b/ar charge entry - university of miamicet.med.miami.edu/documents/bar charge entry 4.0.pdf · b/ar...

University of Miami Clinical Enterprise Technologies

B/AR Charge Entry

Charge Capture

1 © UMCET Training

About this Manual This IDX Training Manual is written to give you a step-by-step guide for your classroom training and a handy reference for your daily work. The list of features in this manual helps you use it more effectively.

Objectives and Summaries - The manual contains class lesson objectives which provide you with the overall goals you will achieve by the end of the course. The manual contains a summary for your review at the end of each lesson.

Practice Sessions - Most modules end with a practice session to help you practice the skills you learned in the lesson. Your instructor will be available to assist you if you need it during the exercises.

Keys - References to keys are presented in bold brackets, for example, <Enter>. Key combinations are referred to in the following format <F7><P>, this would mean to press the F7 key, then press the P key.

Special terms - Important terms or ideas introduced for the first time are presented in bold italic. Thereafter, the word or phrase appears as normal text.

Special Symbols - The manual provides symbols that have special meanings. Look at the samples below for an explanation of each symbol:

This symbol points out a note of additional information for the user.

This symbol calls your attention to a very important point, note, or warning.

This indicates a system short cut for a procedure or indicates options or terms supplied to the users as a reference aid.

The computer icon indicates it is time for an on-line exercise.

This is the symbol that data is being pulled from or checking data in a dictionary or table.

The hourglass icon denotes the end of a section or lesson.

This symbol indicates to write this information down for reference later in the class.

B/AR Charge Entry

UMCET Training 2

Use this Page for Notes

B/AR Charge Entry

UMCET Training 3

Table of Contents Module 1 - Introduction..................................................................................................................7

Course Objectives.................................................................................................................................... 7

Introduction to TES ................................................................................................................................ 8

Terminology............................................................................................................................................. 9

TES Dictionaries.................................................................................................................................... 10

Tables...................................................................................................................................................... 11

TES Flowchart....................................................................................................................................... 12

Flow of TES-Step by Step Process ....................................................................................................... 13

TES Editing............................................................................................................................................ 13

Signing into the TES Module ............................................................................................................... 14

Module Summary.................................................................................................................................. 17

Practice Exercise.................................................................................................................................... 18

Module 2 - Create A TES Batch (F1000/A1).......................................................................21 Batch Overview ..................................................................................................................................... 21

Batch Control Form .............................................................................................................................. 22 Batch Identification Fields...................................................................................................................................24 Batch Default Fields ............................................................................................................................................25 Batch Control Totals............................................................................................................................................27 Batch Control Form Action Codes ......................................................................................................................28

Filing the Batch Control Form............................................................................................................. 29

Module Summary.................................................................................................................................. 30


Module 3 - Encounter/Transaction Entry (F1000/A1) ..............................................................33 TES Screens Overview.......................................................................................................................... 33

Moving around TES Screens................................................................................................................ 34

Levels within TES Data Screens .......................................................................................................... 35

TES Combination Screen ..................................................................................................................... 36 Encounter Information Fields ..............................................................................................................................37 Header Fields.......................................................................................................................................................39 Transaction Detail Fields.....................................................................................................................................42 TES Data Screen Action Codes...........................................................................................................................44

Encounter Filing and Edit Checking ................................................................................................... 52 Viewing Edit Condition Descriptions..................................................................................................................53 Correcting TES Edits...........................................................................................................................................54

Module Summary.................................................................................................................................. 55

B/AR Charge Entry

UMCET Training 4


Module 4 - Editing TES Encounters and Transactions (F1000/A2)..........................................57 Edit Options ........................................................................................................................................... 58

Patient/Encounter Selection Screen..................................................................................................... 59 Patient/Encounter Selector Screen Action Codes................................................................................................60

Transaction Selection Screen ............................................................................................................... 63 Transaction Detail Screen....................................................................................................................................64 Transaction Selector Screen Action Codes..........................................................................................................65

Editing from Workfiles ......................................................................................................................... 67

Editing From Batches ........................................................................................................................... 68 Batch Selector Action Codes ...............................................................................................................................69

Module Summary.................................................................................................................................. 70


Module 5 - Encounter and Transaction Inquiry (F1000/A3) .....................................................73 Inquiry Options ..................................................................................................................................... 74

Viewing Patient Encounters ................................................................................................................. 75 Patient/Encounter Selector Screen Action Codes................................................................................................76

Transaction Inquiry Selection Screen ................................................................................................. 78 Transaction Selector Screen Action Codes..........................................................................................................79

Viewing Workfiles ................................................................................................................................. 80

Viewing Batches..................................................................................................................................... 82 Batch Selector Action Codes ...............................................................................................................................83

Module Summary.................................................................................................................................. 85


Module 6 - Printing a Batch Proof...............................................................................................87 Module Summary.................................................................................................................................. 90

Module 7 - Invoice Inquiry...........................................................................................................91 Overview ................................................................................................................................................ 91

Accessing Invoice Inquiry..................................................................................................................... 92

Parts of the Invoice Inquiry Screen ..................................................................................................... 94

Moving Around the Invoice Inquiry Screen ....................................................................................... 95

Invoice Inquiry Action Codes............................................................................................................... 96 B-Zero Bal/Non-Zero Bal....................................................................................................................................97 D-View Detail .....................................................................................................................................................98 E-Expand/Contract ............................................................................................................................................100 F-Guided Filter ..................................................................................................................................................101 I-More Inquiries.................................................................................................................................................103 M-Multigroup Display.......................................................................................................................................105 O-Oldest/Newest ...............................................................................................................................................107 Q-? Filter ...........................................................................................................................................................108

B/AR Charge Entry

UMCET Training 5

R-Reset Display.................................................................................................................................................109 T-More Actions .................................................................................................................................................110

Module Summary................................................................................................................................ 112

Module 8 - BAR Charge Correction ..........................................................................................113 Overview .............................................................................................................................................. 113

Charge Correction Process ................................................................................................................................113

Using Charge Correction.................................................................................................................... 114

Module Summary................................................................................................................................ 115

Practice Exercise.................................................................................................................................. 116

Module 9 - Posting Patient Payments ........................................................................................117 Overview .............................................................................................................................................. 117

Payment Codes .................................................................................................................................... 118

Step by Step Process............................................................................................................................ 119 Step 1-Enter Function 25-Front Desk................................................................................................................120 Step 2-Complete the Batch Control Form .........................................................................................................122 Step 3-Enter the Patient and Header Information..............................................................................................123 Step 4-Enter the payment information...............................................................................................................124 Step 5-Exit and balance the batch......................................................................................................................126 Step 6-Sign into TES, Function 1000, Activity 1..............................................................................................131 Step 7-Enter the patient and encounter header information ..............................................................................134 Step 8-Link the Invoice .....................................................................................................................................135

Module Summary................................................................................................................................ 137

Module 10 - Appendix.................................................................................................................139 Function Keys ...................................................................................................................................... 140

Patient Lookups................................................................................................................................... 142

Entering Dates ..................................................................................................................................... 143

Entering Time...................................................................................................................................... 143

List of TES System Edits .................................................................................................................... 144

List of IDX Divisions-Dictionary #102............................................................................................... 152

List of Facilities/Hospitals-Dictionary #101 ...................................................................................... 153

List of Place of Service Codes/Locations-Dictionary #100 .............................................................. 157

Invoice Lookup Commands................................................................................................................ 158 Case Level Commands ......................................................................................................................................159 Account Level Commands ................................................................................................................................160 Invoice Header Level Commands .....................................................................................................................161 Transaction Level Commands ...........................................................................................................................163 Selection Criteria Commands ............................................................................................................................164

B/AR Charge Entry

UMCET Training 7

Module 1 - Introduction

Course Objectives After completing this course, you will be able to:

• create a batch through TES

• add encounters and transactions through TES

• edit encounters and transactions

• inquire into encounters

• print a batch proof

• inquire into BAR invoices

• perform BAR charge correction

• post time of service payments

Separate Courses

B/AR Charge Entry

UMCET Training 8

Introduction to TES The Transaction Editing System, or TES, is a front-end transaction suspense system designed to capture, evaluate, correct, and extract charge and claim transactions into the IDX Billing and Accounts Receivable program.

TES helps streamline work flow and prevent incomplete or incorrect information on insurance claim forms by:

• allowing information to be entered as it is available,

• testing for missing or incorrect information,

• filtering transactions into workfiles for efficient editing, and

• allowing transactions to be edited for completeness and retested before they are entered into BAR.

TES can run edit evaluations to check data entered into the system at two points:

• TES checks each encounter when you attempt to file the encounter, and

• TES checks encounters during a nightly edit evaluation using Activity 5, Operations. Most organizations run edit evaluations on a nightly basis.

If TES reports that edits are required when you attempt to file an encounter, you have two options:

• if you have the information you need, you can edit the encounter and file it again, or

• you can file the encounter without making the edit. You can correct the error yourself later or let the encounter be assigned to a workfile for later editing.

The individual who originally enters data is not always the one most knowledgeable about all of the information needed to complete claims. TES therefore allows transactions with errors to be assigned to workfiles, which can in turn be assigned to individuals with specific knowledge about the information needed to edit and complete the transaction.

B/AR Charge Entry

UMCET Training 9

Terminology Below is a list of terms commonly used in the Transaction Editing System:

Term: Description:

TES Acronym for the IDX Transaction Editing System. TES is a charge suspense file that checks data entered up front before they ever enter BAR.

BAR Acronym for the IDX Billing and Accounts Receivable system. Once TES transactions and encounters are clean and have no edits, they are extracted into the BAR application and filed into the receivables.

TES Edit System edits are built in the system in order to check data entry. Edits can be specific to a department or specific to a FSC, such as Medicare.

