MEDICAL TERMINOLOGY

BILLING OUTLINE

PRIMARY TREATING PHYSICIAN (PTP)

MEDICAL LEGAL

Step 1. Once the patient data has been registered, we do the following.

• Click on “ADD P/I Ins”.
• In the new window that appears, click on the magnifying glass.
• In this new window you can search through: Name of the lawyer (FIRM), street or ZIP code.
• A new window will appear, which we click on the corresponding cell.
• Enter the “ACC Date” (Accident date).

Step 2. After searching for the attorney information, we do the following.

• If the patient has insurance, we click on the “Payer” dropdown.
• We finish the registration by clicking on “Update” and finally on “Save/Update” and finally on “Save/Update demographic data”.

MEDICAL TERMINOLOGY

BILLING OUTLINE

PRIMARY TREATING PHYSICIAN (PTP)

MEDICAL LEGAL

Step 1. Once the patient data has been registered, we do the following.

• Click on “ADD P/I Ins”.
• In the new window that appears, click on the magnifying glass.
• In this new window you can search through: Name of the lawyer (FIRM), street or ZIP code.
• A new window will appear, which we click on the corresponding cell.
• Enter the “ACC Date” (Accident date).

Step 2. After searching for the attorney information, we do the following.

• If the patient has insurance, we click on the “Payer” dropdown.
• We finish the registration by clicking on “Update” and finally on “Save/Update” and finally on “Save/Update demographic data”.

STEP 1. Validate that the patient isn’t registered in Remedy.

• Enter the new patient’s name in the box next to “Find”, then press enter on your keyboard.

STEP 2. On the navigation bar, click “main”, then select “New patient”.

STEP 3. We enter the patient data.

• We start the registration by selecting the corresponding clinic.
• We enter the name, surname, date of birth and SNN.
• We indicate the gender of the patient.
• Correctly and completely type the address, ZIP code and city and if you have a telephone and/or mobile number.
• Finally we click on the corresponding insurance (ADD WC INS, ADD COM INS or ADD P/I Ins)

Step 1. Once the patient data has been registered, we do the following.

• Click on “ADD WC INS”.
• In the new window that appears, click on the magnifying glass.
• In this new window you can search through: Company, street or ZIP code.
• A new window will appear, which we click on the corresponding cell.

Step 2. Once we get the company data, we do the following.

• We correctly write the claim number, EAMS#, accident date and the ADJ name if it is available.

Step 3. We register the data of the lawyers

• Click on the magnifying glass.
• In this new window, the search for applicant and defense lawyer is carried out through: Street or ZIP code.

Step 4. We search and register the data of the employer.

• Click on the magnifying glass
• In this new window, the search is carried out by means of its name.
• We click on the corresponding cell, in the new window that appears.

Step 4.1. We register the data of the employer.

• Click on the magnifying glass.
• In this new window, the search is done by name. If it isn´t registered in the data base, we click on “Add New”.
• We enter the name and address, ZIP code, city, state and mobile number.
• We click on “Save”.
• We finish the registration by clicking on “Save/Update demographics”.

Additional Entities

Step 1. Once the data of the patient and the work accident insurance have been registered, we carry out the following.

• If we have information on additional entities, we click on the magnifying glass.
• Then click on the “Type of party to serve” dropdown list.

Step 1.1 By having a second insurance company, it will be registered in “Payer”.

• In this new window you can search through: Payer name, Street or ZIP code.
• A new window will appear, which we click on the corresponding cell.
• In this new window it will tell us that: This is a read-only record. To change, the record of the payer or attorney must be updated through the administration. You can edit the Description, which is saved with the patient.
• We click on “Save”.
• We finish the registration by clicking on “Save/Update Demographics”.

Step 1.2 If it is necessary to add the doctor that refers the patient, we will do it in “Referring Provider”.

• In this new window you can search through: Name, Street or ZIP code.
• A new window will appear, which we click on the check ✓ of the corresponding cell.
• We click on “Save”.
• We finish the registration by clicking on “Save/Update Demographics”.

Step 1.3 If you have an additional Defense Attorney, we choose “Attorney”.

