the insurance company determines your compensation. You receive maximum compensation. 2. The ability to NOT print the patients, or accounts, Aged Receivables balance. If you do not print this aged balance then the Super Bill is strictly an invoice for current charges. If you do print the aged balance then the Super Bill is both and invoice of current charges and a statement that requests payment of total balance due. 3. The ability to print either a Patient, or Account, Aged Receivables balance. This request is only valid if you have requested to print the aged balance. By requesting either Patient or Account you identify the range of transactions to be included in the aged balance. 4. The ability to print the message at the bottom of the Super Bill. This message is for assignment of payment to be made to the physician. If this Super Bill is only for the patient to turn in for reimbursement then there is no need to print the message. Page 27 (I)nsurance claim The request for an insurance claim will initiate a three step process Step #1 = verification, and updating, of patient insurance information: Step #2 = selecting those transactions to be listed on the insurance claim (if the patient is assigned for insurance coverage this is automatically done for you at time of transaction posting). Selected transactions are flagged with an '*': Step #3 = request for printing of the actual claim form: At the time of print request you can give a 'N' response and later print all insurance forms in a batch mode. You have also the option of printing either on plane paper or using the industry standard preprinted insurance claim form. When ever you request an insurance form, or post transactions to a patient assigned for insurance coverage, a record for that patient is placed into the TAG_INS.DBF file. This record identifies to the system that this patient needs to have an insurance form printed. Until you have printed the insurance form, and accepted it as correct, this record will remain in existence. Once you have accepted the printed insurance information this record is deleted and the patients transactions have their insurance flags set/reset. (For charges - if the patient was assigned for insurance coverage the insurance flags are set to a 'Y' to indicate that this transaction was filed for insurance coverage. If the patient was not assigned for insurance coverage then this flag is returned to a space. For receipts and adjustments this flag is always set to a 'Y'.) (Note: Upon completion of the printing of your insurance form('s) you are provided an option to repeat the print request. Answer with either a 'N' or 'Y' only. If you press the <ESC> key the print cycle will be terminated BUT THE REQUEST FOR PRINTING THE INSURANCE FORM WILL REMAIN JUST AS IF THE FORM HAD NEVER BEEN PRINTED. THIS WILL RESULT IN HAVING TO PRINT THE INSURANCE FORMS AGAIN BEFORE YOU CAN CLEAR THE PRINT REQUEST.) Page 28 RECALLS With this option you can either (D)isplay all scheduled recalls for this patient, or you can (P)ost updates to this patients recall schedule. (D)isplay schedule (P)ost updates to schedule (D)isplay The display option will list to the screen all current recalls pending for this patient in date order. If no recalls are on file a message stating that fact will be displayed. (P)ost updates to schedule With this option you can perform the maintenance functions of (A)dd new, (C)hange, and (D)elete recalls scheduled for this patient. Normally all recalls are setup at time of transaction posting to this patients file and are deleted upon the posting of a follow-up visit transaction. These maintenance functions are provided to assist you in maintaining the patient recall schedules without having to post transactions. (A)dd new - With this option you can setup a new recall schedule for the patient. The information required will be the date for the recall and the letter to be printed. (C)hange - With this option you can change any of the parameters of a specific recall on file for the patient. When you request this option a listing of the pending recalls for the patient will be displayed from which you can select the one you wish to perform maintenance on. In this manner you do not have to know the date to key in to pull up the specific recall. (D)elete - With this option you can delete any of the scheduled recalls on file for a patient. Again when you request this option a listing of the pending recalls for the patient will be displayed so that you can select the one to be deleted. You will be displayed a prompt requesting confirmation of the (D)elete request before the recall selected is deleted. (+)skip & (-)skip - These options allow you to skip forward (+), or backward (-), within the patients recall schedule and display the pending recall. The actual printing of patient recall letters is a function in the REPORTS sub-menu of the MED#1 system. Page 29 HISTORY With this option you can keep your patient history file current for all office visits. Upon selecting this function you are displayed a sub-menu for patient history routines. (D)isplay history (P)ost updates to history (D)isplay history With this option you can display, in date order, all history you have on file for the selected patient. This patient history file is keyed from the posting of transactions but is a separate permanent file attached to the patient master. Entries in this file will not be deleted unless you specifically delete them or you delete the patient master. If there is no history on file for the patient a message stating that fact will be displayed to you. (P)ost updates to history With this option you can perform the standard maintenance functions of (A)dd new, (C)hange, and (D)elete of patient history records. These functions are provided so that you can better maintain your patient history file without posting additional transactions. (A)dd new - With this function you can post new history records to the patient history file. Normally you will be posting history immediately following the posting of charges to the patient file. The request for normal history posting is determined by a flag set in you charge table codes. (C)hange - Upon selecting this function you will be displayed a listing of all history on file for this patient from which you can select the history record to receive maintenance. You can change any information, other than the date, displayed in this history record. (D)elete - Upon selecting this function you will be displayed a listing of all history on file for this patient from which you can select the history record to be deleted. After selection, and prior to actual deletion, you are prompted to confirm your request for deletion. In this manner the chances of accidentally deleting a history record is minimized. (+)skip and (-)skip - These options will allow you to advance forward (+), or backward (-), in this patients history file and display each history record. Page 30 The posting of any changes to the patient history file will setup a record for that patient in the TAG_RCAP.DBF file. This record will trigger the request to print a patient RECAP profile sheet. These sheets should be printed and placed into the patients file folder. To print these RECAP profile sheets use the REPORTS sub- menu. Once printed this tag record is deleted. Page 31 REPORTS ENTERING the (R)eports option will give you a sub- menu that allows you to identify the specific report you wish to print. As in the previous section, make your selections by moving the cursor to the area you need to work in and press <ENTER>. This sub-menu contains the following items: 1. Charges and Adjustments: This series of reports will recap your DAILY postings for charges and adjustments. Keep in mind that this report extracts transaction information based upon transaction POSTING date (your system date at time of transaction posting). These transactions are then separated into groups by TRANSACTION DATE and printed as such on the report. (NOTE: Deleted transactions have their posting date changed to the current posting date valid at time of deletion. All deleted transactions are listed as a separate report following your regular report listing.) 2. Receipts: This series of reports will recap your DAILY postings for receipts. This report, while limited to receipts only, is identical to the Charges and Adjustments series of reports. 