TES Charge Entry with Patient Name

Transcription

1 TES Charge Entry with Patient Name Overview Introduction After a visit is created, you can enter a charge using the patient s name. It is often easier to enter charges using an appointment number or a visit number. However, situations may arise when the appointment number or visit number are not available. If only the patient name is available at the time of charge entry, use the patient s name to access the appropriate patient visit for charge entry. A list of appointments and/or visits will appear for you to select. This selection will result in the invoice having all the appropriate visit information needed for billing. Objectives Upon completion of this module, you should: Understand the process used to enter charges in TES using the Patient Name Prerequisites Prior to beginning this lesson, you should have: Met the prerequisites specified for current module Faculty Practice Plan Education Services 1

2 Charge Entry using Patient Name Steps for entering a charge for a visit: 1. Using IDX Web, click located on the Vertical Toolbar (VTB). 2. Click located on the Horizontal Toolbar (HTB). The TES Encounter/Transaction Entry Batch Form Screen displays. Example: TES Encounter/Transaction Entry Batch Form Screen Faculty Practice Plan Education Services 2

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4 3. Create a new batch to enter charges using the steps outlined in the previous section: TES Charge Entry/ Batch Entry Example: TES Encounter/Transaction Entry Batch Form Screen 4. Click to file. The TES Encounter/Transaction Entry Screen displays. Example: TES Encounter/Transaction Entry Screen Faculty Practice Plan Education Services 4

5 5. At the Patient prompt, access the patient by typing nnn,nnn (partial name look-up). Press Example: Partial Name Look-up The Patient Selection Screen will display: Example: Patient Selection Screen Faculty Practice Plan Education Services 5

6 6. Highlight the correct name and click 7. Click to scroll the patient demographic information. The following message displays: 8. Click to bypass the prompt. Faculty Practice Plan Education Services 6

7 9. The system displays a list of current appointments. Highlight the appropriate appointment and click. Example: Appointment List Note: If this encounter should be linked to an AVM Visit, click and the AVM Visit List will display. Highlight and click. Faculty Practice Plan Education Services 7

8 Example: Visit List Faculty Practice Plan Education Services 8

9 10. Press to accept the default of G to generate an encounter. 11. The appointment number displays. Press Note: If the incorrect appointment number is selected, click different appointment number. to select a 12. The Ambulatory Visit Management (AVM) Number displays. Press Faculty Practice Plan Education Services 9

10 Note: If incorrect, click to select a different visit number. 13. Created: prompt is an informational field that defaults the original creation date of the encounter. Note: This informational data displays once the encounter has been filed. 14. User: prompt is an informational field that defaults the username of the individual whom created the encounter. Note: This informational data displays once the encounter has been filed. 15. Stat: prompt is an informational field that defaults the status of the encounter. Note: This informational data displays once the encounter has been filed. Faculty Practice Plan Education Services 10

11 Open Status Extracted Adjusted Deleted Hold Edits Force Extracted Definition Encounter contains edit conditions. Encounter extracted to the Billing and Accounts Receivable (BAR) system. Encounter changed from the time it was originally created. Encounter deleted from TES. Encounter placed on Hold by user in TES. Transaction with edit conditions. Encounter manually placed in Force status will be extracted to BAR regardless of the edit condition. Note: This status is security restricted Clean Current Encounter will be extracted to the BAR system during night jobs. Encounter that remains in TES and have not been: Purged Deleted Extracted into BAR 16. Press to bypass the Alternate Encounter: prompt Currently Not Used. Faculty Practice Plan Education Services 11

12 17. Enter the Provider who rendered the services at the Provider: prompt field. Press Enter the Provider using any one of the following formats: o THAS Provider Mnemonic o 3108 Provider Numeric o THA Provider partial name look-up 18. Enter the Division associated with the service at the Division: prompt. Press Enter the Division using any one of the following formats: o CLN Division Mnemonic o 3103 Division Numeric o OY/C Division partial name look-up Faculty Practice Plan Education Services 12

13 19. Enter the Location where the services were rendered at the Location: prompt. Press Enter the Location using any one of the following formats: o TRN Location Mnemonic o 001 Location Numeric o TRA Location partial name look-up 20. Enter the Service Date at the Ser Date: prompt. Press to continue. Enter the any one of the following formats: 09/12/ Faculty Practice Plan Education Services 13

14 21. Enter the Referring Physician who referred the patient at the Ref Phy: prompt. Press Enter the Referring Physician using any one of the following formats: o THAS Referring Physician Mnemonic o 3108 Referring Physician Numeric o THA Referring Physician partial name look-up 22. Enter the Referral/Authorization Number at the Ref/Auth#: prompt. Press Note: This field will allows you to input characters or numeric values. Faculty Practice Plan Education Services 14

15 23. Enter the Injury Date at the Inj Date: prompt. Press to continue. Note: When the user enters an injury date, the system prompts the user to select the type of injury. This field pulls from an IDX Dictionary. The options are as follows: Automobile injury Worker s Compensation Other Post Operation care Upon completion of the Injury Type, the system prompts the user to enter the Accident State. 24. Enter the Patient Type at the Pat Type: prompt. Press to continue. Patient Type prompt is currently utilized by select departments to gather statistical information for tracking or identifying a group of patients Note: Contact your supervisor for use of this field in your department. Faculty Practice Plan Education Services 15

