The Business Master (3rd Edition)

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(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>. (C)harge code display: 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. 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. 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). (Note: When you setup your tables remember that table numbers '00' - '98' are reserved for chargeable codes, Page 79 receipts, and adjustments. Each table within this range must have a full complement of code types: C=charges, A=adjustments, and R=receipts. With this full complement of code types you are able to post charges, adjustments, and receipts to a patient without changing tables. Table '99' is reserved for your ICD-9 (diagnostic) codes and is made available to all patients.) (I)nquire - The (I)nquire function allows you to request the display of a specific charge code within a specific 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'. When you setup codes for adjustments and receipts use codes that are easy for the operator to remember such as: ADJ, ADJ_INS, CASH, CHECK, CHARGE, INS_PAY, etc.. 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 Page 80 five characters entered. In this manner you do not have to setup codes in your tables for all possible modifiers 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: CASH = 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 description. By using the code reference modifier you can setup multiple table entries for the same code, each having a different description. (Note: Leave the reference modifier field blank for all primary ICD-9 codes. Only use the reference modifier for alternate descriptors.) 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 Page 81 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 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 Page 82 you enter a 'Y' for recall request.) 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. Page 83 (+)skip / (-)skip - The (+)skip and (-)skip options allow you to sequentially step forward, and backward, through the codes of a selected table. 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 84 (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. (Note: if you are using MED#1 on a network only one user can be signed on to use MED#1. This restriction has been put in place due to the overall affect these utilities have on your MED#1 system.) Selecting the (U)tilities option from the MASTER MENU will give you the UTILITIES - SUB-MENU (screen). There are two major grouping of utilities provided in the MED#1 system: (A)pplication support: Application support utilities directly affect your data files and information posted to them. (S)system support: System support utilities cover all other areas. Page 85 (U)TILITIES - APPLICATION SUPPORT Select the (A)pplication support utilities option first, which will give you the UTILITIES - APPLICATION SUPPORT (Screen) with the following options: UTILITIES - APPLICATION SUPPORT UPDATE PRACTICE INFORMATION (U)pdating practice information: This utility is key to your system. Practice Name: The name you enter for your practice name, along with your postal zip code, is what your REGISTRATION number is calculated on. Any change to this information - in spelling, punctuation, case, and spacing - will result in the voiding of your current registration number. Practice address, City, and State: This address information is printed on all insurance forms and used for your return address on statements. As long as your practice name and postal zip code do not change you can change your address any time without affecting your registration number. Practice postal zip code: This is used in conjunction with your practice name to formulate your unique registration number. If you change your postal zip code after registration your registration number will become invalid. Practice Phone Number: This is printed on the standard HCFA-1500 insurance form along with your practice name. S.S. No. and Tax Code: This information is printed on your HCFA-1500 insurance form. You only need to setup one of these numbers. If you are not incorporated you need to setup your Social Security number. If you are incorporated then set up your Federal Tax ID. number. Sales Tax %: This is the sales tax percent that is applied to all taxable charges you post in your system. Claim type Ins. PID No., and Ins. Forms Used: Claim type Ins. PID No.: You have the ability to setup a different unique Practice Identification Number for each of the nine different types of claims you can process. This ID. number will be printed along with your practice name. Page 86 Ins. Forms Used: With this release of MED#1 you now have the ability to identify the specific insurance form to be printed for each claim type for both assigned and non- assigned patients. To see a listing of the current insurance forms available to select from press the 'F2' key when you are in these fields. Only these claim forms are currently supported. (Note: If you have a special form that is not included in this listing send us a copy of it and we will make every effort to place it into our MED#1 program.) There are three types of Electronic Claim form codes setup within MED#1. Only the first one will be valid for the MED#1 Electronic Claims System. The other two codes are reserved for use by other developers for extracting transactions to be filed electronically to State or specific Insurance agencies. Print Aging/Statements by (A)ccount or (P)atient: Enter an 'A' if you wish to print your Accounts Receivable by Account, enter a 'P' if you wish to do it by Patient. (Note: Patient is the preferred method due to insurance tracking. Under this method each patient will be listed individually on your aging reports and also receive a statement. Statements will still be addressed to the account master but will only be for the patient referenced.) Age receivables by (I)nvoice or (D)ate: Enter an 'I' if you wish to maintain your aged receivables