Batch Encounters can be batched into a logical grouping for balancing and editing purposes.

Workfile TES Edits can be worked through TES workfiles. A workfile is a logical grouping of TES edits.

Encounter An encounter is usually related to a patient voucher or visit. In BAR, it is called an invoice.

Transaction A voucher or encounter can contain many transactions or services. A transaction is a CPT code entered on the encounter.

Header The encounter header contains visit level information related to all transactions.

Action Codes One character codes that allow you to enter more information.

B/AR Charge Entry

UMCET Training 10

TES Dictionaries IDX uses dictionaries in its applications to expedite data entry and ensure standardized data for reporting purposes.

Dictionary entries can be accessed by using the name, number or mnemonic of the entry. If you do not know any of these, you can also type a <?> to do a lookup to the entire dictionary.

The following is a list of dictionaries that are used in Charge Capture:

Dictionary: Description:

Group The IDX BAR application can segregate receivables into several groups. Most of UMMG receivables will be in BAR Group 3.

Division An IDX Division is equivalent to a clinical department. All divisions are stored in dictionary #102.

Billing Area An IDX Billing Area is a specialty within a department. This is known in PBS as a division. All Billing Areas are stored in dictionary #202.

Location (POS) Location or Place of Service codes are a HCFA requirement. These include inpatient, outpatient, doctor’s office, etc. All locations are stored in dictionary #100.

Facility The facility is the site where the patient was seen for services, such as JMH or Jackson Towers. All facilities are stored in dictionary #101.

Provider The provider or physician who rendered the services. Must be a billing provider. All UMMG providers/physicians are stored in dictionary #3.

Department Parameter The department parameter field further defines where services took place within a facility for reporting purposes. This field looks up to the Department Parameter dictionary, #704.

Dictionary: Description:

B/AR Charge Entry

UMCET Training 11

FSC FSC is a mnemonic for Financial Status Classification. It determines who gets billed for services rendered, for example, Medicare, Medicaid or Self Pay. FSCs are stored in dictionary #19.

Referring Physician Indicates who referred the patient to the rendering physician. All UMMG and non-UMMG physicians are stored in the Referring Physician dictionary, #123.

Diagnosis Code Contains all ICD-9 diagnosis codes. All diagnosis codes are stored in dictionary #36.

Procedure Code Contains all CPT-4 codes, as well as department pseudo codes. All procedure codes are stored in dictionary #1.

Modifier Contains all modifiers required in Charge Capture. Modifiers are stored in dictionary #5.

Discount Contains discount types, courtesy discounts for true self pay balances. Discount types are stored in dictionary #104.

Tables IDX also uses tables in their applications to store data that uses logic. The table that is used during charge capture is the pricing module. The pricing module stores all the fees associated with procedure codes. It also stores profile fees used during payment posting. Based on the number of units for each procedure code, the system will calculate the total charge amount for the transaction and the encounter.

B/AR Charge Entry

UMCET Training 12

TES Flowchart

Enter Data(Activity 1)

Collect Data fromInterfaces*

Batch Header

Encounter:Registration Level, Encounter Level, Transaction Level

TES checks encounters for Correctness Run Edit Evaluation(Activity 5)

Optional Third-PartyCheckers (nightlyevaluations only)

Medicode

Edit Conditions Set up Edit Conditions(Activity 4)

Is the encounter correct and complete?Extract to BAR orMCA (Activity 5)

Edit Encounter(Activity 2) Fix Now?

Assign Encounter to Workfile (Activity 4)

*TES assigns datacollected frominterfaces directly tencounters. Users dnot see suchtransactions unlessthey need editing.

Yes

NONO

NO

Yes

B/AR Charge Entry

UMCET Training 13

Flow of TES-Step by Step Process Now let’s look at a step by step process for entering charges via the TES Function.

Entering data in TES involves the following steps:

1. Creating or selecting a batch

2. Setting or editing batch defaults (optional)

3. Creating or selecting an encounter

4. Entering encounter and transaction data

5. Filing the encounter

6. Editing missing or incorrect information, if necessary

7. Filing the encounter again (not necessary if no information is missing or incorrect)

TES Editing When you file an encounter, TES automatically checks the data you entered against a set of user-defined edit conditions that have previously been entered into the system. You can fix any problems that TES uncovers at this point, or you can file the encounter anyway. This allows you to continue entering data without having to stop to research incorrect or missing information.

The ability to “save” edits is the core of TES’s efficiency. Your supervisor can provide procedures for how best to resolve problems in encounters. Some TES edits may even be sent to a separate workfile to be worked on later by a specialist.

For a complete list of the TES edits UMMG will be using, please refer to the Appendix.

B/AR Charge Entry

UMCET Training 14

Signing into the TES Module To access TES activities, select Function 1000 from the main BAR menu:

Press <Enter> to branch to the TES Activities menu.

B/AR Charge Entry

UMCET Training 15

When you enter a <?> at the Select Activity prompt, TES displays the following list of activities.

Your TES Activity menu may have different options than those shown above, depending upon your security access.

B/AR Charge Entry

UMCET Training 16

The following 3 TES activities will be used for data entry purposes:

TES Activity: Description:

Activity 1-Encounter/ Trans Entry The Encounter/Transaction Entry activity allows you to:

• create a new batch

• enter new encounters in open batches

• add transactions to existing encounters, and

• edit existing encounters and transactions

Activity 2-Encounter/Trans Editing The Encounter/Transaction Edit activity allows you to edit existing transactions and encounters.

Activity 3-Encounter/Trans Inquiry The Encounter/Transaction Inquiry activity allows you to view (but not change) information entered in encounters and transactions.

B/AR Charge Entry

UMCET Training 17

Module Summary The Transaction Editing System, or TES, is a suspense system for charges.

TES is accessed through Function 1000 in the Billing and Accounts Receivable application.

TES provides up-front edit checking on patient encounters to ensure that a bill goes out cleaner and reduces rejections.

The TES Activity menu allows you to add TES encounters, edit TES encounters, and make inquiries into TES encounters.

B/AR Charge Entry

UMCET Training 18

Practice Exercise 1. What is the primary purpose of the TES module?

2. Describe what a suspense file is.

3. What happens to a TES encounter once it has no further edits?

4. List the 3 activities from the TES Activity menu and describe when each of them would be used.

5. Sign onto the system using the sign on card provided by the instructor. Sign into the BAR application, and access Function 1000. Type a <?> and press <Enter> at the Activity: prompt to view all the TES activities. Practice signing out of the system using the proper procedure.

6. Describe the different steps required to enter an encounter through the TES module.

B/AR Charge Entry

UMCET Training 19

7. Matching Exercise. Please match the PBS term on the left with the new IDX term on the right.

PBS Term: IDX Term:

Department Billing Area

Division FSC

Payor Code Division

Encounter Location

Place of Service Invoice

B/AR Charge Entry

UMCET Training 21

Module 2 - Create A TES Batch (F1000/A1)

Batch Overview In this module, you will learn how to create a batch in the Transaction Editing System. A batch is a way to enter similar encounters into the system. The procedure for how charges are batched is specific to each department. Please contact your supervisor for department procedures and policies on batching. Some departments may have one charge batch per user per day, however, other departments whose volume of charges is much greater, may have several batches per user per day. For example, one data entry user may have one charge batch for all encounters on a specific date of service, for a specific billing area and for a specific facility. They might also have another batch for the same date of service, but for a different billing area and facility. Other departments might batch by provider.

In order to create a new TES batch, sign into Function 1000, Activity 1-Encounter/Trans Entry. You will be presented with a TES batch control form, which needs to be filled out prior to entering TES encounters. The batch control form is an example of a fixed screen. Use the appropriate keys to move around the batch control form. Also, pressing <F9> will give you a list of available action codes and bottom forms used within the batch control form.

Function 1000/Activity 1 has a series of screens for entering TES information, the batch control form is the first screen. A batch control form identifies the batch. It allows you to enter batch identification information, batch defaults and batch control totals. Each batch is unique. Only the user assigned to the batch will be able to access the batch for adding and editing information.

The batch control form serves two purposes:

• It organizes data entry into batches, or groups of similar encounters. Precisely what constitutes a batch depends on your department procedures. There is no system limitation to the number of batches each user can have on a given day.

• It allows you to automate some of your data entry by entering information (such as provider, facility, or date of service) as batch defaults that will appear automatically in each of the encounters and transactions that you create in the batch.

B/AR Charge Entry

UMCET Training 22

Batch Control Form Below is a copy of the batch control form you will see when signing into Activity 1-Encounter/Trans Entry:

By default, every time you enter Activity 1, TES will display the last batch form you used. Type a <G> at the Batch prompt in order to generate a new batch.

B/AR Charge Entry

UMCET Training 23

The batch control form has 4 main parts:

Batch Identification Fields These fields contain information about the batch itself.

Batch Default Fields These fields automate data entry by defaulting the information entered here into each encounter.

Batch Control Totals These fields allow you to balance your total charges or hash total with what is actually entered in the batch.

Action Codes Press <F9> to view further actions that can be taken within the batch control form.

B/AR Charge Entry

UMCET Training 24

Batch Identification Fields The Batch Identification Fields contain information about this batch. You can use them to recall and reuse the batch at a later time. The following is a table of all the Batch Identification Fields:

System Prompt: Description:

Initials This is a display only field. The system will default your user initials from your security sign in.

Batch Creation Date This is a display only field. The system will always default in the batch creation date, which will always be today’s date for generated batches.

Last Modified This is a display only field. The system will automatically default in the date the batch was last edited.

TES Batch This is the TES batch number assigned by the system. Enter one of the following options:

• The number of a previously created batch.

• A <?> to display the batches assigned to your initials in the batch selector.

• <G> to generate, or create, a new TES batch.