3. Month-to-date Summary: This report recaps all postings for the current month summarized by day. There are to major grouping of columns on this report. One set of columns for total charges and one set for insurance charges. The insurance set of columns are provided to give you an idea of the charges and receipts assigned for insurance payment. These numbers are determined by the patient assignment status and the percent you identified as being covered by insurance. 4. General Ledger Journals: This report allows you to generate a Journal of all transactions posted for a given period of time. This report also generates a data file that can be passed on to a Ledger System if one is available. 5. Aged Accounts Receivables: This is your Accounts Receivable Aging report. You can run this report any time without affecting the patient/account balances. This report reads the entire patient transaction file and only prints total calculated by this reading. 6. Statements: This is your Accounts Receivable Statement print routine. You can print statements at any time and for any given range of patient's or account's. The transactions printed on the statement are determined by the date range you identified that this statement request covered. Page 32 7. Insurance Forms Batch Print: This is the routine you use to print all insurance forms that were requested, but not printed, during the day. 8. Letters and Recalls: This is a combined set of reports that allow you to print listings, labels, and letters to patients scheduled for recall, and a SPECIAL feature that allows you to print listings, labels, and letters for patients, and accounts, based upon age, sex, date last seen, and other parameters. 9. Patient Recaps: This request provided you with a listing of patients profiles sheets that have been modified (updated) since the last time you printed this listing. Page 33 DAILY CHARGES/ADJUSTMENTS Entering the (C)harges section will give you a REPORT DAILY CHARGES/ADJUSTMENTS. KEEP IN MIND THAT THIS REPORT EXTRACTS TRANSACTIONS BASED OPON 'TRANSACTION POSTING DATE'. You can then print a record of daily charges by any of the displayed sequences. Select your option and press <ENTER>. Verify the date and press <ENTER> again. All transactions extracted for this report are sequenced in transaction date order and then the sequence requested by the report. In this manner you provided a report that not only shows you the posting made for the current date but also the actual date that these posting affected. All transactions that were deleted during the current day are given the current posting date. These deleted transactions are listed on a separate report following the report for active transactions. The selection options provided allow you to view the current daily charges in any of four different groupings. With these reports you can better gain an idea as to where your time is being spent and revenues are generated. (NOTE: If there was no activity in this area to report, the system will put you back to the (R)eports sub-menu.) The option to print 'by: Invoice number' has been provided to assist you in auditing your postings for the day. We encourage you to pre_number all Super Bill forms to be used during the day and release these forms in numeric sequence. When you select the option to list all charges by invoice number all gaps in the invoice number sequence printed will be flagged. This flagging of missing numbers will assist you in insuring that all Super Bills have been posted. Page 34 DAILY RECEIPTS Selecting the (R)eceipts option from the REPORTS SUB-MENU will give you REPORT of DAILY RECEIPTS. KEEP IN MIND THAT TRANSACTIONS ARE SELECTED FOR THIS REPORT BASED UPON TRANSACTION POSTING DATE. The (R)eciepts report selection works like the (C)harges and Adjustments report selection, providing you a daily recap of receipts in any one of three sequence groupings. Transactions are selected based upon posting date and are then sorted in to transaction date sequence and desired sequence for the requested report. In this manner you can see the transactions posted for the current date and what dates these transactions were for. Deleted receipts are given a new posting date of the date they were deleted. These deleted transactions will be listed in a separate report following the normal receipts report. Page 35 MONTH-TO-DATE SUMMARY Selecting the M)onth-to-date Summary from the REPORTS SUB-MENU will give you the REPORT: Month-to-Date Summary. KEEP IN MIND THAT THE TRANSACTIONS SELECTED FOR THIS REPORT ARE SELECTED AND GROUPED BY TRANSACTION POSTING DATE. THE ACTUAL TRANSACTION DATE IS NOT USED FOR THIS REPORT. You type in the month you want the report for and the system will give you a summary of transactions posted for that month, in summary by day. The insurance summary of this report is to be used as a guide only and not taken as being exact. Once you select this report you are given the option of calculating the reports beginning balance. (Note - In order to calculate the reports beginning balance ALL prior transactions on file must be read. If you have been using your MED#1 system for some time you could have a rather large transaction base. The larger your transaction base the longer it takes to calculate the beginning balance. Please consider the time necessary to read these transactions before you request the beginning balance.) Page 36 GENERAL LEDGER JOURNALS There are two basic types of reports you can produce with this option: 1. You can select a specific transaction code for a given period of time. This provides you with the ability to view how many times a given procedure was performed, and how much money was earned. 2. You can select all entries for a given period of time. This is the Journal Format of this option and can be used to interface with Ledger System. When you request this option you are provided with the added option to include, or ignore, transactions that have been reported on before. If you chose to ignore transactions that have been reported on before you are requesting a Journal that will show only new transactions. At the end of processing of this request you are provided the option to set a flag on these transactions to indicate that they have been reported on. Use of this selection, and flag setting, option allows you to create journals that show only those transactions newly posted and never recorded in your Ledger before. By selecting the option to include all transactions you can produce a recap of prior journals for any give time period. In addition to producing you a Journal listing the MED#1 system also creates a transaction file for all of the entries reported upon by the Journal. This file named MEDGL.DBF that is used to create the fore mentioned Journal listing. This file can also be passed on to another system for actual posting of your journal entries. (Note - Be careful how you use this extracted information. Be sure to set flags for those postings that are passed on to a Ledger system. Otherwise repeated requests for extraction of transactions for a given period will give you just that - duplicate extractions. It is up to you to insure that no duplicates are passed on to any external accounting system.) There are three sections to the 'Journal Listing' that is produced: 1) Charges, 2) Recap of Taxable Sales, and 3) Receipts and Adjustments. When you request the option to print a 'Journal Listing' you are provided the option to not print that section of the report related to taxable sales. If you do not have any taxable sales then do not request this section of the listing. MEDshare is developing a special General Ledger system that will accept the Journal file created by this report. All registered users of MED#1 will be notified when this module is available. Page 37 AGED ACCOUNTS RECEIVABLE Your AGED ACCOUNTS RECEIVABLE listing provides a breakdown of the current status of your Accounts Receivables. (NOTE: You should always run (A)ged accounts before you run statements.) This report can be ran at any time in either of two sequences: by ACCOUNT number, or by account last name. When you request this report you are prompted to enter two dates: date #1 = the date you last selected statements, date #2 = the current period ending date to be used. This date range provides: a) All transactions after the entered period ending date will be ignored and not considered in this report. b) All transactions prior to, and including, last statement date are used only to calculate the aged balance of each account. c) All transactions between these dates are considered as current postings form which all receipts will be listed in detail. This receipts listing will aid you in monitoring your accounts willingness to pay. You should find this a valuable feature for those accounts having a balance over 60 