by invoice number. Enter a 'D' if you wish to maintain your aged receivables by transaction date. ('I' IS YOUR CURRENT DEFAULT MODE OF AGING YOUR RECEIVABLES.) You can change between aging modes any time. When you change your transaction index files will be rebuilt for the new sequence. If you are doing any insurance processing you should always use the (I)novice mode of processing. This will require greater operation attention when posting receipts and adjustments, but it is the only way you can properly track invoicing covered by insurance. Last invoice number: This is the last invoice number assigned to charges posted to your system. In your transaction posting cycle the next highest number is calculated and presented to the operator for use. The operator has the ability to delete, use, or replace this number with what they wish to use. MED#1 will save the last highest number used. If you accidentally post an invoice using a number higher than you wish you can reset the next number to be used by modifying the number presented in this field. Last Account NO.: This is the last assigned account number you have currently setup in your system. This may not be the highest account number you have assigned to date. MED#1 now provides you with the ability to re-use old account numbers that have been taken out of service. Page 87 In order to utilize the re-use feature you must first be sure that you have physically removed all deleted records from your data files (see UTILITIES - SYSTEM SUPPORT - PURGE DELETED RECORDS). MED#1 will search your patient master file in account sequence, starting with the last account number assigned, until it locates a missing account number or the end of your patient file. The account number last accessed will be incremented by '1' and be made available to the new account. (Some times the operator will accidentally setup an account using a number outside of the range you are working in. If this happens just reset this Last Account Number value to the number you wish to start with. You do not need to renumber the account setup in error unless you really want to.) REGISTRATION NUMBER: This number is provided to you upon MEDshare receiving your paid registration. This number is formulated from your practice name and postal zip code and is only valid that specific name and zip code. MEDshare reserves the right to change this number for new versions of MED#1 program being released. Page 88 UTILITIES - APPLICATION SUPPORT DELETE OLD INVOICING The primary use of this function is to tag as deleted transactions no longer needed for your accounts receivables and patient ledgers. AUDIT TRAIL CONSIDERATIONS: Because the deletion of transactions removes all reference to these transactions from all reports and (most) displays a security feature has been installed. Before anyone can use this function they must enter a secret PASSWORD. This password is only provided to registered users and should only be know to the person('s) responsible for system maintenance. After you have entered your valid PASSWORD you are requested to enter a date. All transactions that have a zero balance prior to this date will be tagged as deleted in your transaction data base. The space these records occupied will NOT be returned to you for new transactions until you physically remove them (see UTILITIES- SYSTEM SUPPORT - PURGE DELETED RECORDS). (Keep in mind that these are only your accounts receivable transactions and not patient history or notes.) Before any transactions are deleted a backup copy of your current transaction file is created. This backup copy is a full copy of your transaction file and should be transferred to a removable storage media and placed in a safe place. By saving this backup file you will have the ability to restore and search old patient ledgers if the need arises. The delete cycle is performed in two steps: 1) A backup of your current transaction file is made that should be placed on a removable media and stored in a safe place. 2) All transactions prior to and including the period date entered are reviewed and those charges, receipts, and adjustments that net to zero are tagged as deleted. If you are maintaining your aged accounts receivables in date order then all transactions in date sequence by patient are reviewed and deleted when a zero balance is noted within the requested date range. If you are maintaining your aged receivables by invoice number then all transactions of a unique invoice number within the given date range per patient that have a zero balance are deleted. In both cases all active transactions having a transaction date greater than the period date entered are ignored for processing. YOU SHOULD ONLY DELETE OLD INVOICING ON A CONTROLLED CYCLE FOLLOWING A GENERAL LEDGER JOURNAL LISTING FOR THE SAME PERIOD. Page 89 CREATE NEW CHARGE TABLE (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. DELETE EXISTING CHARGE TABLE (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. FINANCE CHARGES (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 a given cut off date, after all 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. This is a two step process. STEP #1 = Calculate finance charges.: In this step you 1) identify the parameters for the qualification of those accounts subject to a finance charge, 2) identify the days of interest to charge for, 3) set a minimum finance charge amount, 4) establish the monthly interest rate to use for calculating the finance charge, and 5) set the number of days of interest to calculate finance charges for. The monthly interest rate that you enter is annualized and then broken down to a daily rate multiplied by the number of days to charge interest for. After you enter this information the MED#1 system locates each patient (or account) that qualify for receiving a finance charge and calculates the respective charge. This is captured in a transaction format record in a temporary file. At the same time this record is generated a printed report of all patients/accounts receiving a finance charge, and the charge amount, is created for your review. (Note: If upon your review you do not wish to accept the charges calculated you can rerun this calculation cycle until it meets your approval. NO RECORDS ARE POSTED INTO YOUR TRANSACTION DATABASE UNTIL YOU DECIDE TO ACCEPT THE CALCULATED FINANCE CHARGES.) Page 90 STEP #2 = Post Calculated Finance Charges: After you have accepted the calculated finance charges you must post those charges to your transaction database. Not until you do this posting will any of these charges show up in the patient/account balance, ledgers, aging, or statements. Upon completion of posting these finance charges the temporary file containing them will be deleted. TRANSFER PATIENT DATA (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 for the patient you are working on. 