Batch Description This is a required field. Enter a brief description of the batch to identify it later from the batch selector.

B/AR Charge Entry

UMCET Training 25

Batch Default Fields The batch default fields allow you to specify information for some data entry fields that all of the encounters in the batch have in common. Any information you enter here in the batch default fields appears automatically in each encounter and transaction you create within the batch, thus saving you valuable keystrokes. All of the fields are optional. You can complete as many or as few of them as you need, and you can change the defaults without creating a new batch.

For any of the batch default fields, only enter them if they will truly save you time in entering encounters. If all your encounters are unique, you’d be better off not entering in any batch defaults.

The following is a list of the batch defaults fields available:


Provider Enter a provider’s name, number or mnemonic.

Billing Area Enter the corresponding Billing Area for the provider and for the encounters. In most cases, the billing area relates to a division within a department.

Division Enter the division name from the division dictionary. The IDX division corresponds to the UMMG department. In most cases, a provider only practices in one division and it will default into this field. It is strongly recommended that this field be always populated, particularly, in cases where a provider practices in more than one division.

POS (Loc) Enter in a Place of Service code (or Location code) for all the encounters.

Facility Enter in the facility for which all the encounters took place in. The facility is also a dictionary lookup.

B/AR Charge Entry

UMCET Training 26


Dept Para: Enter the default department parameter from the department parameter’s dictionary.

Serv Date Using any of the valid date formats, enter in a default date of service for all the charges.

The more batch default fields you use, the more you restrict your batch. Use only those fields which apply to all encounters in the batch.

B/AR Charge Entry

UMCET Training 27

Batch Control Totals Batch Control Totals identify whether or not your batch is in balance. Once your encounters or charge tickets for the batch are grouped together, you need to run an adding machine tape on the total charge amount or the procedure hash total, depending upon your department’s balancing procedures. When you have entered all the transactions into the batch, the system checks to see if the actual amount entered in the batch balances with the control total entered. If there is a difference between the two, you will have to follow department procedures for reconciling the batch.

The following is a list of the different batch control totals. The system requires you to balance by either procedure hash total or total charge amount. Your department procedures dictate which one should be used.


Hash Range Enter the decimal place range for calculating the hash total, for example, 1-3. For alpha-numeric codes, only use the numeric portion. For example, Anesthesia will be using a hash range of 3-8.

Proc Hash Enter the procedure hash total for all procedure codes in the batch.

Procedure $ Enter the total charge amount for all procedures in the batch.

Proc Units This field is optional. Enter the total number of units for all procedures in this batch.

Transactions Enter the total number of transactions in this batch.

B/AR Charge Entry

UMCET Training 28

Batch Control Form Action Codes There are several action codes available in the Batch Control Form of Function 1000/Activity 1. All screen action codes are accessed by pressing <F9>.

The following is a list of the available action codes in the Batch Control Form:

Action Code: Description:

C-Batch Control Totals Use this action code to change batch control totals.

P-Procedure Code Defaults Use this action code to enter a procedure code prefix or a procedure code suffix default for all procedure codes.

T-Detailed Totals This action code provides a screen with more detailed information on batch control totals.

B/AR Charge Entry

UMCET Training 29

Filing the Batch Control Form Once you have entered all applicable information in the Batch Control Form, press <F10> to file and save the Batch Control Form you just created. Any time you add or change information on the Batch Control Form, you must file it.

The system brings you into the next screen, UTT1.A, where you will be creating encounters and entering transaction information from the charge tickets for this batch. This screen is called the TES Combination Screen.

If you wish to quit out of the Batch Control Form without saving the information entered, then press <F7><Q> to quit. <F7><Q> will also get you back to the activity prompt, but make sure you have filed your Batch Control Form first.

B/AR Charge Entry

UMCET Training 30

Module Summary The first step in adding charges into the system is to create a TES batch.

The screen used to identify batch information is the Batch Control Form.

The Batch Control Form has 4 parts: batch identification fields, batch defaults, batch control totals and action codes.

Batch Identification fields are used to recall and reuse batches entered in TES.

Batch Default fields are used to expedite data entry.

Batch Control Totals are used to balance your charge batches.

Action Codes allow you to take further actions from within a data entry screen.

In order to save the data entered on the Batch Control Form and begin to enter encounter level information, press <F10>.

B/AR Charge Entry

UMCET Training 31

Practice Exercise 1. What is the purpose of the Batch Control Form?

2. Name the 4 different parts of the Batch Control Form.

3. What is the purpose of Batch Default Fields? Based on your current procedures, which ones would you use?

4. Sign onto the system and enter Function 1000, Activity 1. Complete the batch identification fields. Since the training batches you will be using today contain all different types of charges, do not fill in any of the Batch Default Fields. Enter Procedure $ given by the instructor prompt for the batch control total. File the Batch Control Form by pressing <F10>. Where does the system bring you to?

B/AR Charge Entry

UMCET Training 32

B/AR Charge Entry

UMCET Training 33

Module 3 - Encounter/Transaction Entry (F1000/A1)

TES Screens Overview Once you file the batch control form, you are brought into another screen and are ready to enter patient encounters from your charge tickets in the batch. There are several data entry screens available for encounter/transaction entry after the batch control form. Based on the information you enter in the activity’s first screens, TES opens the data entry screen that is most appropriate for the type of information you need to enter, edit, or view.

There are six data entry screens available in the TES Encounter/Transaction Entry activity. Which screen you use most depends on the type of data you need to enter.

Screen Name: Description:

Combination Screen This screen allows you to enter both header and transaction level data for an encounter. This screen will be used for creation and data entry of all encounters.

Diagnosis Screen This screen allows you to display more diagnoses at once than the combination screen does, but does not display transaction detail. Use this screen to change or add diagnosis codes.

Transaction Detail Screen This screen displays more detailed information about individual transactions than the Combination screen does. Each Transaction Detail Screen displays information about a single transaction. Use your arrow keys to move between the different transactions. Once you file the TES header information, it must be changed at the transaction level.

B/AR Charge Entry

UMCET Training 34

Screen Name: Description:

On-Line Dictionary Maintenance Form Used by data entry to forward provider information to the IS department.

Comment Screen The comment screen contains a word processing field that allows you to enter up to 100 lines of free text information.

EPSDT Screen Used by the department of pediatrics to enter EPSDT procedure codes and related information.

Moving around TES Screens You can move from one TES data screen to another in one of the following ways:

• By using your <Page Up> and <Page Down> keys

• By pressing <F7><P> to access the Go To Page: prompt and enter the page number.

No matter how many times you move around the different screen pages, TES does not save the data you entered in any page until you press <F10> to file the encounter.

To exit the data entry screens:

• Press <F7><Q> to return to the activity batch or option selection form without saving any changes made in any of the data screens in the encounter, or

• Press <F10> to file the encounter and save any changes you made in any of the data screens.

B/AR Charge Entry

UMCET Training 35

Levels within TES Data Screens TES data is organized in four different sections. Each screen within TES Encounter/Transaction Entry contains a different combination of information in these sections, as summarized in the following table:

Section:

Description:

Available in Screen page:

Encounter Information Fields

Identifies the patient and the encounter All

Header Fields In the Combination and Transaction Detail screens, header fields contain information about the encounter, including diagnoses, provider, billing area, location and facility.

When header fields appear in the Transaction Detail screen, the information in them applies to the selected transaction only.

1, 2 and 3

Transaction Detail fields Repeating fields that contain specific information about each procedure performed in this encounter.

1 and 3

Action Codes Lists the available action codes across the bottom of the screen. You press <F9> to display the action code list, then select an action code to perform one of a variety of additional data entry tasks or to access certain other BAR functions.

1, 2, and 3

Not every field in each section appears in every screen page that contains the section. For example, the Transaction Detail screen contains some header fields, but not all of them. Likewise, the Combination screen contains most, but not all Transaction Detail fields.

B/AR Charge Entry

UMCET Training 36

TES Combination Screen As previously stated, the TES Combination Screen allows you to enter both encounter header and transaction detail information all in one screen. This is the screen used for charge data entry.

When you press <F10> to file the batch control form, the TES Combination Screen is the first TES data entry form you will see.

The following is an example of our TES Combination Screen:

B/AR Charge Entry

UMCET Training 37

Encounter Information Fields As discussed earlier in this module, TES data is organized into 4 different sections, the first of these is Encounter Information Fields. Encounter Information fields identify the patient and the encounter. You can only work on one patient, in one batch, and on one encounter at a time.

Below is a field by field description of all the Encounter Information Fields in the TES Combination Screen:

Field: Description:

Patient Enter the patient’s name, using the proper format of LASTNAME,FIRSTNAME, or use any of the Patient Lookups to access the patient you want to enter charges for.

This field is required, you cannot proceed without entering a patient name.

UMMG # The patient’s UMMG account number will display in this field, once the patient has been identified correctly at the patient prompt. The UMMG # is generated during the registration process.

Encounter The encounter number. Enter one of the following:

• A valid encounter number

• <R> to recall the last encounter

• <G> to generate a new encounter

• <?> to display the encounter selector for the patient identified

This field is required. You cannot proceed without entering or generating an encounter number.

Alt Enc This field is display only and will only be used for the JMH interface. You will never enter anything into this field.

Field: Description:

B/AR Charge Entry

UMCET Training 38

Visit # You can enter the visit number generated with the patient appointment in this field and the system will automatically default in some of the header fields from the appointment into the encounter. This field is optional.

Case Enter a valid case for the patient. A case defines an episode of care.

B/AR Charge Entry

UMCET Training 39

Header Fields The Header Fields contain information about the encounter or visit, such as the billing provider, the billing area, the location and the facility. Each encounter can only be associated with one entry for each of the header fields. In other words, each patient encounter or visit can only have one billing provider, one billing area, one location and one facility associated with it. Most of these fields are also dictionary lookups, so that they can be used for reporting purposes.