• In this new window you can search through: Name, Street or ZIP code.
• A new window will appear, which we click on the check ✓ of the corresponding cell.
• In this new window it will tell us that: This is a read-only record. To change, the record of the payer or attorney must be updated through the administration. You can edit the Description, which is saved with the patient.
• We click on “Save”.
• We finish the registration by clicking on “Save/Update Demographics”.

Step 1.4 For another type of entity we choose “Other”, example: Workers Compensation Appeals Board.

• In this window we go to the option name, address of the company.
• We click on “Save”.
• We finish the registration by clicking on “Save/Update Demographics”.

Step 1. Once the patient data has been registered, we do the following.

• Click on “ADD COM INS”.
• In the new window that appears, click on the magnifying glass.
• We click on the drop-down list and select the corresponding insurance.
• If you have additional insurance, we click on “MCR 2ND”.
• To select the relationship between the patient and the owner of the insurance we click on “Rel code” and fill in the fields indicated with ().
• We finish the registration by clicking on “Update” and finally on “Save/Update demographics”.

Step 1. Once the patient data has been registered, we do the following.

• Click on “ADD P/I Ins”.
• In the new window that appears, click on the magnifying glass.
• In this new window you can search through: Name of the lawyer (FIRM), street or ZIP code.
• A new window will appear, which we click on the corresponding cell.
• Enter the “ACC Date” (Accident date).

Step 2. After searching for the attorney information, we do the following.

• If the patient has insurance, we click on the “Payer” dropdown.
• We finish the registration by clicking on “Update” and finally on “Save/Update” and finally on “Save/Update demographic data”.

Step 1. On the navigation bar, click “Main”, then select “Batch Billing”.

• We click on the drop-down list, select the location and then click on “continue”.

Step 2. We do the following.

In “Number of Encounters”, we indicate the patients attended.

Click on the “Batch Type” dropdown list, select “Complete Billing Batch”.

We indicate the date that the service was performed in “Date of service”.

We click on the drop-down list of “Rendering Provider”, we select the corresponding provider.

In “Supervising Provider”, select it if necessary.

We click on the “Service Location” drop-down list, select the corresponding location.

We finish the registration by clicking on “Continue”.

Step 1. On the navigation bar, click “Main”, then select “Batch Billing”.

• We click on the drop-down list, select the location and then click on ‘continue’.
• We select the Pertaining Batch, clicking on the row according to the date of service (DOS), Provider (Rendering Provider) and corresponding location (Location).

Step 2. We do the following.

• The “Batch has been set/selected” message indicates that the batch was selected correctly.
• In the box next to “Find”, you can search for the patient using their name, surname or PID. Then press Enter on your keyboard.
• In the next window, we validate the patient data (name, surname, DBO, Claim number and DOI).
• Finally we click on “Billing”.

Step 2.1 Summary of the form.

Step 3. We validate and register data.

We corroborate the data of the patient, date of the encounter and the provider.

We click on the “Episode” dropdown list, and select the insurance company.

In “Referring Provider”, we enter the NPI of the doctor, if it exists in the case.

In “Prior Authorization” and “Box 19”, we will enter the authorization information (AME, QME, PQME SERVICE)

Step 4. Diagnostic record and proc.

We are going to click on the “ICD10-CM” option.

In the boxes numbered from 1 to 8, enter the code of the diagnosis made. On the side it will indicate the part of the body to which the code refers.

In the ‘Proc’ boxes, we enter the code of the service provided.

In the ‘BR’ box, we click to type the description if necessary.

In the “Modifiers” boxes, type the modifiers: “RT” Right, “LT” Left and “59” when the code of the service provided is the same.

In “DX Pointers”, indicate the diagnosis according to the service provided.

Step 5. Typification.

• We click on the drop-down list next to “Clear” and select the corresponding typification.
• If it is necessary to put the claim on Hold, the corresponding typification is chosen in the drop-down list. If we do not find the indicated one, we select “Other” and in the side box, we write the reason.
• Finally we click on the “Subtmi” button.

Step 1. On the navigation bar, click “Main”, then select “Batch Billing”.

• We click on the drop-down list, select the location and then click on “continue”.
• Click on the pencil of the row according to the date, provider and location, which you are going to edit.
• In this new window you can update the number of Encounters.
• To update the “Rendering Prov”, “Supervising Provs” and “Service Location”, you must click on the corresponding dropdown.

Step 1. Once the patient data has been registered, we do the following.