days old. The optional listing of zero and credit balance accounts will allow you to control the size (number of patients, or accounts, listed) of your Aged Receivables report. At the end of the report you are provided with two sets of totals: a) a set of totals for the patients, or accounts, listed on the report, and b) a set of totals that show the total accounts receivable currently on file. We recommend that you run a complete report at the end of the year so that you have a listing of all accounts you have performed services for. Page 38 STATEMENTS STATEMENTS can be printed at any time. Transactions posted after the current statement period ending date are not considered for processing. You have the option of using either custom statement forms, or they can be printed on standard 8 1/4" by 11" paper. (Custom forms are available from MEDshare.) You are also given the following options: 1.) Printing statements for a given billing cycle. Each patient, and account, can be assigned to a specific billing cycle (see screen #3 of patient maintenance). You can then limit your statements to only those patients, or accounts, for a specific billing cycle. One possible use is to give a specific billing cycle code to patients that are assigned to insurance coverage. In this manner these patients would only receive statements when you specifically request then. (Note: Billing cycle codes are printed on your Aged Receivables report directly below the patient/account number.) 2) printing statements for a limited account number range. If you only need a statement for a single, specific, account then enter that account number for both the starting, and ending, account number range parameters. (NOTE: Statements are always printed in account sequence. Also remember that if this patient, or account, is assigned a billing cycle code you must also enter this code in order for the statement to be printed.) 2) printing debit balance accounts. Within this option you can limit the printing of statements to only those accounts having a debit balance above a given minimum dollar value. With this option you can save the cost of handling statements that will cost you more than you will receive. 3.) printing zero balance accounts. 4.) and, printing credit balance accounts. (Note - If you answer 'N' to all of these options then the request to print statements will be canceled.) You identify the transactions to be printed on each statement by identifying the last statement date and the current period ending statement date. All transactions prior to, and including, the last statement date will be considered as balance forward only and will not be listed on the statement. Only those transactions after the last statement date to, and including, the current period ending date are listed in detail on the statement. All Page 39 transactions are listed in date/patient order with the patients name printed for each group of transactions related to that patient. (Note - Remember that all transactions are listed in date order and not in patient and date order. This sequencing will result in possible multiple repeat listing of patient names - depending upon the date of the transaction.) MED#1 does not create any balance forward record nor does it have a rigid closing cycle for your Accounts Receivables. All transactions for each account are read in date sequence to determine the account current balance. No transactions are considered in this calculation that are past the current period ending date. Using this concept you can rerun statements at any time for any period and see the same results. Page 40 INSURANCE FORMS BATCH PRINT NOTE: You can print insurance forms at the end of the day or week, or at the time of actual transaction posting. At the time of the office visit, the patient receives the 'super bill' and usually pays the amount not covered by insurance. If payment is assigned directly to the doctor, you can then wait to do insurance billing later. For a patient who hasn't assigned direct payment, an insurance statement can be printed at the time of the visit by accessing the 'BILL' cycle and selecting those transactions to be listed on an insurance claim form. For all patients not assigned for insurance coverage all transaction insurance flags will be set off following the printing of the insurance form. Selecting (I)nsurance Forms Batch Print from the REPORTS SUB-MENU will give you the following prompts: USE PREPRINTED HEALTH INSURANCE CLAIM FORM (Y/N): If you answer with a 'N' then your insurance claim form will be listed on plane paper. If you answer with a 'Y' then the HCFA-1500 claim form will be used. PERFORM FORMS ALIGNMENT TEST (Y/N): With this option you are provided with a test pattern that is printed in block #1 of the HCFA-1500 claim form. You can repeat this option as many times as needed in order to set your printer forms alignment. PRINT INSURANCE ADDRESS ON TOP RIGHT SIDE OF FORM (Y/N): This prompt is provided so that you can print the address of the insurance company you are filling this claim with in the blank space at the top of your insurance form. This space will be either on the right, or left, top side of the form and is dependent upon the source supplier of the form and the existence of a printed bar code. Check your forms in order to determine which side to use. PRINT FORMS FOR SECONDARY INSURANCE COVERAGE (Y/N): This prompt allows you the option to print an insurance form for any secondary insurance coverage the patient may have. This form can then be placed in the patients file and filed later after the primary insurance coverage has paid their liability. With this option you save time of having to call-up and reprint all insurance filings in order to file with a secondary insurance company. Page 41 REPRINT (Y/N): This option is provide so that you can make multiple copies of your insurance claim forms without having to go through the cycle necessary to reset the transaction insurance flags. If you enter a 'N' then the print cycle is terminated and the system reviews all transactions printed on the claim forms and adjusts their insurance posting flags to either an 'off' or 'on' status depending upon the insurance status of the patient. (NOTE: IF YOU PRESS THE <ESC> KEY IN ANSWER TO THIS REQUEST THE PRINTING WILL BE TERMINATED BUT THE INS_TAG FILE IDENTIFYING THE INSURANCE FORMS TO BE PRINTED WILL NOT BE CLEARED. THIS WILL RESULT IN THE NEED TO REPRINT ALL INSURANCE FORMS IN THE INS_TAG FILE.) Page 42 RECALL LETTERS There are four options available for RECALL letters: 1. print letters, 2. print labels, 3. print listing of pending RECALL's, and 4. Special selections. (Note - For options 1-3 if you intend to print LABELS and LETTERS print the labels first without updating the 'letter sent count. Printing LETTERS always updates the 'letter sent count' by +1.) (P)rint recall letters You can limit the RECALL LETTERS to those patients between a given date range and a specific 'letter sent' count. All letters printed will update the recall 'letter sent' count by +1 upon printing of the letter. Remember - all recall reminders remain on file until the patient receives another posting for the same treatment that triggered the recall request, or until you manually delete it. Use of the 'letter sent' count will limit the letters you write to only those patients that you want to receive a recall letter. When letters are printed they are printed for all selected recalls. Each recall identifies the specific letter format to be used. These letter formats are extracted from your LETTER.DBF/DBT master file. In this manner you only need to know the date range you wish to print recall letters for - not the specific recall letter. (Note - Each patient can have multiple recalls on file at any one time. Recalls are only removed by posting a follow-up visit transaction, or by (D)eleting the specific recall.) (M)ailing labels If need labels for either post cards, or letters, use this option to print your mailing labels before you actually print the letters. If you do not plan to print letters then allow this routine to update the 'letter sent' count, otherwise let the letter routine update this count. (L)ist pending recalls This feature provides you with a proof list of all pending recalls on file scheduled prior to a given date. We suggest that you print this proof list before you actually print the letters or labels. If you see patient Page 43 recalls listed in your pending recall listing that you do not wish to send letters to you will need to go into the (P)atient - (R)ecall maintenance function for each such patient recall and adjust that patients recall schedule as necessary. (S)pecial This feature allows you to select patients for letters, labels, and listings directly from your patient data base using various parameters. These parameters are: 1. Code - this is the 'CODE' you assigned to the patient and is located between the patient account number and name prefix. This CODE field is not used anywhere else in the system and is fully user definable. 