The following table provides a field by field description of all the header fields in the TES Combination screen:

Field: Description:

Provider Enter the billing provider for the encounter. This is a dictionary lookup field (dictionary #3), so you can access the provider’s entry by using the unique provider number, the mnemonic or by doing an alpha lookup. You can also enter a <?> here to display a list of all the providers. This is a required field.

Division The IDX Division (dictionary #102) is equal to the provider’s department. In most cases, the system will automatically default in the provider’s division from the dictionary and you will not have to enter anything in this field. However, there are a few providers who practice in multiple divisions (or departments). For these providers, you may have to override the default division. Since this is another dictionary lookup, you can type a <?> here to see which divisions the provider practices in or is associated with in the dictionary.

This is a required field.

B/AR Charge Entry

UMCET Training 40

Field: Description:

Bill Area Enter a corresponding billing area for the provider and the patient encounter. In most cases, an IDX billing area corresponds to a UMMG division within a department. You can type a <?> at this field to see the billing areas the provider is associated with from the dictionary. This field looks up to the billing area dictionary (#202) and you can access an entry from this dictionary by specifying the entry’s number or mnemonic, or by doing an alpha lookup. The billing area entered in this field has to correspond to the provider, or else the system will tell you they do not match.


POS (LOC) Enter in the valid Place of Service or Location code for claim form purposes. This field looks up to the Location (#100) dictionary, therefore, you can enter the code, mnemonic or name here to specify the Place of Service, or type a <?> to see all the entries.


Facility Enter the physical site where the patient was seen for services. This may be the name of a hospital or a clinic, for example, Jackson Medical Towers or Jackson Memorial Hospital. This field looks up to the Hospital/Facility dictionary, #101. You can enter in the name, number or mnemonic to specify the facility, or a <?> to see all the entries from the dictionary.


B/AR Charge Entry

UMCET Training 41

Field: Description:

Dt of Serv Enter the service date for the encounter, using any of the valid date responses.

FSC Flow The system automatically enters the default FSC Flow, or FSC list, from Registration.

FSC The system will default in the appropriate FSC, or Financial Status Classification, for the encounter. This indicates who is to be billed for services. An encounter can only be in one FSC at a time. The system uses a sequential billing process in Payment Posting to bill secondary and tertiary FSCs.

In some cases, you may have to override the default FSC. This field looks up to the FSC Dictionary, #19.

This field is required.

Ref Phys If appropriate, enter the Referring Physician’s name for the patient encounter. This field looks up to the Referring Physician’s dictionary, #123. This field is optional.

Diagnosis Enter the diagnosis for the patient encounter. You can enter up to 10 diagnoses with each encounter. The screen only shows 3, however, it will branch you to a bottom form after the third one is entered, where you can enter up to a total of 10.

The diagnosis fields look up to the Diagnosis dictionary, #36. It is not recommended that you ever use a <?> at this field, due to the large size of the dictionary. If you do not know the code, you can do an alpha lookup at this field.

B/AR Charge Entry

UMCET Training 42

Transaction Detail Fields The following fields contain information about a specific transaction within the encounter.

Field: Description:

Proc Enter the procedure code. Must be a valid entry from the procedure codes dictionary, #1.

You can also enter a portion of the procedure code description, and the system will display a list of procedures based on the description you enter. You can then choose the correct procedure from the list.

Mod Enter the modifier(s), if applicable, for this procedure from the modifier dictionary, #5.

Serv Date The system will default the service date from the encounter header field. If this is not the service date for this procedure, enter the date the procedure was performed, using one of the valid date formats.

Thru Serv Dt For daily charges, the system will ask you to enter an ending date and it will calculate the number of units based on the date range.

Dx The system defaults in the primary diagnosis code for each procedure.

You may override this field by entering a string of diagnoses from the header, i.e. 1,2,3.

Un Enter the number of units for this procedure. The system will always default 1 unit.

B/AR Charge Entry

UMCET Training 43

Field: Description:

Unit Amt Cost per unit in dollars. The system defaults in the unit price for this procedure from the pricing module.

FSC The system will default the primary FSC from the FSC flow, as long as it is in effect on the date of service for the procedure.

You may override this field. Enter the actual Financial Status Classification (FSC) from the FSC dictionary, #19.

The FSC for the encounter will determine who is billed for the services.

If more than one FSC is entered in the transaction detail fields, the system will automatically create two encounters. An encounter can only be in one FSC at a time.

Total Amt The Total Amount is calculated by the system (Unit times Unit Amount).

This is a display-only field.

B/AR Charge Entry

UMCET Training 44

TES Data Screen Action Codes TES uses action codes that allow users to enter additional data or access other BAR functions. In order to access action codes in any IDX application or screen, press the <F9> function key. The action codes that will display depend upon what screen you are in and where your cursor is in that screen. Action codes display under the key display portion of the fixed screen.

Action codes allow you to enter additional information in fields that do not appear in the data screens. When you access a specific action code, the system displays a bottom form with more fields to enter the additional data. You can access an action code by typing in the one letter code indicated. You do not need to press the <Enter> key.

TES has action codes in both the header and transaction detail portions of the screen. Based on your individual security, you may or may not have access to all possible action codes.

B/AR Charge Entry

UMCET Training 45

Header Level Action Codes The following action codes are available when you press <F9> in the header portion of the TES Combination Screen:

The following pages contain a description of each of the above Header Level Action Codes and their corresponding fields.

B/AR Charge Entry

UMCET Training 46


1-Dental Allows oral surgery to enter dental prosthesis and tooth extraction data. Used with FSC 66.

2-Department Parameter Allows those departments who use the Departmental Reporting Parameter to enter a valid entry from dictionary #704.

A-Auth Number Allows you to enter a Medicare Prior Approval Number, if one is required by the FSC. The approval number can be up to fifteen characters.

B-Facility Allows you to enter or edit hospital/facility information, such as the name of the hospital or facility, and admission and discharge dates.

C-Case Allows you to enter case information for an encounter, such as the case number, case type, package ID, or case FSC.

D-Discount Allows you to enter or edit the discount type and percent for this encounter. The discount is only applied once the encounter is in a self pay FSC.

I-Injury Allows you to enter or edit injury information for this encounter, such as the injury date, injury type and worker’s compensation case #.

M-MCA Elements Enables you to enter referral information for this encounter. The system will prompt you for the Referral #, authorization # and the missing referral type.

O-Toggles The system will prompt you if you want to prevent transaction repricing. Enter Y to set a toggle that prevents recalculation by the Pricing Module. The default is N.

B/AR Charge Entry

UMCET Training 47


Q-Display Edits Displays the Edit Condition selector screen, which lists open edit conditions for the encounter. You can select an edit and view the detail by pressing <D>.

R-Referral Accesses the Add/Edit activity of the Managed Care application, Referral module.

T-Ent Totals Displays summary information about the encounter. The system will display the number and dollar amount of the original transactions entered, open transactions, extracted transactions, deleted transactions, transactions on hold, transactions with unresolved edits, transactions forced to BAR, clean transactions waiting for extraction, transactions edited from their original amount, purged transactions, and current transactions.

V-BAR Info Allows you to post TES transactions to new BAR invoices or to existing BAR invoices. Used to attach charges to a time of service payment (credit balance invoice).

X-Diagnosis Allows you direct access to the diagnosis fields, where you can add or edit diagnosis information for this encounter.

Y-Audit Trail Displays the Header Audit Trail screen. The Audit Trail displays the screen as it appeared each time you filed the encounter, allowing you to see a history of changes made to the encounter. Use the up and down arrow keys to view earlier versions and return to later versions.

B/AR Charge Entry

UMCET Training 48

Transaction Level Action Codes The following action codes are available when you press <F9> in the transaction portion of the TES Combination Screen:

The following pages contain a description of each of the above Transaction Level Action Codes and their corresponding fields.

Changes made with action codes in the transaction portion of the screen will affect only the selected transaction, not all transactions on the encounter.

B/AR Charge Entry

UMCET Training 49


1-Dental Allows oral surgery to enter dental prosthesis and tooth extraction data. Used with FSC 66.

2-Department Parameter Allows those departments who use the Departmental Reporting Parameter to enter a valid entry from dictionary #704.

A-Auth Number Allows you to enter a Medicare Prior Approval Number, if one is required by the FSC. The approval number can be up to fifteen characters.

B-Facility Allows you to enter or edit hospital/facility information, such as the name of the hospital or facility, and admission and discharge dates.

C-Case Allows you to enter case information for the transaction, such as the case number, case type, package ID, or case FSC.

E-Proc Desc This field allows you to override the procedure code description. Enter one of the following, if necessary:

• <A> to add new text to the end of the standard description

• <C> to change the diagnosis description

H-Ba/Dv/Lc/Gp This action code allows you to enter add or edit the billing area, division, location or group for the selected transaction.

I-Injury Allows you to enter or edit injury information for this transaction, such as the injury date, injury type and worker’s compensation case #.

B/AR Charge Entry

UMCET Training 50


M-Modifiers Allows you to enter and display up to four modifiers for a procedure code. The system will prompt you for the modifier code from the modifier dictionary, #5, and then it will display the modifier description and a flat rate adjustment, if any, as defined in the modifier dictionary.

N-Dental TSQ Enables you to enter information related to a dental procedure code, as defined in the procedure code dictionary, #1. The system will prompt you for the tooth number, the surface code, and quadrant.

O-Toggles The system manager may set up some edit conditions that should be ignored under certain circumstances. For example, an edit for patient gender may not apply if you are entering charges for a company instead of a person. Enter Y in this field to ignore the edit conditions. Some edit conditions may be set up so that they cannot be ignored.