16 25. Enter the Discount Type at the Disc Type: prompt and press. Enter the Discount Type from Discount Type Dictionary #104 or click to display a list. 26. Enter the Discount Type and % at the Disc Type: prompt and the %: prompt. Press TES will default the % from the Discount Dictionary #104. The Discount % can be modified by entering a number between If a Resident, Fellow or Certified Resident Nurse Anesthetists (CRNA) assisted with the service, enter at the Res/Fel/CRNA: prompt. Press Faculty Practice Plan Education Services 16

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18 28. Enter the Type of Anesthesia at the TOA: prompt. Press to continue. Example: G General R Regional M Monitored Anesthesia Note: Used by the Department of Anesthesia 29. The Financial Service Classification (FSC) prompt will automatically default based on the primary plan attached to the AVM visit. In some scenarios, the user may need to manually modify this field. Note: It is Critical that the information listed in this field also be housed in the AVM visit attached. Claims cannot go out the door if the FSC is not listed in the AVM visit screen. Please check your internal department specific procedures. Faculty Practice Plan Education Services 18

19 30. Enter the ICD9 Diagnosis Number at the Diag 1: prompt. Press Note: A maximum of 10 diagnosis codes may be entered Only four diagnosis codes will print on the HCFA 1500 Claim Form An edit is generated if more than four diagnosis codes entered Third party payors limit four diagnosis codes per claim submitted Post the four most related/severe diagnosis codes in positions 1, 2, 3, 4 If additional diagnosis codes need to be posted, create a separate encounter Example: Procedure codes: ,2,3,4 Diagnosis: 1) ,3,4,5 2) ,3 3) ,2 4) ) You can only have four diagnoses on an encounter - create a separate encounter for additional diagnosis codes Faculty Practice Plan Education Services 19

20 31. Charity %: prompt is an informational field that defaults the percentage for the charity discount entered in registration. 32. Enter Hospital MRN # if applicable in the Other #: prompt. Press 33. Enter Y at the Doc OK: prompt if the documentation was reviewed and approved for Medicare Compliance. Press Note: TES will default the date and user name when the Doc OK field is answered. Faculty Practice Plan Education Services 20

21 34. Enter Y, N or E at the Res Inv: prompt to denote a Resident was or was not active during the service. Press Y N E GC modifier NR modifier GE modifier 35. Enter the CPT procedure code at the Proc: prompt. Press to continue. Note: o o o A maximum of 12 CPT codes may be entered on a charge Only six (6) of the 12 CPT codes will print on the HCFA 1500 claim form The six (6) CPT codes that do not print on the HCFA 1500 claim form will print on a separate HCFA 1500 claim form and reference the same invoice number Faculty Practice Plan Education Services 21

22 36. Press to move the cursor back to the O: prompt. The O: prompt allows you to enter an A append or C changes the description on the CPT code. Press 37. Service date listed in the Encounter Header portion of the screen will default. The user can update this field by manually overriding the date at the Ser Dt prompt. Press continue. to 38. Enter the Thru Date for daily service procedure codes at the Thru Dt prompt. Note: A thru date is needed for D Daily type codes. 39. Enter the number of units billed for the procedure at the Un prompt. Press Faculty Practice Plan Education Services 22

23 40. Enter modifiers at the MOD prompt. Press Note: The system will default the GC and/or NR modifier based on how you answer the Res Inv prompt. 41. The unit amt defaults from the fee schedule. Press to continue. Note: The fee amount may be manually overridden. To override the amount, enter the new amount and press. 42. The Financial Status Classification (FSC) prompt represents the insurance being billed from the plan(s) assigned in the AVM visit attached to the Encounter. Note: This field can manually be overridden at this prompt. However, it is crucial that the insurance information also live in the AVM visit. Faculty Practice Plan Education Services 23

24 43. Press at the Dx prompt and the system will automatically link the diagnosis to the procedure code for the selected line. Note: This field can be manually overridden. 44. The Total Amt is used by the system to display the calculated amount based on the unit amount. 45. Click to file and save data. Faculty Practice Plan Education Services 24

25 46. Note the system will automatically notify the user of any TES edits associated with the newly created encounter. Faculty Practice Plan Education Services 25

26 Practice Using practice patient #2 and the fee tickets for that patient provided by your trainer, enter charges through TES using the following criteria: At this field Enter the following Patient ZTEST Appointment List Select 1 appointment from the list Provider Thawley MD,Stanley Bill Area OY-ADULT OTOLARYNGOLOGY Location WEST COUNTY OFFICE Diag Ref Phy MOELLER MD,F DELBERT Ref/Auth# NOTREQ Doc OK Y Res Inv? N Proc Click to file and save your work! Faculty Practice Plan Education Services 26

27 Lesson Summary In this lesson, you learned: Procedures and services performed during encounters with a provider are recorded on charge tickets. Charges must be entered in the system as transactions. Charges are entered in batches on the TES Encounter/Transaction Entry screen. A batch can contain multiple encounters, and within each encounter, there can be multiple transactions (charges). When you generate an encounter, if the patient has an appointment already created in the system, you can link the encounter to an existing appointment. The appointment data defaults into the TES Encounter/Transaction Entry Screen. During transaction entry, when you enter a (CPT) charge code at the procedure, service date, provider, a FSC defaults from the encounterlevel data. Action codes allow you to quickly return to a field on the designated screen to make necessary changes. The system has two sets of action codes: 1. Encounter Header 2. Transaction Level Faculty Practice Plan Education Services 27