2. Finance code - this is the 'FINANCIAL CODE' you assigned to the patient and is located on screen #2 of patient maintenance. This FINANCIAL CODE is not used anywhere else in the system and is fully user definable. 3. Sex - This allows you to limit your selection to patients by sex. 4. Birthdate (from/to range) - This allows you to select patients by age, born prior to, and born after a given date. 5. Date last seen (from/to range) - This allows you to select patients that have not been in your office for a given period of time. This date is maintained automatically for you during transaction posting. 6. Zip Code - This allows you to limit your selection to patients within a given area. You can enter in as much of the zip code as you wish to match on. 7. Accounts only (Y/N) - This allows you to limit your selection so that you only print labels and letters to a single household and not to all patients within the household. (Note: Parameters for sex and birthdate have little value with this option.) After you have entered your selection parameters you can then direct you selection to: Mailing labels, letters, or listing. You can run this selection process any time as there are no flags set and no files updated. With this option you will find it possible to keep in touch with your patients. Page 44 PATIENT RECAP'S The purpose of the PATIENT RECAP profile listing is to provide you with a hard copy of information you consider important to that patient treatment history. You identify those transactions in your charge tables that should be posted into your patient history file. When you post one of these transactions to the patient you are prompted to setup a record in the patients history file. If you post an entry into the patients history file record is also placed into a TAG_RCAP.DBF file for that account/patient number. This record stays in existence until you print the patient recap listing. Your patient recap listings can be requested for a specific patient or for all patients having information posted to their history file. Requesting a recap for a specific patient does not delete a corresponding account/patient record in the TAG_RCAP.DBF file even if it exits. WE RECOMMEND THAT YOU PRINT THIS REPORT AT LEAST ONCE A WEEK. Page 45 (L)ETTERS You can setup up to 99 different letter formats. These letter formats are called into use when you print your PATIENT RECALLS and with the SPECIAL selection recall feature. AUTOMATIC RECALL REQUESTS To initiate the request for a patient recall associated with transaction postings you first must set the RECALL FLAG in your charge tables to a 'Y' for the CPT code(s) that require a recall, and reference an existing letter format contained in your LETTERS master file. At the time of posting these transaction codes to the patient you will be displayed a special window. When this window is displayed you can setup the patient for a RECALL. (Note - You can also use the (P)atient - (R)ecall maintenance function to setup these recall requests.) Page 46 WORD PROCESSOR MED#1 has built into it a limited word processor. The following keys are used to control the editing of your letters. KEY PURPOSE --------------------------------------------------------- Uparrow or Ctrl-E Move up one line Dnarrow or Ctrl-X Move down one line Leftarrow or Ctrl-S Move left one character Rightarrow or Ctrl-D Move right one character Ctrl-Leftarrow or Move left one word Ctrl-A Ctrl-Rightarrow or Move right one word Crtl-F Home Beginning of current line End End of current line Ctrl-Home Beginning of current window Ctrl-End End of current window PgUp Previous edit window PgDn Next edit window Ctrl-PgUp Beginning of letter Ctrl-PgDn End of letter Return Move to beginning of next line Delete Delete character at cursor Backspace Delete character left of cursor Ctrl-Y Delete current line Ctrl-T Delete word right Tab Insert tab character or spaces Printable character Insert character Ctrl-B Reform paragraph Ctrl-V or Ins Toggle insert mode Ctrl-W Finish editing and save Esc Abort edit, return original Page 47 Selecting the (L)etters option from the main menu will call up the RECALL LETTERS SUB-MENU. (D)isplay letters With this request you will be displayed a listing of all letter titles you currently have on file. From this display list you can highlight and select the specific letter format you wish to perform maintenance on, or inquire into. Upon selecting the desired letter format you are automatically taken into the (M)aintenance function in the (I)nquire mode and the selected letter is displayed to you. (M)aintenance The letter maintenance functions allow you to fully maintain your letter formats, and to add new formats to your letter file. The following maintenance functions are provided: (I)nquire - With this option you can request the display of a specific letter format. Once displayed you can then select any of the other maintenance options. (A)dd new - Use this option to setup new letter formats in you letter file. Each letter must be assigned a unique ID. code between the values of '01' to '99'. In addition to this code you should assign a brief descriptive title to the letter that will provide you will enough information that you can determine the contents of the letter format to follow. (Note - When you do search displays of the letter formats you have on file the only information displayed to you will be the letter code and this brief description.) Finally you are provided a window through which you can setup your letter body. When you setup a letter keep in mind that MED#1 will perform all of the addressing functions for you - only setup that portion of the letter body that is common to what you want all patients to receive. In the RECALL LETTER BODY 'field', the system works like a word processor with most of the features one would expect. You can rework the body of the letter without affecting the other parameters of your recall letter format. Correcting mistakes can be done by moving the cursor to the mistake and typing over it. If you need to 'insert' a word or space pressing <CTRL-V> will activate an INSERT capability. Press <CTRL-V> again when you're finished with the INSERT. Page 48 When you're finished with the letter, press <CTRL-W> to 'save'. You will receive a 'prompt' in the message line at the bottom of your screen: INFORMATION CORRECT (Y/N) Y Press <ENTER> if your answer is yes. The system will then add that letter to your file. (C)hange - The (C)hange function works in the identical fashion as the (A)dd new function except the letter must already be in existence. Once you have selected a letter to be changed you can modify any displayed information other than the letter ID. code. (D)elete) - To delete a letter, move to the (D)elete function and press <ENTER>. The cursor will automatically position itself at the CODE # 'field. If this is the letter you want to delete, press <ENTER>. You will then receive a 'prompt' in the message line on the bottom of your screen: DELETE THIS RECORD (Y/N) N This give you the opportunity to reconsider deleting this record. If you're sure, press 'Y' and <ENTER>. (+/-)skip - The (+)skip & (-)skip functions are there to allow you to move quickly through your RECALL LETTER file. (+)skip moves you forward to the next letter format on file. (-)skip moves you backward a to the previous letter format on file. LIST RECALL LETTERS When you're ready to print RECALL letters choose the (L)ist to printer option from the RECALL LETTERS SUB - MENU. A question will appear in the message line at the bottom of your screen: LIST ALL LETTERS (Y/N): N If you enter a 'N' and press <ENTER> and you will receive a display of the letters you have on file. They will be listed by code and title. Move to the specific letters you want to print and press <ENTER>. If you enter a 'Y' and press <ENTER> you will immediately start printing a proof listing of all letter formats you have on file. Upon termination of the letter proof listing you are returned to the (L)etter sub-menu. Page 49 (I)NSURANCE COMPANIES This is the section of the system where you will establish and maintain documentation on insurance companies you