P-Payment Data Allows you to enter information about any payments already made for the transaction. The system will prompt you for the unapplied cash invoice #, the amount to apply and also displays the current invoice balance.

Q-Display Edits Displays the Edit Condition selector screen, which lists open edit conditions for the transaction. You can select an edit and view the detail by pressing <D>.

T-Time Based Displays a form that allows you to enter additional information about time-based charges. Enter the starting and ending times for the procedure and the system will calculate the duration. You can also enter base unit information, reduction percentage and additional time reasons.

U-Comment Allows you to enter a comment of up to 60 characters. Use this field to enter a comment that applies to the transaction only.


B/AR Charge Entry

UMCET Training 51

V-BAR Info Allows you to post TES transactions to new BAR invoices or to existing BAR invoices. Used to attach charges to a time of service payment (credit balance invoice).

Y-Audit Trail Displays the audit trail screen for the currently selected transaction. The audit trail displays the screen as it appeared each time you filed the encounter. Use the up and down arrow keys to move to different versions. The system will also display action codes to be used for inquiry purposes only.

Z-MCA Elements Shows adjudication information for capitated services.

B/AR Charge Entry

UMCET Training 52

Encounter Filing and Edit Checking When you finish entering information in the TES data screens, you have to press <F10> in order to file the encounter.

When you file the encounter, a message appears on your screen briefly while TES checks edit conditions.

After a few moments, one of two things will happen:

• If no errors exist in the encounter, TES returns you to a blank Combination screen at the Patient prompt.

• If errors do exist in the encounter, TES displays the Edit Conditions selector, which lists open edit conditions for the encounter.

The Edit Condition selector screen looks like this:

B/AR Charge Entry

UMCET Training 53

Viewing Edit Condition Descriptions To view descriptions of the edits required, highlight the edit conditions for which you want to see descriptions and press action code <D>.

TES displays the definition of the first edit in the list in a screen that looks like this:

The system will tell you the procedures to follow to fix the edit.

Press <F10> to display the next edit selected, or <F7><Q> to return to the Edit Conditions selector screen. If there are no more edits to view, both <F10> and <F7><Q> will return you to the Edit Conditions selector screen.

B/AR Charge Entry

UMCET Training 54

Correcting TES Edits To correct any of the errors shown in the Edit Conditions selector, press <F7><Q> to exit the selector screen and return to the Combination screen. Make any changes you can and press <F10> to file the encounter again.

If you cannot make any changes at the present time, press <F10> from the Edit Conditions selector screen to file the encounter without making further changes. The edit will still need to be fixed at a later time.

Once you file an encounter, TES returns you to a blank encounter screen. You can either:

• Create or recall another encounter, or

• Press <F7><Q> to return to the batch form

From the batch form, you can edit batch defaults and press <F10> to return to the Combination screen, or press <F7><Q> to exit the TES Encounter/Transaction Entry activity.

TES Edits which require header information to be changed, must be changed at the transaction level once the encounter has been filed.

B/AR Charge Entry

UMCET Training 55

Module Summary TES has several screens in which data can be entered. The TES

Combination Screen will be used the most often to enter header and transaction TES data.

Action Codes are used in TES screens to enter further information about the TES encounter or individual transactions. Action Codes can be displayed by pressing the <F9> key.

A TES encounter is entered and then filed using the <F10> key.

Some TES encounters may receive edits which prevent the TES encounter from reaching the BAR application.

TES edits contain descriptions and procedures to follow to fix the edits. By pressing action code D, you can view the TES edit description.

TES edits can be fixed at the time or saved and fixed at a later time.

TES edits that affect header level information must be fixed at the transaction level.

Press <F7><Q> to return to the batch form once all encounters have been entered.

Press <F7><Q> to exit the batch form and return to the activity prompt.

B/AR Charge Entry

UMCET Training 56

Practice Exercise 1. What is the name of the TES data screen where most TES data is entered?

2. What are the 4 different parts of the TES Combination screen?

3. What is the purpose of TES edits?

4. Sign back into TES, Function 1000/Activity 1 in BAR. Access the same batch you created in Module 2 (it should default the batch for you). Press <F10> to move to the TES Combination Screen. Begin entering charge data into TES from the encounter forms given to you by the instructor. File each encounter and check if there are edits that need to be fixed. Once all encounters have been added, get back to the batch control form and check if your batch is in balance.

B/AR Charge Entry

UMCET Training 57

Module 4 - Editing TES Encounters and Transactions (F1000/A2)

This module describes how to use the TES Encounter/Transaction Edit activity, activity 2.

When you select Activity 2, TES Encounter/Transaction Edit, you first see the following TES Encounter/Transaction Editing selection screen:

The information in the box on the left hand side of the screen is the Patient/Encounter Selection Header.

The information in the box on the right hand side of the screen is the Patient/Encounter Filter Header.

B/AR Charge Entry

UMCET Training 58

Edit Options There are 3 different ways you can use the TES Encounter/Transaction Editing activity to access and edit encounters and transactions:

• You can use the Patient/Encounter Selection header to select a patient and edit encounters and transactions for that patient directly,

• you can use the Patient/Encounter Filter header to select workfiles assigned to you and edit the encounters and transactions in those workfiles,

• or, you can use the Patient/Encounter Filter header to select batches to edit.

B/AR Charge Entry

UMCET Training 59

Patient/Encounter Selection Screen To edit an encounter or transaction for a specific patient, select activity 2 and enter a patient name in the Patient field of the Patient/Encounter Selection screen, using any of the valid name formats.

TES displays the Patient/Encounter Selector screen. You can also access this screen by typing in a <?> at the encounter field, after a patient has been identified.

The Encounter Selector screen looks like this:

At this point, you have 2 options:

• You can use the action codes displayed at the bottom to edit encounter and header information, or

• you can press <Enter> to select an encounter, then press <F10> to place the cursor in the Transaction field. This allows you to edit specific transaction data.

B/AR Charge Entry

UMCET Training 60

Patient/Encounter Selector Screen Action Codes Action codes at the bottom of the Encounter selector screen give you a variety of editing options. This section lists and describes the action codes available from the Patient/Encounter Selector screen.


1-Edit Trans This action code will branch you immediately to the Transaction Detail screen.

2-Edit Diag This action code will branch you to the diagnosis screen, where you can change or add diagnosis codes.

A-Edit Reg This action code allows you to edit patient registration information, such as demographic, insurance and case data. Press <F10> to file the changes and return to the Encounter Selector screen.

B-More Actions This action code displays the following additional action codes:

B-Batch Totals Displays summary totals for a selected batch. This action code only works when you display the Patient/Encounter Selector by using the Batch filter to first select a batch.

P-Pat/Ent Filters Displays additional action codes that allow you to change the sort order of the encounter display.

W-Workfile Totals Displays summary totals for a selected workfile. This action code only works when you use the Workfile filter to first select a workfile to display the Patient/Encounter Selector.

B/AR Charge Entry

UMCET Training 61


I-Invoice Inquiry Displays BAR invoice information for the patient. If no invoice exists, the system will display an error message.

M-Move Encounter Use this action code to move the TES encounter to another patient. Enter a new patient name and press <Enter>. The system will ask you if you are sure you want to move the encounter, say <Y> and press <Enter> again to file the change.

P-Patient Inquiry Displays the information from Function 49-Patient Inquiry. Refer to the Patient Inquiry training materials for more information.

Q-Display Edits Displays the Edit Condition selector screen, which lists open edit conditions for this encounter.

To view descriptions of the edits, highlight the edit conditions and press <D>.

TES displays a description of the first selected edit in the list. Press <F10> to display the next edit selected or <F7><Q> to return to the Edit Conditions selector screen. If there are no more edit conditions to view, both <F10> and <F7><Q> will return you to the Edit conditions selector screen.

R-View Reg Allows you to view, but not edit, the patient registration information on this patient.

S-Change Ent Status Allows you to change the status of the encounter. Enter a valid encounter status from the TES Encounter Status Codes dictionary, #33052, or press <?> to display a list of the valid options. Press <F10> to accept the change or <F7><Q> to leave this form without changing the encounter status.

B/AR Charge Entry

UMCET Training 62


T-Ent Totals Displays summary information about the encounter. The system will display the number and dollar amount of the original transactions entered, open transactions, extracted transactions, deleted transactions, transactions on hold, transactions with unresolved edits, transactions forced to BAR, clean transactions waiting for extraction, transactions edited from their original amount, purged transactions, and current transactions.

W-Workfiles Displays a selector list of workfiles that apply to a selected encounter.

X-Delete Encounter Allows you to delete the encounter, providing all transactions in the encounter have been deleted first. The system will prompt you to enter a reason for the deletion from the TES Deletion codes dictionary, #33053, as well as a free text comment.

If you try to delete an encounter that contains transactions or has been extracted, TES displays an error message.


Z-Display Trans This action code will display the Transaction selector screen for the encounter.

B/AR Charge Entry

UMCET Training 63

Transaction Selection Screen When you select action code Z-Disp Trans from the Encounter Selector, or when you select an encounter from the Encounter selector and press <F10>, TES displays the Transaction Selector screen, as shown below:

Select a transaction by placing the selector bar on the transaction you want to view the detail on, and press the <Enter> key to select it. The press <F10> to view the Transaction Detail screen for the selected transaction, or use one of the action codes at the bottom of the selector screen to edit or view transaction information.

B/AR Charge Entry

UMCET Training 64

Transaction Detail Screen Below is an example of the Transaction Detail Screen:

B/AR Charge Entry

UMCET Training 65

Transaction Selector Screen Action Codes Action codes at the bottom of the Encounter selector screen give you a variety of editing options. This section lists and describes the action codes available from the Patient/Encounter Selector screen.


C-Change Multiple Trans This action code opens the Transaction Quick Change Form for the selected transactions. This form allows you to make a number of changes at once to more than one transaction at a time.

