Managing Service Details

Service details keep track of services provided by the physician to the patient. The service information also includes the details of payments made by the patients and the insurance companies. The information for each service is organized into four folders for ease of viewing. The first one contains the main service details and patient payment. When a new service is being added, only this folder can be accessed and the others left alone. The second folder contains payment details from the insurance companies and adjustments. This folder will be accessed when payments are received from the insurance companies. The third folder contains the dates the insurance companies were billed. There are at most three dates associated with each submission of claim to the insurance company. The first one shows the very first time the claim was submitted. The last one shows the most recent claim submission. The middle one shows the submission date just before the most recent one. Note that all the entries in this tab are display only. The fourth tab contains miscellaneous items such as specification of ailment if any or a changing of the referring physician or extra narrative to be associated with each service detail. 

To manage the service details, click on "Patient" option. The "Patient and Guarantor Search Page" is displayed.

Screen 1 - Patient and Guarantor Search Page



On the above screen, first select the insurance type from Health / Auto / Workman and Service-Main / Service-Payment from the available options, by clicking the radio button adjacent to the options. Doing so allows one to directly go to the service details screen under the correct tab. 

Also give the search criteria to search the patient from the existing list whose details are to be viewed. The physician can search the patient on:

• Search By Patient Details
• Account Number
• Last Name and First Name
• Phone Number
• Search By Guarantor Details
• Guarantor SSN (Social Security Number)
• Last Name and First Name

Then click on [Service Details] to view / enter the service details. A list of patients will be displayed depending upon the search criteria given. 

Screen 2 - Patient Search Result



In the above screen, click on the link on [Last Name] to view the service details of that patient. See the screen of "Service-Main Details" - Screen 3.

Depending upon the selection of the options, the respective tab will be displayed. By default the one views the "Service-Main" for Health insurance. See the following display (Refer Screen 3).

Service-Main

This option gives the main details of services provided to the patient. It also shows the patient payment in case the patient makes the payment for the portion that he is responsible for. When adding a new service, only the details in this part (i.e. under this tab) needs to be filled in.

Screen 3 - Service-Main



Add New Service Details
In the Screen 3, click on the [Add Row] button to add new service details. See the following screen.

The service details include :-

• Service Date,
• Number of consecutive days the same service is provided. Default is one.
• Physician Group Member ID. This column is displayed only for a Group Practice containing multiple physicians.
• Place Of Service (POS),
• Facility / Hospital ID where the service is provided,
• Order (O). This allows one to order or arrange the services provided on any single service date.
• Diagnosis Code (ICD),
• Procedure Code (CPT),
• Type Of Service (TOS). This is associated with the CPT code.
• Charges. This is associated with the CPT code.
• Date of Patient Payment,
• Amount Paid by the Patient,
• Balance Amount. This is display only.

Click on [Done] button to add the service details. The [Cancel] button will take back to the Patient and Guarantor Search Page.

Service-Payment

This option gives the details of payment to be done by the insurance companies. See the following screen.

Screen 4 - Service-Payment



The screen displays the following details :-

• Service Date, Physician Group Member ID and CPT code are display only and are displayed here to serve as reference.
• Payment received from the Primary and Secondary Insurance Company. For each the first field is the payment date and the second field is the amount.
• Billing Party. This indicates to whom the bill is to be sent. It can be "P" for Primary Insurance Company, "S" for Secondary Insurance Company, "R" for Receipt to be given to the patient or "X" for indicating Do not Bill.
• Responsibility Indicator. This indicates the responsibility of payment. It can be "P" for patient's responsibility, "Blank" indicating the responsibility of the Insurance Company or "C" for (Collection Agency).
• The Balance Amount. This is display only.

Click on [Done] button or the [Cancel] button to go back to the Patient and Guarantor Search Page.

Apply Check
The patient or the primary or the secondary insurance company will pay the amount for various services provided by the physician by cash, check or credit card. The amount received is to be adjusted against the various services provided.

To apply check, click on "Patient" option on the Practice Home Page. The "Patient and Guarantor Search Page" is displayed. 

On the Screen 1, for the option [Apply Check] first select the paying party from the drop-down list box adjacent to the option name. The check can be received from Patient, Primary Insurance Company or Secondary Insurance Company. Then, click on [Apply Check] option. 

A list of patients will be displayed depending upon the search criteria given. See the following screen displaying the list of patients.

Screen 5 - Patient Search Result



Click on the link on [Last Name] to enter the check details for that patient. See the following screen.