normally do business with. Selecting the (I)nsurance company option from your MASTER MENU will give you the INSURANCE COMPANIES - SUB-MENU. The first time you use this option you should select '(M)aintenance' from the sub-menu where you can create your file of insurance companies. DISPLAY INSURANCE COMPANIES ON FILE After you've created your insurance companies file, you can select (D)isplay from your sub-menu, which will give you a list of companies on file. If you want to make a change or an update of information on a particular company, you can move the cursor through the list until it's highlighting the desired company and then press <ENTER>. Upon selecting a specific insurance company you will automatically enter into the (I)nquiry mode of the (M)aintenance function. (I)nquire - In this mode you will be displayed the total information you have on file for the selected insurance company. (A)dd new - Enter the (A)dd new function, and type in the information. The 'code' information needed here is the abbreviation of a particular insurance company that you assigned in creating your 'tables'. ie, BX = Blue Cross. The rest of the information needed is standard. When you setup new insurance company masters take care to assign meaningful codes. These codes should be an abbreviation of the insurance companies name and possibly a number to identify that will distinguish between various agencies that coverage through this insurance company. After you have defined the code to be used for identifying the insurance company you can then enter all remaining information. (C)hange - With this option you can modify any information on file for a specific insurance company record on file. The only field you cannot change is the code field you setup to identify this specific insurance company record. Once you have retrieved the desired insurance company record you can move from field to field until you are on the field you need to change. Type in the changes and move to the end. A 'prompt' will appear in the message line on the bottom of your screen: Page 50 INFORMATION CORRECT (Y/N) Y Press <ENTER> if the information is correct. (D)elete - The (D)elete function of (M)aintenance is used to delete any insurance companies you no longer do business with. Entering the (D)elete function will request the code number of the company you want to delete. Type in the code number and you will receive a 'prompt' on the message line on the bottom of your screen: DELETE THIS RECORD (Y/N) N This prompt is provided so that you do not accidentally delete and insurance company master from your files. (+)skip / (-)skip - The (+/-)skip options allow you to step through your insurance company master file one record at a time - (+)skip = to the next insurance company record on file, (-)skip = back to the previous insurance company record on file. You can then select any of the displayed insurance company records for (C)hange or (D)elete actions. (L)ist to printer With this option you can list all of your insurance company master records to the printer. This master listing of your insurance companies will be printed in ID. code sequence. Depending upon the number of insurance companies you have setup this listing could take a few minutes. Page 51 (D)OCTORS The (D)octors section is used for keeping records of the doctors associated with your practice and referring doctors. Those records will be accessed during other functions of the system. Selecting the (D)octors option from the MASTER MENU will give you the DOCTORS - SUB-MENU (screen). (D)isplay The (D)isplay option from the sub-menu will give you a list of the doctors on file. You can select a specific doctor record for further processing by highlighting the desired displayed doctor and pressing the <ENTER> key. Once you have selected a doctor for processing you will be immediately taken into the doctor (M)aintenance function and that doctor's record will be displayed to you in the (I)nquiry mode. You can then select any of the maintenance sub-menu functions for further processing of the displayed information. DOCTOR MAINTENANCE (I)nquire - The (I)nquire option allows you to request the display of a specific doctors record. This is the mode you will be placed in upon selecting a specific doctor from the (D)isplay function. After the requested record has been displayed you are returned to the (M)aintenance sub-menu for selection of the next action to be taken. (A)dd new - The '(A)dd new' function of (M)aintenance will create space for you to type in information for a particular doctor. When you first setup your doctors we suggest that you assign the default doctor the ID. code of '00'. Use of this number will reduce the number of key strokes required by the operator to assign this doctor to a patient, or while posting transactions. The rest of the information is standard. Entering the doctors Medicare ID number will result in that number to print in box 19 of the HCFA-1500 form for referring doctors and in box 24-H for doctor performing service. (C)hange - The (C)hange option allows you to request a specific doctor's record for retrieval and maintenance. Once you have the desired record displayed on the screen you can step down through the displayed fields by pressing the <ENTER> key and change the field in error. Page 52 (D)elete - The (D)elete option allows you to request a specific doctor's record for retrieval and possible deletion. Once you have the desired record displayed you will be presented with a prompt to confirm your deletion request. DELETE THIS DOCTOR (Y/N) N A response of 'Y' will delete the displayed doctor record in your doctor data base. A response of 'N' will terminate your delete request. After you have responded to the prompt the desired action will be taken and you will be returned to the doctor (M)aintenance sub-menu with a message displayed at the bottom of the screen for the results of the action taken. (+)skip / (-)skip - The (+/-) skip options allow you to sequentially advance forward (+), and backward (-), one record at a time in your doctor file. DOCTOR LIST TO PRINTER The (L)ist function will list all doctors in your doctor data base to the printer in sequence by the assigned doctor code. While this option may not seem to be of value in a small practice keep in mind that although this function is provided for maintaining your doctor information you can also us it to maintain information on any other member of your staff. You do not have to limit the information you place into your doctor database to only doctors! This is a convent file for maintaining all address and phone number information for your staff - just do not assign those who have no patient responsibility to a patient. Page 53 (T)ABLES This section of the system contains all your charge codes (CPT codes and codes for adjustments and receipts) for your billing purposes and other financial transactions. It has multi-level capabilities, and with it, you can set up as many as 99 different files, 00-98. Table #99 is reserved for ICD-9 codes and descriptions. Selecting the (T)ables option from the MASTER MENU will give you the CHARGE TABLE - SUB-MENU (screen). (NOTE: Since the other sections of this system rely on the availability and accuracy of information in this section, you MUST set up your tables first.) For the benefit of the first-time computer users, we will take you through this section in detail. More experienced users can take a coffee break. (D)isplay tables Once you've been working with the system for some time, the most efficient use is to take the first option from the sub-menu to (D)isplay tables. It will list tables by name and code number. From there, you can select a table by highlighting it and pressing <ENTER>. After you have selected the table you are requested to identify the sequence in which to display the code by. This sequence is either by code, or by alpha description. Following the sequence selection you are provided the option to identify a starting value for section of the table you wish to display. If you enter no value then your display starts with the first entry in the table. Your table is then displayed to you so that you can select the code entry you wish to do maintenance on. Nest you are taken into the (C)harge code display. (C)harge code display When you first request this function you are asked if you wish to display by (D)escription or (C)ode. If you request (D)escription your table entries will be listed in alphabetical order by the description you gave it. If you requested (C)ode your table entries will be listed in code sequence. Within the (C)harge