Be careful using this form. TES does not display the old values of any of the transactions you are editing. It is easy, therefore, to make changes that you do not intend to make to some transactions.

To make changes using the Transaction Quick Form:

1. Select the transactions you want to change in the Transaction Selector screen and enter <Z> to access the Transaction Quick Change form.

2. Enter the new data in the appropriate fields in the Transaction Quick Change Form.

3. Press <F10> to enter the new data in all of the transactions you selected in the Transaction selector.

E-Edit Trans Displays the Transaction Detail edit screen for the highlighted transaction.

M-Move Trans Allows you to move the transaction to another encounter for the same patient.

Enter the number of the encounter to which you want to move the transaction. You must know the encounter number; no list is available for this field.

Q-Display Edits Displays the Edit Conditions selector list for the highlighted transaction.


B/AR Charge Entry

UMCET Training 66

S-Change Trans Status Allows you to change the status of the transaction.

Enter a valid status from the TES Transaction Status Codes dictionary, #33062, or press <?> to display the list of statuses. Press <F10> to accept the change or <F7><Q> to leave this form without changing the encounter status.

V-View Trans Allows you to view, but not edit, the Transaction Detail screen for the highlighted transaction.

X-Delete Trans Allows you to delete the selected transaction.

The system will prompt you to enter a reason for the deletion from the TES Deletion Codes dictionary, #33053, or you can type a <?> to display the list of reasons, as well as a free text comment.

Y-Audit Trail Displays audit trail screens for the transaction. The audit trail displays the transaction screen as it appeared each time you filed the encounter, allowing you to see a history of changes made to the transaction. Use the <Up Arrow> and <Down Arrow> keys to view earlier and later versions.

Note that you can view, but not edit information in audit trail screens.

B/AR Charge Entry

UMCET Training 67

Editing from Workfiles Workfiles are groups of edits that have been organized for efficient editing. Some workfiles will include only certain types of edits, and some may include only those edits in encounters created by specific users.

To edit encounters or transactions in a specific workfile:

1. Select Activity 2, TES Encounter/Transaction Editing, from the TES main menu to display the TES Encounter/Transaction Editing selection screen.

2. Press <Enter> from the Patient field to place the cursor in the Workfile field.

3. Enter the number of the workfile you want to access, or press <?> to display the Workfile Selector screen, shown below.

4. Use the <Up Arrow> and <Down Arrow> keys to move through the selector list. Highlight the workfile to edit, press <Enter> to select it and then <F10>. When you select a workfile, TES displays the Patient/Encounter selector for the workfile.

5. Select the patient encounter to edit and press <F10> to access the edit screens for the selected encounter, or use one of the action codes at the bottom of the screen to access information to edit directly.

B/AR Charge Entry

UMCET Training 68

Editing From Batches To edit encounters or transactions in a specific batch:

1. Select Activity 2, TES Encounter/Transaction Editing, from the TES main menu to display the TES Encounter/Transaction Editing selection screen.

2. Press <Enter> twice from the Patient field to place the cursor in the Batch field.

3. Enter the number of the batch you want to access, or press <?> to display the Batch selector screen. When you select a batch, press <Enter> and <F10>, TES then displays the Patient/Encounter selector for the batch.

4. You can select an encounter and press <F10> to access the edit screens for the encounter, or you can use one of the action codes at the bottom of the screen.

B/AR Charge Entry

UMCET Training 69

Batch Selector Action Codes The Batch Selector screen contains several action codes. This section lists and describes the action codes available from the Batch Selector screen.


C-Close Batch Changes the status of the selected batch to closed.

D-Delete Batch Deletes the selected batch. You can only delete a batch that is currently in the status of open.

P-Print Batch Proof This action code allows you to print a copy of the batch proof to your screen or a printer.

T-Detailed Totals This action code allows you to view detailed batch totals. The system will display the number and dollar amount of the original transactions entered, open transactions, extracted transactions, deleted transactions, transactions on hold, transactions with unresolved edits, transactions forced to BAR, clean transactions waiting for extraction, transactions edited from their original amount, purged transactions, and current transactions for the batch.

B/AR Charge Entry

UMCET Training 70

Module Summary If you cannot fix TES edits for a specific encounter while entering the

encounter through Activity 1, you can always come back to it later through Activity 2 to fix the encounter.

TES encounters will not file into BAR until all edits have been resolved.

There are 3 different ways to edit TES encounters: by calling up the patient, the workfile, or the batch.

TES header information must be fixed at the transaction level, using action codes on the first screen or by using the Transaction Detail screen.

Action Codes allow you to edit additional information about the patient, encounter or transactions.

Activity 2 allows you to print a batch proof in order to reconcile out of balance batches.

B/AR Charge Entry

UMCET Training 71

Practice Exercise 1. The instructor will provide you with another batch to enter into the system. This time, the

encounters created will generate TES edits. Enter the batch and file the edits.

2. Correct the TES edits for the encounters just entered in #1 through Activity 2.

B/AR Charge Entry

UMCET Training 72

B/AR Charge Entry

UMCET Training 73

Module 5 - Encounter and Transaction Inquiry (F1000/A3)

This module describes how to use the TES Encounter/Transaction Inquiry activity, activity 3. Activity 3 allows you to view, but not edit, TES encounters and transactions in the system.

When you select Activity 3, TES Encounter/Transaction Inquiry, you first see the following TES Encounter/Transaction Inquiry selection screen:

The information in the box on the left hand side of the screen is the Patient/Encounter Selection Header.

The information in the box on the right hand side of the screen is the Patient/Encounter Filter Header.

B/AR Charge Entry

UMCET Training 74

Inquiry Options You view information in TES much the same way as you access information to edit. You have 3 inquiry options from the TES Encounter/Transaction Inquiry screen:

• you can use the Patient/Encounter Selection header to select a patient and view encounters and transactions for that patient, or

• you can use the Patient/Encounter Filter header to select workfiles and view the encounters and transactions in those workfiles, or

• you can use the Patient/Encounter Filter header to select batches to view.

B/AR Charge Entry

UMCET Training 75

Viewing Patient Encounters To view an encounter for a specific patient:

1. Select Activity 3, TES Encounter/Transaction Inquiry, from the TES main menu to display the TES Encounter/Transaction Inquiry selection screen.

2. Enter a patient name in the Patient/Encounter Selection header, using any of the valid name formats.

3. TES then displays the Patient/Encounter selector screen. You can also enter a <?> in the Encounter field to display the Patient/Encounter selector screen.

The Patient/Encounter selector screen looks like this:

At this point, you have the following options:

• you can press <Enter> to select an encounter, then press <F10> to place the cursor in the Transaction field. Enter a <?> to display the Transaction Selection Inquiry screen, or

• you can use action codes to select encounter viewing options.

B/AR Charge Entry

UMCET Training 76

Patient/Encounter Selector Screen Action Codes Action codes at the bottom of the Encounter selector screen give you a variety of editing options. This section lists and describes the action codes available from the Patient/Encounter Selector screen.


B-More Actions This action code displays the following additional action codes:

B-Batch Totals Displays summary totals for a selected batch. This action code only works when you display the Patient/Encounter Selector by using the Batch filter to first select a batch.

P-Pat/Ent Filters Displays additional action codes that allow you to change the sort order of the encounter display.

W-Workfile Totals Displays summary totals for a selected workfile. This action code only works when you use the Workfile filter to first select a workfile to display the Patient/Encounter Selector.

I-Invoice Inquiry Displays BAR invoice information for the patient. If no invoice exists, the system will display an error message.

P-Patient Inquiry Displays the information from Function 49-Patient Inquiry. Refer to the Patient Inquiry training materials for more information.

Q-Display Edits Displays the Edit Condition selector screen, which lists open edit conditions for this encounter.

To view descriptions of the edits, highlight the edit conditions and press <D>.

TES displays a description of the first selected edit in the list. Press <F10> to display the next edit selected or <F7><Q> to return to the Edit Conditions selector screen. If there are no more edit conditions to view, both <F10> and <F7><Q> will return you to the Edit conditions selector screen.


B/AR Charge Entry

UMCET Training 77

R-View Reg Allows you to view, but not edit, the patient registration information on this patient.

W-Workfiles Displays a selector list of workfiles that apply to a selected encounter.


Z-Display Trans This action code will display the Transaction selector screen for the encounter.

B/AR Charge Entry

UMCET Training 78

Transaction Inquiry Selection Screen The Transaction selector screen appears when you perform one of the following actions:

• Select the Z-Display Trans action code from the Patient/Encounter selector screen, or

• Enter a <?> in the Transaction field

Select a transaction by placing the selector bar on the transaction you want to view the detail on, and press the <Enter> key to select it. The press <F10> to view the Transaction Detail screen for the selected transaction, or use one of the action codes at the bottom of the selector screen to edit or view transaction information.

B/AR Charge Entry

UMCET Training 79

Transaction Selector Screen Action Codes Action codes at the bottom of the Encounter selector screen give you a variety of editing options. This section lists and describes the action codes available from the Patient/Encounter Selector screen.


Q-Display Edits Displays the Edit Conditions selector list for the highlighted transaction.

V-View Trans Allows you to view, but not edit, the Transaction Detail screen for the highlighted transaction.

Y-Audit Trail Displays audit trail screens for the transaction. The audit trail displays the transaction screen as it appeared each time you filed the encounter, allowing you to see a history of changes made to the transaction. Use the <Up Arrow> and <Down Arrow> keys to view earlier and later versions.

Note that you can view, but not edit information in audit trail screens.