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. (NOTE: Be careful when you delete the old patient master. If the patient is also the account master for the old account ALL RECORDS AND ALL OTHER PATIENT MASTERS WITHIN THIS ACCOUNT WILL BE DELETED. Be sure that the patient you are deleting is not the ACCOUNT MASTER or there are no other patients within this old account.) LEDGER CODE UPDATE POSTING (L)edger code transaction update post - This utility allows you to post new ledger codes to all transactions already on file. Normally when you setup a new system you do not know the general ledger codes to be assigned 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 function will re-post ALL General Ledger codes to all transactions currently on file. 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. Page 91 (U)TILITIES - SYSTEM SUPPORT The '(S)ystem support utilities' function is where you fit the system to your computer and to your unique needs. You also have a few features that are more general in support as to those under Application Support. RE-INDEX DATA FILES Each of your database files have associated file index('s) that allow you to access information in these files in various sequences. Records are added to your database files in the sequence that you enter them into your system - new records are always added to the end of the file. Index files give logical placement of this information within the MED#1 system. Without these file indexes it would be impossible to locate information once it is entered into your system. These index files are constantly being modified due to new information being entered into your system. Because of this constant modification they are the files most sensitive to system faults which can affect your ability to locate information. THIS RE-INDEX UTILITY PROVIDES YOU WITH THE ABILITY TO REBUILD YOUR DATABASE FILE INDEXES SO THAT INFORMATION CAN BE LOCATED WITHIN YOUR FILES. (NOTE: Any time you perform a function such as a purge or file re-index you should always be sure that you have a good backup of your files first. Any system fault while these utilities are running may result in loss of your data files.) NO RECORDS ARE PHYSICALLY REMOVED FROM YOUR DATA FILES BY THIS FUNCTION. ONLY NEW FILE INDEXES ARE BUILT. TO REGAIN SPACE OCCUPIED BY DELETED RECORDS YOU MUST RUN THE UTILITY TO 'PURGE DELETED RECORDS'. USER REGISTRATION FORM (U)ser 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. (NOTE: BEFORE YOU SEND IN THIS FORM BE SURE THAT YOUR PRACTICE NAME AND POSTAL ZIP CODES ARE CORRECT AND HOW YOU WISH TO SEE THEM ON ALL INSURANCE FORMS. YOUR REGISTRATION NUMBER IS FORMULATED FROM THIS INFORMATION. IF YOU CHANGE YOUR PRACTICE NAME OR POSTAL ZIP CODE YOUR REGISTRATION NUMBER WILL BE INVALID.) Page 92 (P)URGE DELETED RECORDS The primary use of this function is to physically remove all records tagged as deleted from your data files and return that space to your system. A secondary feature of this function is to place records in your data files into the physical sequence that will decrease the system access time for patient information. AUDIT TRAIL CONSIDERATIONS: Because the deleted records are physically removed from your data files all audit tail tracking features are lost. To prevent this feature from being used for other reasons a 'PASSWORD' is required before access is granted. Before anyone can use this function they must enter a secret PASSWORD. This password is only provided to registered users and should only be know to the person('s) responsible for system maintenance. After you have entered in the valid 'PASSWORD' each data file will be copied to a new file removing all deleted records from the new file. This copying is done in a controlled sequence that will place all records in the most logical sequence bringing all patient records into a continuous sequence group. Upon successful generation of the new file the old file is deleted and the new file is renamed to replace the old file. Utilizing the concept no data can be lost if a system fault occurs during the purge process. After the files have been successfully copied new indexes are generated. ADJUST DATE FORMAT The growing popularity of MED#1 has spread to as distant places as Australia and other countries. With this use outside of the U.S.A. there has developed a need for various date formats. This utility allows you to select the date format you wish to use. To select the desired date format just highlight the nationality that uses a format that you also use and press the <ENTER> key. You will note that the date in the top left corner of your screen is now in that format. All dates entered, displayed, and printed will now be in the selected format. NO CHANGES ARE MADE TO YOUR DATA FILES AND YOU CAN CHANGE DATE FORMATS AT ANY TIME. (NOTE: CANADIAN USERS - MED#1 NOW WILL SUPPORT YOUR NEEDS. WHEN YOU SELECT A DATE FORMAT OTHER THAN THE U.S.A. FORMAT YOU WILL ACTIVATE A MODIFICATION IN THE PATIENT MAINTENANCE FUNCTION. ON SCREEN #1 OF PATIENT MAINTENANCE YOU WILL SEE - UNDER BIRTH DATE - A PLACE TO ENTER YOU 'HEALTH CLAIM IDENTIFICATION NUMBER'. THIS NUMBER WILL BE PRINTED ON THE INSURANCE FORM FOR 'CANADA' INSURANCE FILING.) Page 93 