Physicians Billing 6.0

Claims Creation: Setup new insurance claims.

Claims Editing: Modify claims before submission or resubmission. Since claims are stored in a data base you may at any time modify a claim and/or resubmit it without having to re-enter any of the claims information.

Claims Printing: All claims will print on the AMA and Medicare approved HCFA claims submission form. For ease of mailing, claims print in insurance carrier groups with corresponding address labels for the insurance carriers printed.

Electronic Claims: Send electronic claims with no per claims fees.

Claim Format: Decrease the time required to fill out the standard AMA and Medicare approved HCFA claims submission form using a claim format template to specify required and non required fields for each insurance carrier to which you submit claims.

Claims/Secondary/Tertiary: Claims to both secondary and tertiary insurance carriers are automatically submitted and tracked by your billing system.

Claim Tracking: On demand view or print the status of all or selected groups of insurance claims within your system. Find out what has or has not been billed, those that have been billed and not paid. This capability alone will significantly improve your collections and cash flow.

Aging: Patient accounts are aged by individual service using periods of current, 30, 60, 90, 120 and 180 days. For more accurate tracking, periods are determined by the date of the report, thus allowing the report to be printed at any time during the month.

Services: Enter services, payments, write-offs and adjustments all from the same entry screen, saving time and providing better control of your billing procedures. These transactions are all entered into a journal where they may be reviewed and modified before being posted to the patient accounts.

Payments: Record your payments against individual services, including the date, amount and any write-off all in one process. You can differentiate insurance payments from private payments to better improve cash flow and track collections. Speed up your entry process by using the built in automatic payment calculation facility,

Write-Offs: Your write-offs are tracked separately from other correcting transactions, affording a complete analysis of your office collection capability.

Adjustments: You are afforded complete flexibility to maintain good fiscal control of you patient accounts with an adjustment capability necessary to accommodate instances such as refunds and corrections.

CPT Codes: Exercise complete control over the coding of your services, through you own, modifiable CPT data base. Record standard fees, allowables, unique codes and fee schedules per insurance carrier.

ICDA Codes: Setup and modify a data base of the diagnosis codes you use in your practice, and with the system wide lookup facility, find any of them via description or code.

Doctors: Both clinic and referral doctor information can be kept in your own modifiable data base, saving hours of entry time as well as eliminating costly clerical mistakes.

Insurance Carriers: Save valuable time by creating and maintaining a data base of all the insurance carriers to which you submit claims.

History: Free up your time and peace of mind knowing that you maintain and can review a complete accounting history of each and every patient account. The history is provided in chronological order and includes a detail of every service, payment, write-off and adjustment recorded.

Itemization: Each service provided to a patient is itemized and recorded along with each payment, write-off and adjustment applied to that specific service. See the date the item was billed to insurance, the date and amount received from insurance and the amount owing by the patient.

Notes: Important information concerning agreements with the patient may be kept in a free form note context. The notes are available for review by you and your staff while being kept confidential to your office.

Productivity: Of paramount concern in any office is the issue of productivity. With this report you are able to see how you are being reimbursed for each procedure you are providing. The report is categorized to provide insight into compensation from each insurance carrier as well as from individuals. The date selectivity option allows you to review any required time frame for which you have maintained records.

Patients: Patient demographic and insurance coverage information need be entered only once into you patient data base. Thereafter it will automatically be called up and used on any claims submitted.

Recalls: Providing ongoing care for your patients is easily accomplished by the facility of setting up multiple recall appointments for any and all patients. With the capability of producing name, address, appointment date & time reports, the quality of care you are capable of providing is enhanced.

Referrals: Good business practice as well as social courtesy are both accomplished via the referral reporting capability. Know which and how many patients are being referred to you each month and from which doctors those referrals are coming.

Appointments: A task which has never been easy is now through the appointment scheduling facility, finally manageable. Find open appointments, search for previously scheduled appoints by patient name, print a day sheet for each doctor, setup unique office schedules for every doctor in the clinic.

Statements: The printing of private statements with a clear detail of each service, when it was billed to insurance, when insurance paid, how much insurance paid, how much you are writing off and how much is due from the patient, provide your office with the help it needs to communicate with the patient and improve your collections. Statements may be printed in batch or individually with the capability of immediate printing while the patient is in the office.

Superbills: Although Superbills are no longer acceptable as a form of billing to most insurance carriers, within the clinic they still perform a much needed function, tracking and recording the services provided to the patient. Superbills may be printed on an as required basis or from the appointment schedule.

System Features: Incorporated into the operation of the Physicians Billing system are features that will make your work easier and allow you the maximum use of your computer system.

Single Level Menu: All menu items in the Physicians Billing system are visible and selectable from a single screen using the unique drop down action box.

Reporting: Reports have been created using Crystal Reports by SAP and are optionally modifiable by the end user.