B/AR Charge Entry

UMCET Training 80

Viewing Workfiles To view encounters or transactions in a specific workfile:


2. Press <Enter> from the Patient field to place the cursor in the Workfile field.

3. Enter the number of the workfile you want to view, or enter a <?> to display the workfile selector screen.

4. Use the <Up Arrow> and <Down Arrow> keys to move through the selector list. Highlight the workfile to view, press <Enter> to select it and then <F10>.

B/AR Charge Entry

UMCET Training 81

Once you select a workfile, TES displays the Patient/Encounter selector for the workfile:

From this point, you can select the patient encounter to view and press <F10> to select a transaction for the selected encounter, or use one of the action codes at the bottom of the screen to access information to view directly.

B/AR Charge Entry

UMCET Training 82

Viewing Batches To view encounters or transactions in a specific batch, first select a batch as follows:


2. Press <Enter> twice from the Patient field to place the cursor in the Batch field.

3. Enter the number of the batch you want to access, or press a <?> to display the Batch selector screen.

B/AR Charge Entry

UMCET Training 83

Batch Selector Action Codes The Batch Selector screen contains several action codes. This section lists and describes the action codes available from the Batch Selector screen.


P-Print Batch Proof This action code allows you to print a copy of the batch proof to your screen or a printer.

T-Detailed Totals This action code allows you to view detailed batch totals. The system will display the number and dollar amount of the original transactions entered, open transactions, extracted transactions, deleted transactions, transactions on hold, transactions with unresolved edits, transactions forced to BAR, clean transactions waiting for extraction, transactions edited from their original amount, purged transactions, and current transactions for the batch.

B/AR Charge Entry

UMCET Training 84

When you select a batch and press <F10>, TES displays the Patient/Encounter selector for the batch.

From this point, you can select the patient encounter to view and press <F10> to select a transaction for the selected encounter, or use one of the action codes at the bottom of the screen to access information to view directly.

B/AR Charge Entry

UMCET Training 85

Module Summary TES Activity 3-Encounter and Transaction Inquiry, allows you to inquire

into TES encounters and transactions without editing.

Activity 3 provides 3 different inquiry options: you can look up encounters/transactions by the patient, by the workfile, or by the batch.

Once a patient has been specified, the system provides you with several action codes to view other information about the patient or the encounter.

Viewing batches through Activity 3 allows you to print a batch proof.

B/AR Charge Entry

UMCET Training 86

Practice Exercise 1. Inquire into your batch through Activity 3. Use the batch inquiry option.

2. Look up one of your patients by using the patient inquiry option. Use several of the action codes in order to view additional information about the patient/encounter.

B/AR Charge Entry

UMCET Training 87

Module 6 - Printing a Batch Proof A batch proof report is a detailed listing of batches and their entries. The report lists batches in numerical order and lists the batch entries within each batch in the order they were entered into the system.

You can print a batch proof in one of the following ways:

• through action code P-Print Batch Proof in TES activity 2 or 3, after typing a <?> at the batch prompt, or

• through Activity 6, Activity 1.

The batch proof can be printed to your screen or to a printer. It can be used to reconcile out of balance batches. It is basically a hard copy of everything in your batch. It contains information such as batch identification information, batch control totals, encounter and transaction information and batch totals.

B/AR Charge Entry

UMCET Training 88

The following is an example of the first page of a batch proof:

This page shows all the batch identification information, as well as the control totals entered.

B/AR Charge Entry

UMCET Training 89

This is an example of the encounter detail that will print in a batch proof. When printing a batch proof to the screen, the report will wrap around to the second line. When printing a batch proof to the printer, specify a right margin of 132 characters.

B/AR Charge Entry

UMCET Training 90

Module Summary A batch proof is used to reconcile out of balance batches.

Batch proofs contain all the batch header information, control totals and encounter details.

Batch proofs can be printed to the monitor or sent to a printer.

Entries display in the order they are entered in the batch.

A batch proof can be printed via Action Code P-Print Batch Proof in TES Activities 2 and 3.

B/AR Charge Entry

UMCET Training 91

Module 7 - Invoice Inquiry

Overview Once TES encounters are extracted into the Billing and Accounts Receivable application, they create a BAR invoice and can then be viewed in Invoice Inquiry. Invoice Inquiry is a utility that enables you to display patient and financial information at the invoice, account and group levels.

Since UMMG will be a single BAR group, the Invoice Inquiry screen will always show all invoices for the group, or all departments within BAR Group 3. The system does, however, allow you to filter this information for specific criteria.

From Invoice Inquiry, you can view the following types of information:

• invoices for a patient

• details of an invoice

• patient account information

• financial and general comments for a patient

• payment information

• fee schedules

• case and package information

• dictionary information

• financial information by FSC and by Group

Invoice Inquiry also allows you to print a statement or ledger for a patient account and look across applications using the Patient Inquiry function.

B/AR Charge Entry

UMCET Training 92

Accessing Invoice Inquiry Invoice Inquiry can be accessed several different ways:

• BAR, Function 7

• Action Code Q in Charge Entry or Payment Posting in BAR

• Action Code I-Invoices in Patient Inquiry, any application

When you access Invoice Inquiry through BAR Function 7 or via an action code in Charge Entry or Payment Posting, you are brought to a patient identification screen. You must first type in the patient name using any of the valid patient lookup options and then type a <?> at the Invoice prompt and press <Enter> to see a list of all the invoices.

If you already know the specific invoice number you want to view detail for, you can enter the invoice number at the invoice prompt, and it will bring you directly to the invoice detail for that invoice number.

B/AR Charge Entry

UMCET Training 93

The system then displays the list of invoices for the specified patient. The following is an example of the invoice inquiry screen:

The display that defaults is a summary list of all open invoices on the patient’s account, including zero balance invoices. They display showing the most recent (newest) invoices at the top. The highlight bar is called a selector bar. It allows you to select invoices to perform further actions on, such as viewing the invoice detail.

At this screen, you can use action codes to perform additional inquiries or to reorganize the invoice display. The action codes automatically appear in the Invoice Inquiry screen, so you do not need to use the <F9> function key in order for them to display.

B/AR Charge Entry

UMCET Training 94

Parts of the Invoice Inquiry Screen The Invoice Inquiry screen is divided into 4 parts:

Screen Banner The screen banner shows the function you are signed into, in this case it is Invoice Inquiry, the group number, and the form and screen name.

Patient Header The patient header shows patient registration and insurance information for the patient you specified, such as their name, address, UMMG #, SSN, date of birth and Registration FSC list.

Invoice Summary The invoice summary screen displays 1-2 lines of summary information about each invoice, such as the sequential number on the patient account, the invoice number generated in BAR, the Service Date, the Patient Name, the physician, location, facility and billing area, the original charge amount, the current invoice FSC and the current invoice balance.

Most invoices will have one line of information. Two lines of invoice information will display for those invoices that have had a charge correction associated with it, a linked referral, a scheduling visit, or have a case tied to it.

The system will always calculate the total invoice balance due for the invoices displayed, even if the display changes.

Action Codes At the bottom of the screen, the system displays action codes, which are one character codes used to take further inquiries or actions on an invoice or invoices, or to reorganize or alter the invoice display.

B/AR Charge Entry

UMCET Training 95

Moving Around the Invoice Inquiry Screen To move around this screen, you can use several different keys:

Key: Description:

Up Arrow To move the selector bar up to the next invoice.

Down Arrow To move the selector bar down to the next invoice.

Page Down To view the next page of invoices.

Page Up To go back up a page at a time.

<Enter> To select an invoice. You can select more than one invoice at a time.

<F7><Q> To quit out of the invoice inquiry screen.

B/AR Charge Entry

UMCET Training 96

Invoice Inquiry Action Codes The following table contains a list of the valid action codes available in the Invoice Inquiry screen:


B-Zero Bal/Non-Zero Bal Removes invoices from the screen if they have a zero balance.

D-View Detail Displays details of the selected invoice(s).

E-Expand/Contract Will remove the second line of invoice display, if there is one, for those invoices with more than one line of information.

F-Guided Filter Views invoices matching specific criteria, such as all invoices in a self pay FSC for the department of Medicine.

I-More Inquiries… Displays additional action codes.

M-Multigroup Display Allows you to specify the groups for which you want to view invoices.

O-Oldest/Newest Toggles the order of the invoice display. The default shows the most recent invoices first. Use this action code to see the oldest invoices first.

Q-? Filter Lets you view invoices by using a command filter.

R-Reset Display Resets the display of invoices to the original default.

T-More Actions… Displays additional action codes.

All of these action codes will now be discussed in more detail.

B/AR Charge Entry

UMCET Training 97

B-Zero Bal/Non-Zero Bal This action code removes all the zero balance invoices from the invoice display. You can use the action code again to bring back all the zero balance invoices, or use the Reset action code.

The following screen is an example of an invoice display with all zero balance invoices removed. Notice how the sequential number on the far left does not change.

B/AR Charge Entry

UMCET Training 98

D-View Detail Use this action code to view details about one or more specific invoices. The View Invoice Detail screen appears when using action code D from the Invoice Inquiry screen.

This screen contains patient identification information, invoice header information, all the invoice transactions, and more action codes. Use the up and down arrow keys to scroll through all the transactions on the invoice.

The transaction level information shows the date the transaction was posted, the date of service for charges, the CPT code or payment code and the corresponding description, the payment amount, the adjustment amount, the charge amount, the FSC, and the batch the transaction was posted in. Anything that affects the A/R will be logged as a transaction on the invoice, including charges, payments, adjustments, write-offs, etc. A transaction could also be a claim form prepared message which shows the date a claim form was produced for the invoice.

The description may also contain codes, such as the diagnosis code, the number of units, the modifier and tooth/surface codes.

Line item payment information will also display under each charge if the payment was posted line-item.

B/AR Charge Entry

UMCET Training 99

View Detail Action Codes There are further action codes in the View Invoice Detail screen:


C-All Charges View details of all the charges on the invoice.