MONOGRAPHICS / COLOR (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 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. SET DEFAULT VALUES Default values are available for you to customize selected features of the MED#1 system for your specific use. TYPE OF SERVICE codes Utilization of this feature allows you to modify the 'TYPE OF SERVICE' code to be printed on insurance forms for each type of claim you will be filing. When you utilize this feature keep in mind that the 'TYPE OF SERVICE' code you use in your transaction posting is not necessarily the code to be printed. The codes you enter are the single position standard codes that are printed on the back of the 1984 HCFA-1500 insurance form. For each of these codes you can setup a different code to be printed on each of the nine different types of insurance claims you can file. This print code can be up to three characters. To change the default 'TYPE OF SERVICE' codes to printed just: 1) highlight the 'TYPE OF SERVICE' code to be modified, 2) press the <enter> key to activate the maintenance feature for printer default settings, 3) enter the value you wish to print for each of the nine different insurance claims you can print. After you have set these 'TYPE OF SERVICE' codes you will be able to continue to post the standard code and still have the new default value printed on the respective insurance claims. Page 94 PLACE OF SERVICE codes Utilization of this feature allows you to modify the 'PLACE OF SERVICE' code to be printed on insurance forms for each type of claim you will be filing. When you utilize this feature keep in mind that the 'PLACE OF SERVICE' code you use in your transaction posting is not necessarily the code to be printed. The codes you enter are the single position standard codes that are printed on the back of the 1984 HCFA-1500 insurance form. For each of these codes you can setup a different code to be printed on each of the nine different types of insurance claims you can file. This print code can be up to three characters. To change the default 'PLACE OF SERVICE' codes to printed just: 1) highlight the 'PLACE OF SERVICE' code to be modified, 2) press the <enter> key to activate the maintenance feature for printer default settings, 3) enter the value you wish to print for each of the nine different insurance claims you can print. After you have set these 'PLACE OF SERVICE' codes you will be able to continue to post the standard code and still have the new default value printed on the respective insurance claims. OTHER DEFAULT VALUES The original design of MED#1 addressed the needs of the general medical practice. With our growing base of satisfied users we have been required to adapt our MED#1 software to the needs of users in various specialities outside of our original scope of system design. To provide the user with a limited ability to customize MED#1 to their specific needs this function to set selected default values has been developed. 1) HCFA-1500 forms supplier: While the HCFA-1500 form is a standard form it is standard in content only and not in precise format. Each manufacturer of this form provides a form with a variation in field size and alignment. Currently we support two forms suppliers: COLWELL and SAFEGUARD. Forms from other suppliers will most likely not properly line up for MED#1 print spacing and field size. To select the correct supplier of your forms just highlight the correct supplier and press the <ENTER> key. Page 95 2) Transaction posting: A: Type of service code - enter the default code used by your practice. These codes are found on the back of the HCFA-1500 insurance form. B: Place of service code - enter the default code used by your practice. These codes are found on the back of the HCFA-1500 insurance form. 3) Supper Bill Message: The bottom inch and half of the MED#1 super bill (invoice) printed can contain any message you may wish to have printed. You can also leave it blank. The message provided by MED#1 is a payment acceptance message to assign payment directly to the doctor. To change this message just type in the message you wish to have printed. Page 96 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 97 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. PATCASE - In addition to the general information on each patient this record provides the ability to capture information specific to the reason for this patient to receive treatment. Currently only one of these records can be setup per patient. Future enhancements will provide for up to ten of these records per patient. 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. Page 98 At the end of day you can recap your daily activity by table. 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. MEDGL - This file is a temporary file created whenever you request a General Ledger Journal listing. Page 99 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 100 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) 985-0759 (Note: MEDshare, Inc. does not, and will not, provide any assistance with hardware, networking, and operating system, problems. We recommend that you establish support for these items from within your local area.) MEDshare, Inc. 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) 985-0759 (no charge for this call) MEDshare, Inc. 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) 985-0759 Page 101 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) 985-0759 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 102 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 files or new fields within your database. If you fail to install all upgrades as they are released these files and 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 103 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 all of the time. As changes are made in the insurance industry, and as new computers and operating systems be come available, improvements will be made to MED#1 to take advantage of these changes. Also, 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 104