• Click on “ADD P/I Ins”.
• In the new window that appears, click on the magnifying glass.
• In this new window you can search through: Name of the lawyer (FIRM), street or ZIP code.
• A new window will appear, which we click on the corresponding cell.
• Enter the “ACC Date” (Accident date).

Step 2. After searching for the attorney information, we do the following.

• If the patient has insurance, we click on the “Payer” dropdown.
• We finish the registration by clicking on “Update” and finally on “Save/Update” and finally on “Save/Update demographic data”.

Step 1. On the navigation bar, click “Main”, then select “Batch Billing”.

• We click on the drop-down list, select the location and then click on “continue”.

Step 2. We do the following.

In “Number of Encounters”, we indicate the patients attended.

Click on the “Batch Type” dropdown list, select “Complete Billing Batch”.

We indicate the date that the service was performed in “Date of service”.

We click on the drop-down list of “Rendering Provider”, we select the corresponding provider.

In “Supervising Provider”, select it if necessary.

We click on the “Service Location” drop-down list, select the corresponding location.

We finish the registration by clicking on “Continue”.

Step 1. Once the patient data has been registered, we do the following.

• Click on “ADD WC INS”.
• In the new window that appears, click on the magnifying glass.
• In this new window you can search through: Company, street or ZIP code.
• A new window will appear, which we click on the corresponding cell.

Step 2. Once we get the company data, we do the following.

• We correctly write the claim number, EAMS#, accident date and the ADJ name if it is available.

Step 3. We register the data of the lawyers

• Click on the magnifying glass.
• In this new window, the search for applicant and defense lawyer is carried out through: Street or ZIP code.

Step 4. We search and register the data of the employer.

• Click on the magnifying glass
• In this new window, the search is carried out by means of its name.
• We click on the corresponding cell, in the new window that appears.

Step 4.1. We register the data of the employer.

• Click on the magnifying glass.
• In this new window, the search is done by name. If it isn´t registered in the data base, we click on “Add New”.
• We enter the name and address, ZIP code, city, state and mobile number.
• We click on “Save”.
• We finish the registration by clicking on “Save/Update demographics”.

Additional Entities

Step 1. Once the data of the patient and the work accident insurance have been registered, we carry out the following.

• If we have information on additional entities, we click on the magnifying glass.
• Then click on the “Type of party to serve” dropdown list.

Step 1.1 By having a second insurance company, it will be registered in “Payer”.

• In this new window you can search through: Payer name, Street or ZIP code.
• A new window will appear, which we click on the corresponding cell.
• In this new window it will tell us that: This is a read-only record. To change, the record of the payer or attorney must be updated through the administration. You can edit the Description, which is saved with the patient.
• We click on “Save”.
• We finish the registration by clicking on “Save/Update Demographics”.

Step 1.2 If it is necessary to add the doctor that refers the patient, we will do it in “Referring Provider”.

• In this new window you can search through: Name, Street or ZIP code.
• A new window will appear, which we click on the check ✓ of the corresponding cell.
• We click on “Save”.
• We finish the registration by clicking on “Save/Update Demographics”.

Step 1.3 If you have an additional Defense Attorney, we choose “Attorney”.

• In this new window you can search through: Name, Street or ZIP code.
• A new window will appear, which we click on the check ✓ of the corresponding cell.
• In this new window it will tell us that: This is a read-only record. To change, the record of the payer or attorney must be updated through the administration. You can edit the Description, which is saved with the patient.
• We click on “Save”.
• We finish the registration by clicking on “Save/Update Demographics”.

Step 1.4 For another type of entity we choose “Other”, example: Workers Compensation Appeals Board.

• In this window we go to the option name, address of the company.
• We click on “Save”.
• We finish the registration by clicking on “Save/Update Demographics”.

Step 1. Once the patient data has been registered, we do the following.

• Click on “ADD COM INS”.
• In the new window that appears, click on the magnifying glass.
• We click on the drop-down list and select the corresponding insurance.
• If you have additional insurance, we click on “MCR 2ND”.
• To select the relationship between the patient and the owner of the insurance we click on “Rel code” and fill in the fields indicated with ().
• We finish the registration by clicking on “Update” and finally on “Save/Update demographics”.

Step 1. On the navigation bar, click “Main”, then select “Batch Billing”.