Screen 6 - Check Details



In the above screen, enter the following details :-

• Check Amount,
• Check Date,
• Check Number - If check number is not entered, the mode of payment is treated as "Cash".
• Check Distribution Indicator. The amount of the check can be distributed automatically or manually for the services provided.

To manually distribute the check amount, tick the check boxes adjacent to the services and then enter the amount in the "Patient Payment" column. If the amount is to be distributed automatically, tick the check boxes adjacent to such services, click "Auto" distribution indicator and then click [Apply]. The total amount of check will be distributed according to its balance. The remaining amount of the will be displayed in the "Remaining Check Balance" field. The amount won't be applied, unless the remaining check balance is "0". And in turn, the amount will not be displayed in "Service-Payment" screen of "Service Details" option. 

E.g., In the above screen, the "Check Amount" is Rs. 10,000/- If it is to be distributed automatically among the available services, first select the services and then click the "Check Distribution Indicator" - 'Auto'. The it will be distributed according to the balance of the selected services.

If the "Remaining Check Balance" is "0", click on [Submit] button. The amount will thus be displayed in "Service-Payment" screen of "Service Details" option. The [Cancel] button will take back to the Patient and Guarantor Search Page.

Service-Bill Dates

This option displays the billing dates of primary and secondary insurance companies. There are at most three dates associated with each submission of claim to the insurance company. The first one shows the very first time the claim was submitted. The last one shows the most recent claim submission. The middle one shows the submission date just before the most recent one. Note that all the entries in this tab are display only. See the screen below.

Screen 7 - Service-Bill Dates



The billing details displayed are :-

• Service Date, Physician Group Member ID and CPT code are display only and are displayed here to serve as reference.
• First Billing Date for Primary / Secondary Insurance Company,
• Previous Billing Date Primary / Secondary Insurance Company,
• Current Date Primary / Secondary Insurance Company,
• Balance Amount. This is display only.

Click on [Done] button or the [Cancel] button to go back to the Patient Info Page.

Service-Miscellaneous Details

Invoke this tab for changing the Referring Physician or associating an ailment with the service detail. See the screen below.

Screen 8 - Service-Miscellaneous



The miscellaneous details that can be viewed or entered are :-

• Service Date,
• Physician who gave the service,
• Procedure Code,
• Referring Physician,
• Ailment details - The ailment details give the information of illness of the patient. Click the '? icon' adjacent to the "Ailment Details" field. It will take you to the screen (Screen 9 - Ailment Details) given below which allows you to view the details of the existing ailments, or add new ailment details for a patient. If the illness details does not exists, add the details and then those will be available to select for the next patient.
• Balance Amount.

Screen 9 - Add Ailment Details



In the above screen, enter all the details related to the illness of the patient and then click the [Add] button. [Cancel] will take one back to the Service Details Page.

Partial Payments

Sometimes the patient or on rare occasions the primary and secondary insurance companies may make the payment in installments. This is known as Partial Payment. Each partial payment is separately entered and tracked. On the completion of partial payment entry/entries, the focus shifts to the tab in the service details screen. What is shown here in the amount column is the sum of all the partial payments. The date column shows the date on which the last partial payment was made.

If the patient does the payment in installments, the partial payment amount can be entered through the "Service-Main" option. Expand the column of "Patient Payment" of Service-Main screen by clicking on the - or + image. The following Patient Partial Payment screen is displayed.

Screen 10 - Patient Partial Payment



By clicking on the [Add Row] button repeatedly, enter as many entries as there are partial payments.

The physician may receive payment in installments from insurance company also. This partial payment can be entered through the "Service-Payment" option. Expand the column of "Primary Insurance Payment" of Service-Payment screen by clicking on the - or + image. The following Partial Primary Insurance Payment screen is displayed.

Screen 11 - Partial Primary Insurance Payment

By clicking on the [Add Row], enter the partial payment.

Follow similar procedures to create partial payment entries for the secondary insurance if necessary.

The physician may want to adjust the due amount from the patient or insurance company in some cases. Sometimes, the patient or the insurance company may pay the partial amount of the actual bill amount. The amount left is ignored and is not paid. The physicians in such case, write off the partial amount (if the amount is small) and make the balance zero for that patient. This adjustment amount can be entered through the "Service-Payment" tab. Expand the column of "Adjustment" of Service-Payment screen by clicking on the - or + image. The following Partial Adjustment screen is displayed.

Screen 12 - Partial Adjustment



By clicking on the [Add Row], enter the partial adjustment details, such as, the Date of Adjustment, Amount Adjusted, Adjustment Type and the Comments specifying the reason for adjustment. One can add any number of adjustment amounts for the particular patient.