code display, you can highlight the table record you want to access, press <ENTER>, and that table record will be brought up under the (I)nquiry mode of the (M)aintenance function. Page 54 CHARGE TABLE MAINTENANCE Following the initialization of your system you go directly to the (M)aintenance option of your CHARGE TABLE - SUB-MENU. Enter (M)aintenance by moving the cursor until that option is highlighted and press <ENTER>, or by just pressing the 'M' key. This will give you the CHARGE TABLE - MAINTENANCE (Screen). (I)nquire - The (I)nquire function allows you to request the display of a specific charge code within a specific charge table. If you selected a specific table code from the table display routine it will be passed to the maintenance function and initially displayed in the (I)nquire mode. Once a specific table code has been displayed you are returned to the (M)aintenance sub-menu from which you can select the next desired action to be taken. (A)dd new - You can add new tables and codes by entering the '(A)dd new' function. First identify the table by entering its assigned number. (For setting up your standard, or 'DEFAULT', table we encourage you to use the code of '00. This will save you key strokes in setting up patients and assigning them to this table.) The 'DEFAULT' table will be used most of the time. You can use the UTILITIES to copy any existing table on file for use for setting up other tables. (Note - This table copy routine will only work for tables '00' - '98'. Table '99' is reserved for your ICD-9 codes and must be setup manually.) SETTING UP YOUR CODE TABLES (Note: for tables '00' - '98' you must setup - WITHIN EACH TABLE - codes for 'C = Charges, R = Receipts, and A = Adjustments'. MED#1 uses a common posting screen for entering of charges, receipts, and adjustments and all of these codes can be posted in the same posting cycle.) The system is setup so that you can either enter the standard CPT codes, or define your own. These codes can be any combination of numbers or alphabetic characters. For your charge codes you have two formats within a single code structure. The first five characters are your primary code, the last three characters are for an optional modifier. You can setup standard codes with modifiers that will be retrieved when you enter that eight position code in your transaction posting cycle. If in the transaction posting cycle you enter codes having modifiers not already setup in your tables the MED#1 system will look for a table entry that matches the first five characters entered. In this manner you do not have to setup codes in your tables for all possible modifiers Page 55 you may use. When you are in the transaction posting cycle you have the option to key over the description and rate returned for valid codes. After you have entered the code the system checks for the possible existence of that code already on file for this table. You cannot setup duplicate codes within a given table. If there is no duplicate code on file you are requested to enter the 'description' field. (Note - For setting up codes for receipts and adjustments we suggest that you use codes that are easy to remember such as: PAYCASH = for a cash payment, etc. YOU DO NOT NEED TO SETUP RECEIPT CODES FOR EACH CHARGE CODE. For setting up your charge codes you can use the standard five digit CPT codes followed by up to a two position modifier separated with a hyphen.) The 'Code description' is a free form field. In it you can use whatever designation you want, but for uniformity you may want to use a code description from the standard CPT codes. ICD-9 CODE TABLE Note: Table '99' is reserved for your ICD-9 codes. This table only requires fields for the codes, a code reference modifier, and the code descriptions. By using the code reference modifier you can setup multiple table entries for the same code, each having a different description. You retrieve these codes in your transaction posting cycle by pressing the 'F2' key and selecting the ICD-9 code you wish to use. If you are posting to table '99' you will have a screen displayed that only displays/requests these three fields. CPT CODE TABLE(S) There are three types of codes to set up; charge, adjustment and receipt in each of these tables. This is what the 'Type (C,A,R)...' field is asking for. TYPE 'C' = Charge For charge's enter the actual charge amount in the 'Rate' field. This field is passed over for adjustments and receipts. When you post charge transactions you have the option to override this rate with any value you wish. 'Taxable (Y/N)...:N' has an automatic default for the 'no' response since most services are not taxable. But you can select 'yes' for those few occasions when a charge is taxable. (NOTE: There is a built in flexibility in the system which allows you to override the 'Taxable' designation when you're working in the (P)atients section of the main system. So if you designate non-taxable here, and at a later point it becomes a taxable service, you can change it at the time Page 56 of transaction posting. It will change on individual billing and not alter your main charge table.) The 'G/L Account...:' field is an optional field for use if you have an outside General Ledger account you want this system to interface with. If you do, just type in the GENERAL LEDGER CODE this charge item should be posted against. The system will group them when Journal Reports are posted based on that number. The 'Insurance (Y/N): N' field is for identifying whether transactions posted using this code are insurance related. The system assumes a default of 'Y' for all charge codes, and a default of 'N' for all adjustments and receipts. For all charge codes this must be a 'Y' and also the patient assignment flag must be a 'Y' before the transaction is automatically flagged for insurance posting. For adjustments and receipts only the flag in this record is used to determine if the transaction being posted is insurance related and therefore automatically flagged for insurance posting upon entry. The following table summarizes this relationship: Patient Coded for Transaction assigned insurance flagged for ins. Charge Codes: N N N N Y N Y N N Y Y Y * (* = transaction is automatically flagged for insurance upon posting.) In the 'History (Y/N)...: N' field you have the ability to flag a charge transaction as being something you want to be part of the patient's permanent record. If you answer 'yes', then during transaction posting a mini-screen is called up where you can enter that information for history. This eliminates the need to remember to call up a separate function for entering patient history information. The 'Recall (Y/N)...: N Letter:' field will let you set up a recall letter for follow up visits pertaining to this charge. Answering 'yes', at time of transaction posting, will give you a mini-screen where you can setup the next patient recall for this service. (Note - You must have already setup the recall letter format before you enter a 'Y' for recall request.) Page 57 TYPE 'R' = Receipts and TYPE 'A' = Adjustments The 'G/L Account...:' field is an optional field for use if you have an outside General Ledger account you want this system to interface with. If you do, just type in the GENERAL LEDGER CODE this charge item should be posted against. The system will group them when Journal Reports are posted based on that number. The 'Insurance (Y/N): N' field is for identifying whether transactions posted using this code are insurance related. The system assumes a default of 'Y' for all charge codes, and a default of 'N' for all adjustments and receipts. For all charge codes this must be a 'Y' and also the patient assignment flag must be a 'Y' before the transaction is automatically flagged for insurance posting. For adjustments and receipts only the flag in this record is used to determine if the transaction being posted is insurance related and therefore automatically flagged for insurance posting upon entry. The following table summarizes this relationship: Patient Coded for Transaction assigned insurance flagged for ins. Adjustment & N N N Receipts N Y Y * Y N N Y Y Y * (* = transaction is automatically flagged for insurance upon posting.) (C)hange - The (C)hange option allows you to change information for a specific code within a specific table. (Note - If you need to setup multiple tables that have only minor variances with the standard, 'DEFAULT', table use the function in the UTILITIES section for making a copy of an existing table. After you have made a copy of the standard table you can then use this '(C)hange' function