• We click on the drop-down list, select the location and then click on “continue”.

Step 2. We do the following.

In “Number of Encounters”, we indicate the patients attended.

Click on the “Batch Type” dropdown list, select “Complete Billing Batch”.

We indicate the date that the service was performed in “Date of service”.

We click on the drop-down list of “Rendering Provider”, we select the corresponding provider.

In “Supervising Provider”, select it if necessary.

We click on the “Service Location” drop-down list, select the corresponding location.

We finish the registration by clicking on “Continue”.

Step 1. Once the patient data has been registered, we do the following.

• Click on “ADD WC INS”.
• In the new window that appears, click on the magnifying glass.
• In this new window you can search through: Company, street or ZIP code.
• A new window will appear, which we click on the corresponding cell.

Step 2. Once we get the company data, we do the following.

• We correctly write the claim number, EAMS#, accident date and the ADJ name if it is available.

Step 3. We register the data of the lawyers

• Click on the magnifying glass.
• In this new window, the search for applicant and defense lawyer is carried out through: Street or ZIP code.

Step 4. We search and register the data of the employer.

• Click on the magnifying glass
• In this new window, the search is carried out by means of its name.
• We click on the corresponding cell, in the new window that appears.

Step 4.1. We register the data of the employer.

• Click on the magnifying glass.
• In this new window, the search is done by name. If it isn´t registered in the data base, we click on “Add New”.
• We enter the name and address, ZIP code, city, state and mobile number.
• We click on “Save”.
• We finish the registration by clicking on “Save/Update demographics”.

Additional Entities

Step 1. Once the data of the patient and the work accident insurance have been registered, we carry out the following.

• If we have information on additional entities, we click on the magnifying glass.
• Then click on the “Type of party to serve” dropdown list.

Step 1.1 By having a second insurance company, it will be registered in “Payer”.

• In this new window you can search through: Payer name, Street or ZIP code.
• A new window will appear, which we click on the corresponding cell.
• In this new window it will tell us that: This is a read-only record. To change, the record of the payer or attorney must be updated through the administration. You can edit the Description, which is saved with the patient.
• We click on “Save”.
• We finish the registration by clicking on “Save/Update Demographics”.

Step 1.2 If it is necessary to add the doctor that refers the patient, we will do it in “Referring Provider”.

• In this new window you can search through: Name, Street or ZIP code.
• A new window will appear, which we click on the check ✓ of the corresponding cell.
• We click on “Save”.
• We finish the registration by clicking on “Save/Update Demographics”.

Step 1.3 If you have an additional Defense Attorney, we choose “Attorney”.

• In this new window you can search through: Name, Street or ZIP code.
• A new window will appear, which we click on the check ✓ of the corresponding cell.
• In this new window it will tell us that: This is a read-only record. To change, the record of the payer or attorney must be updated through the administration. You can edit the Description, which is saved with the patient.
• We click on “Save”.
• We finish the registration by clicking on “Save/Update Demographics”.

Step 1.4 For another type of entity we choose “Other”, example: Workers Compensation Appeals Board.

• In this window we go to the option name, address of the company.
• We click on “Save”.
• We finish the registration by clicking on “Save/Update Demographics”.

Step 1. Once the patient data has been registered, we do the following.

• Click on “ADD COM INS”.
• In the new window that appears, click on the magnifying glass.
• We click on the drop-down list and select the corresponding insurance.
• If you have additional insurance, we click on “MCR 2ND”.
• To select the relationship between the patient and the owner of the insurance we click on “Rel code” and fill in the fields indicated with ().
• We finish the registration by clicking on “Update” and finally on “Save/Update demographics”.

Step 1. Once the patient data has been registered, we do the following.

• Click on “ADD P/I Ins”.
• In the new window that appears, click on the magnifying glass.
• In this new window you can search through: Name of the lawyer (FIRM), street or ZIP code.
• A new window will appear, which we click on the corresponding cell.
• Enter the “ACC Date” (Accident date).

Step 2. After searching for the attorney information, we do the following.

• Si el paciente tiene seguro, haga clic en el menú desplegable “Pagador”.
• Terminamos el registro haciendo clic en “Actualizar” y finalmente en “Guardar/Actualizar” y finalmente en “Guardar/Actualizar datos demográficos”.