to modify it as needed.) (D)elete - The (D)elete options allows you to delete a specific table code from a specific charge table. (Note - If you wish to delete an entire table use the routine in the UTILITIES section.) (S)how - This option will take you back to the table display screen where you can select another code for maintenance. (+)skip / (-)skip - The (+)skip and (-)skip options allow you to sequentially step forward, and backward, through the codes of a selected table. Page 58 LIST TABLES TO PRINTER The (L)ist tables option can be used for printing out copies of existing tables for review or filing purposes. Upon requesting this option you are asked to identify the sequence that you wish to list your tables code in. This sequence is either by code, or by alpha description. After selecting the sequence you are provided with the opportunity to either list all tables on file, or to select a specific table for listing. If you request to list only a specific table you will then be displayed a list of the tables you have on file from which you can make a selection from. Page 59 (U)TILITIES This section of the system is designed to assist you in modifying and maintaining the overall MED#1 system to meet the unique needs of your individual practice. There are two major grouping of utilities provided in the MED#1 system: (A)pplication support and (S)system support. Application support utilities directly affect your data files and information posted to them. System support utilities cover all other areas. (A)pplications support - UTILITIES Select the (A)pplication support utilities option first, which will give you the UTILITIES - APPLICATION SUPPORT (Screen) with the following options: (U)pdating practice data - allows you to make informational changes when necessary to keep your system personalization current. This is the same screen presented to you during system initialization. (P)urge old invoicing - will clear information no longer needed to give you room for new information. Again, you can enter by highlighting and pressing <ENTER>, or by pressing 'P'. (Note - Only invoicing that has a zero balance as of the requested purge date will be flagged for deletion. In this manner active accounts that have open balances as of the requested date will retain all of their transactions.) (C)reate new charge table from existing - gives you the opportunity to save code table setup time by copying the contents of an existing table an creating a new table. You can then limit your maintenance to only those codes within the new table that need adjusting. Use the same process for entering this function. (D)elete existing charge table - allows you to eliminate an out-dated charge table without going through an involved process of changing information on-screen. (F)inance charge-calculations/posting - is the function that handles the charges for past-due accounts. It gives you the flexibility of varying the charges or applying a standard minimum rate. (Note - Only those accounts that were setup to receive finance charges, and have a positive balance on last statement charges after current payments/adjustments have been applied, will receive a finance charge. Finance charges are a system generated transaction and will show up in the account ledger. Page 60 (T)ransfer patient data to new account - will be the most used of all the utilities. With this function you can transfer all patient transactions, history, recall, and notes to another patient account. An example of the need for this utility is when a child becomes old enough to have responsibility for their own bills. Before you can use this utility you must set up a new patient master record. Then you can call up this utility and by just entering in the old patient account number and the new patient account number all patient information is placed under the new account. You can then delete the old patient master record. (L)edger code transaction update post - This utility allows you to post new ledger codes to all transaction already on file. Normally when you setup a new system you do not assign general ledger codes to the codes you setup in your CPT code tables. Also later you may want to assign new ledger codes so that you can better group your transactions for ledger postings. THIS UTILITY CAN NOT BE INTERRUPTED ONCE STARTED. ALL TRANSACTIONS ON FILE WILL BE PROCESSED AGAINST YOUR CPT CODE TABLES AND THE NEW LEDGER CODES FOUND WILL BE TRANSFERRED INTO THE TRANSACTION RECORD. (S)ystem support - UTILITIES The '(S)ystem support utilities' function is where you fit the system to your computer and maintain it. These utilities are: (R)eindex data files - will 1. physically remove all records flagged as deleted and return the space to your system, 2. rebuild all file pointers. (NOTE: If you restore your data files from a backup, you must run the 're-indexing' function before you use them. Failure to do this will corrupt the restore data files, requiring you to reload them from the same backup and start over.) (P)rint registration form - is the function you use to print the registration form you must send in to register you as a user of MED#1 add remove you from the 100 patient limit. (M)onographics color: N - provides the option of using a color screen or black and white. MED#1 normally automatically tests your computer to see if it supports a color monitor and if it does you will see all displays in color. Some computers have color capabilities but use a Page 61 monochrome monitor. If you are testing MED#1 on a laptop computer you may wish to force the color to monochrome display. Currently most laptops only display in shades of gray and use of the color display option will make reading your screens difficult. (C)hange printer codes - will allow you to enter control codes unique to your printer that handle the ability to switch between normal and compress print. CURRENTLY THIS FEATURE IS NOT USED BY MED#1. SOON YOU WILL BE PROVIDED WITH REPORTS THAT WILL REQUIRE MORE THAN THE STANDARD 80 CHARACTER PRINTER WIDTH. BY SETTING UP CODES FOR COMPRESS AND NORMAL PRINT YOU WILL NOT NEED TO MANUALLY SET YOUR PRINTER FOR THESE REPORTS. Page 62 GLOSSARY BUFFER The space in the computer's memory where text is temporarily stored while the computer is on. CONFIG.SYS A file used to modify the parameters of machine operation. DBF Data base files. DEFAULT Word used to designate 'standard', most common. In MED#1, 'default' is 00 unless specified otherwise. DOS Disk operating system. FIELDS Specific areas for receiving information. FLAG An instruction put in one function that cross references with another function requesting an activity. FREEFORM FIELD A field that doesn't require information every time the function is used. INITIALIZATION Bringing up the system and customizing it to create DBF. INSTALLATION Physically putting the software on disks by copying. MESSAGE LINE Space at the bottom of the screen for 'prompts' and 'help'. PROMPT A question or request that appears on screen which has to be answered before continuing with the function. PURGE Remove outdated information and create space for new information. Page 63 DATA FILES USED The following data files are created, and used, by MED#1. PATIENT - Contained in this file are all of your account/patient master records. Accounts and patient masters have the save data structures and therefore share the same database. This makes it easy to locate both patients and accounts by searching on account no., last name, or first name. While an account can be a patient, any patient master having a patient number greater than '00' cannot be an account. There can be 100 patients per account '00' - '99'. Accounts contain the information parameters that control the billing cycle that affects all patients within the account. COMMENTS - This is an optional file that can be related to individual patient masters. Contained within this file are any notes that you setup that you wish to remain with the patient record. Each of these notes are date related. You are not limited to the number of notes you enter per patient (other than available disk space). HISTORY - Each patient can also have associated with it an unlimited number of history records. These records differ from COMMENTS. You are prompted to setup this information whenever you are posting specific charges to a patient. RECALLS - Patients can have have an unlimited number of recalls scheduled. These recall requests are prompted for setup for specific charges contained within your charge table. Each recall can be for different dates, follow up action, and can reference a unique recall letter. These records stay on file until you post a follow up action charge or specifically delete the given patient recall request. CHGTABLE - Your charge tables are the heart of your system. You can have up to 99 unique charge tables '00' - '98', with table '99' reserved for your ICD-9 diagnostic codes. You must setup at least one charge table before you can setup any patients. Each patient is assigned a default charge table for the posting of all transaction. In this manner you can have various rates for the same treatment depending upon the table assigned to the patient. At time of transaction posting you many override the default table assignment with another table. At the end of day you can recap your daily activity by table. Page 64 DOCTOR - You must setup at least on doctor in this file before you can setup any patients. Each patient is assigned to a specific doctor for care and follow up. You may also use this file to maintain information on members of your staff - just be careful not to assign any staff to the care of a patient. INSCO - This file contains basic information related to the various insurance companies your patients may file claims with. The only true limit to the number of insurance companies you can setup is disk space. To make things manageable we suggest that you structure the identification code for each insurance company from some common name abbreviation and number. The use of a number in the key will allow you to setup several records for the same insurance company even though there are several agencies supplying that coverage. Each patient can have reference to two insurance companies. LETTERS - This set of files (LETTER.DBF and LETTER.DBT) contain all of your RECALL letter formats. The LETTER.DBT file is a special structure file that carries the body of the recall letter. The LETTER.DBF file contains the letter ID. code and description and points to the LETTER.DBT file for the letter body. TRAN - The transaction data base contains all charges, adjustments, and receipts posted to your patient. MED#1 maintains this file in date order for each account and patient. Aged account/patient balances are recalculated each time by reading this file for each account/patient in date sequence. NO BALANCE FORWARD RECORD IS MAINTAINED IN THE MED#1 SYSTEM. TAG_INS - This file is a temporary file created to identify those patients that are to receive an insurance claim form. Once the claim form has been printed the record in this file related to that patient is deleted. In this manner you can print insurance claim forms in batch mode at the end of the day, week, or any time schedule you wish to use. TAG_RCAP - This file is a temporary file created to identify those patients that require a printed patient profile recap. An entry in made in this file for each patient having a posting made to their HISTORY data base. In this manner you can batch print patient profile updates in batch mode at the end of day, week, or any time schedule you wish to use. Page 65 MEDGL - This file is a temporary file created whenever you request a General Ledger Journal listing. Not only is this file used for the printing of your G/L Journal listing, but you can also use it to interface to any external G/L system you may have. (Note - no transaction flagging is done when this file is created. This means that if you request a repeat extraction of a specific G/L Journal you will extract and list transactions shown any earlier request for this journal.) Page 66 SERVICE / SUPPORT MEDshare provides service and support to the user on a "Pay As You Go" type arrangement. Under this method you pay only for the time and services needed to answer your questions. The rate is $60.00 per hour, billed in 15 minute units, with a minimum billing of $15.00. All service and support is provided over the phone, Monday - Friday, 9:00 am to 4:00 pm cst. Phone:(214) 736-3668 (Note: MEDshare does not, and will not, provide any assistance with hardware, and operating system, problems. We recommend that you establish support for these items from within your local area.) MEDshare also encourages local VAR's and DEALERS to promote and service MED#1. Authorized VAR'S and DEALERS provide a more personal level of support and in many cases may be in your area. Their rates for their support are not controlled by MEDshare and in most cases will be less. For the name and phone number of an authorized VAR or DEALER in your area call: Phone:(214) 736-3668 (no charge for this call) MEDshare is always looking for VAR's and DEALERS to support the MED#1 family of products we offer to the medical practitioner. We offer an interesting, if not unique, market participation plan to all VAR's and DEALER's that wish to become authorized support centers for our products. If you know of a VAR or DEALER in your area that would be interested in becoming an authorized support center for our products have them call us at: Phone: (214) 736-3668 Page 67 UPGRADES There are two types of UPGRADES to be considered: 1. Upgrades due to errors detected in prior releases of MEDshare products. FOR ALL CURRENT REGISTERED USERS OF MED#1 this type of upgrade is free. When we are notified of a problem we will make all effort necessary to correct it in the shortest time possible. When the correction is made we will provide all CURRENT registered users with a copy of the corrected program at no cost. (BY CURRENT WE ME REGISTERED USERS OF THE CURRENT VERSION THAT THE ERROR WAS IDENTIFIED IN. IF YOU ARE NOT A USER OF THIS CURRENT VERSION YOU MAY PURCHASE THIS UPGRADE FOR A NOMINAL FEE.) If you encounter an error in your program please do the following: A. Write down the error message - exactly as displayed. B. Call MEDshare immediately at (214) 736-3668 and describe the problem and read to use the error message. C. If possible capture to the printer a copy of the screen that is displaying the error message. This can be done by turning on your printer and pressing (at the same time) the Shift and the 'PrtSc' keys on your printer keyboard. 2. Upgrades due to improvements and new features being incorporated into MEDshare products. MEDshare is constantly in the process of evaluating and improving the MED#1 and related software products provided to our users. While we cannot give any hard dates for releasing new versions of our programs we hope to have about two major releases per year. Some of these releases will be new programs and not upgrades to existing programs. All new programs will be offered to registered users at a special price. If you are not a current registered user your price will be considerably higher. Registered users: We encourage you to install all upgrades when received. Some upgrades may require the creation of new fields within your database. If you fail to install all upgrades these fields will not be available for the next upgrade that we send you. Page 68 Users that have failed to purchase upgrades: If you have failed to purchase upgrades as they become available you may purchase them later at a nominal cost. The cost of each upgrade will be determined by the new features it incorporates and will vary. Please request a price listing of all upgrades. You will need to purchase all upgrades released that have a higher version number than the current version you are using (if you wish to carry your current data up into the new formats). Some upgrades may require the creation of new fields within your database. If you fail to install all upgrades as they are released these fields will not be available for the next upgrade that we send you. TO ALL USERS ______________ NEW REGISTERD USERS RECEIVE A. A newsletter informing you of what's new, etc., B. A special price the purchase of special purpose programs developed to enhance our products features, C. The access to our telephone support. (Sorry but we can only support our registered users.) Page 69 NEW RELEASES New releases are not to be confused with upgrades. Upgrades are improvements in a specific product. New releases are new products and may have a new name or a new version number series. MEDshare is dedicated to providing you, the medical practitioner, with the best program to manage your practice with. We realize that one program cannot address all needs. As we grow MEDshare will be creating new programs for various specialities and methods of practice management. As these programs become available we will be notifying all current users of our products of their availability. Current registered users will be offered the opportunity to purchase these products at a reduced rate. Page 70