I-More Inquiries… Allows you to access these additional inquiry action codes:

C-Case Inquiry Brings you into case inquiry, where you can view cases for a patient.

D-Dictionary Inquiry Enables you to inquiry into a BAR dictionary.

E-Employer Inquiry Used for Occupational Medicine employers only. We will not be using this action code.

F-Financial Inquiry Displays the financial inquiry screen for the patient. The screen shows insurance, self pay and unbilled balances for the patient.

M-Comments Displays the financial or general comments for a patient.

P-Patient Inquiry Brings you into Patient Inquiry (Function 49), where you can view appointment, referral, demographic, insurance, case and invoice information. Please refer to the Patient Inquiry training manual for more information.

R-Pricing Module Displays additional action codes which enable you to access inquiry activities within the Pricing Module.

M-More Invoice Header Information

View additional header screens, including rejection information.

O-Oldest/Newest Toggles the transactions from oldest to newest and vice versa.

T-Transaction Detail

View payment and rejection information of selected charges on an invoice.

B/AR Charge Entry

UMCET Training 100

E-Expand/Contract Action Code E-Expand/Contract is a toggle for the second line of information in the Invoice Inquiry screen. The default shows the second line of information about each invoice, if applicable. Using Action Code E will remove the second line of information to simplify the display. Using it again will bring back those lines it removed.

Below is an example where all the second lines of invoice information have been removed:

Notice how each invoice only has one line of summary information. At this point, you can also use Action Code R to Reset the display back to the default display.

B/AR Charge Entry

UMCET Training 101

F-Guided Filter Action Code F-Guided Filter will be a very useful tool. Since all of UMMG will be in BAR Group 3, the default invoice inquiry screen will show invoices for all departments the patient has been seen in. The Guided Filter will allow you to specify certain criteria and then it will filter out all the rest of the unwanted invoices.

For example, you may want to see all open invoices in the FSC of Self Pay for the department of Medicine. The Guided Filter will allow you to easily perform this task.

The following is a screen print of the guided filter form. It will prompt you for several different parameters for which you can filter the invoices by. You may choose multiple parameters to filter by. Press <F10> when the form has been completed.

B/AR Charge Entry

UMCET Training 102

Once you file the Guided Filter form, the Invoice Inquiry screen change to show only those invoices that meet the criteria you specified in the bottom form:

The system also will recalculate the total balance for the invoices that matched the criteria. At this point, you can use Action Code R to reset the display back to the default display.

B/AR Charge Entry

UMCET Training 103

I-More Inquiries Action Code I-More Inquiries allows you to access additional action codes:

B/AR Charge Entry

UMCET Training 104

The following table contains a description of all the action codes available in Action Code I-More Inquiries:


C-Case Inquiry Brings you into case inquiry, where you can view cases for a patient.

D-Dictionary Inquiry Enables you to inquire into a BAR dictionary.

E-Employer Inquiry Used for Occupational Medicine employers only. We will not be using this action code.

F-Financial Inquiry Displays the financial inquiry screen for the patient. The screen shows insurance, self pay and unbilled balances for the patient.

M-Comments… Displays the financial or general comments for a patient.

P-Patient Inquiry Brings you into Patient Inquiry (Function 49), where you can view appointment, referral, demographic, insurance, case and invoice information. Please refer to the Patient Inquiry training manual for more information.

R-Pricing Module… Displays additional action codes which enable you to access inquiry activities within the Pricing Module.

B/AR Charge Entry

UMCET Training 105

M-Multigroup Display This action code allows users who have security access to multiple groups, inquire into patient invoices in other BAR groups. The following is an example of the screen you will see when pressing Action Code M:

B/AR Charge Entry

UMCET Training 106

Indicate which groups you want to display patient invoices for and press <F10>. The system will then display all of a patient’s invoices for the groups specified. It displays them in numerical order, so Group 3’s invoices will display first and then Group 4’s, and so on. The system will total up balances for all invoices at the end.

Any group security restrictions that have been set up in Security Plus, will apply to inquiry access through this action code.

B/AR Charge Entry

UMCET Training 107

O-Oldest/Newest Action Code O-Oldest/Newest changes the order in which the system displays the invoices. The default display shows invoices with the most recent first and the oldest last. Action Code O will change the display to the oldest invoices first and the newest invoices last. Each time you use this action code, the system reverses the current order of the invoices.

The following is an example of the Invoice Inquiry screen after using Action Code O-Oldest/Newest. Notice how the first invoice on the patient’s account now displays first.

B/AR Charge Entry

UMCET Training 108

Q-? Filter This action code allows you to filter a list of invoices using one or more of the Invoice Inquiry commands, which are listed in the Appendix of this manual. It is similar to the Guided Filter in that it allows you to filter out unwanted invoices and only display those meeting certain criteria. However, you do have to know the particular command to use in order to use this action code. It also allows you to see additional information that is not available through the Guided Filter.

If you do not know the command to use, you can either refer to the appendix in the back of this manual, or you can use your Help key, <Shift><F5>, to get the list of commands on-line.

The following is an example of a ? Filter command:

This command, ?P=KRAD, is used to filter out all of Dr. Kramer’s invoices.

B/AR Charge Entry

UMCET Training 109

Press <F10> after entering the filter command and then the system will change the display to show all of Dr. Kramer’s invoices:

In order to reset the display, use Action Code R-Reset Display.

The system redisplays the Invoice Inquiry commands at the Filter Invoice prompt that you entered previously. If you use Action Code R-Reset Display, the system will not keep the previously entered invoice commands.

You can also string several commands together at one time, with no punctuation in between, i.e. ?P=KRAD?F=SEL, which will display all of Dr. Kramer’s invoices that are currently in a Self Pay FSC.

You can also type in the Invoice Lookup Command at the Invoice prompt in Invoice Inquiry.

R-Reset Display This action code is used to reset the Invoice Inquiry screen and return it to the original default display, where all invoices are showing in reverse chronological order. If you have used other action codes to filter the items on the screen, this action code will restore all of the original items to the default display.

B/AR Charge Entry

UMCET Training 110

T-More Actions Action Code T-More Actions displays additional action codes that enable you to perform additional actions and inquiries.

The following is an example of the 3 additional action codes:

B/AR Charge Entry

UMCET Training 111

T-More Actions Action Codes The following table describes each of the additional action codes available in the T-More Actions action code:


D-Demand Statements This action code enables you to reprint a statement for the patient. This action code performs the same function as the Demand Statement Activity. Say <Y> to Reprint? and specify the printer name.

L-Print Ledgers This action code enables you to print a patient ledger for the patient. A ledger is a hard copy of the entire patient’s account. Again, you need to specify the printer name to send it to.

You can select specific invoices to include in the ledger first from the invoice inquiry screen. Otherwise, the ledger will print all of the invoices on the patient’s account.

P-Patient Account Summary

This action code provides a summary of patient account information. The screen shows patient payments, account balances by FSC, statement summary information, statement messages, and statement dunning levels.

This action code has additional action codes at the bottom of the Patient Account Summary screen:

I-More Inquiries Accesses additional inquiry action codes, such as dictionary inquiry, case inquiry, patient inquiry, comments, etc.

S-Specify Groups Allows you to change the groups that are included in the Patient Account Summary screen.

V-View Payments Displays payment information by posting date and payment code. This screen has also has additional action codes which allow you to view invoice detail, perform a guided filter, go to the More Inquiries action codes, toggle between the Posting Date and the Bank Deposit Date, or Reset the display.

B/AR Charge Entry

UMCET Training 112

Module Summary After invoices enter the BAR application from TES, you can use Invoice

Inquiry to view them.

Using Invoice Inquiry, you can view invoice detail, patient account information, financial and general comments, payment information, fee schedules, case and package information, dictionaries, and financial information by FSC and by Group.

You can also use Invoice Inquiry to reprint a patient statement or print a patient ledger.

Invoice Inquiry can be accessed through Patient Inquiry, BAR Function 7, or Action Code Q in Function 2 or 4.

Action Codes are available in multiple levels within Invoice Inquiry and allow you to perform further inquiries or actions, or reorganize or alter the invoice display.

The default invoice display in Group 3 shows all invoices for the patient, for all UMMG departments, with the most recent invoices first.

The Guided Filter or ? Filter action codes will allow you to filter out unwanted invoices and view only those that meet your specific criteria.

Action Code D-View Detail will display all the transactions on an invoice, such as payments, claim form prepared messages, charges and adjustments.

B/AR Charge Entry

UMCET Training 113

Module 8 - BAR Charge Correction

Overview The Charge Correction Function allows you to edit an invoice in a BAR batch that has been processed by Night Jobs and closed. It is used to correct charges that have already gone from TES into BAR.

Charge Correction is done through Function 2 in BAR. All data entry of charges will take place in Function 1000-Transaction Editing System. However, there may be situations where the invoice needs to be corrected and it has already filed into BAR.

Charge Correction Process When you use Charge Correction to correct an invoice, the system uses the following process:

1. The system enters a credit into the invoice that is equal to the total debit balance of the invoice. The payment code for the credit is 97. This changes the total balance of the invoice to zero, so that dollar amounts on monthly reports are not affected by this invoice. The system also changes the FSC associated with the invoice to the Do Not Bill (DNB) FSC. It does this by posting payment code 70 to the invoice. This ensures that none of the transactions entered in the invoice will appear on any claims or statements.

2. The system then creates a reversal invoice. The reversal invoice is a duplicate of the original invoice, except that the dollar amounts for each transaction are negatives of the original values. This includes the Paycode 97 that was entered by the system in Step 1. This step cancels the individual transactions in the invoice. The system also assigns the reversal invoice to the DNB (Do Not Bill) FSC by posting payment code 70 to the invoice. This ensures that none of the transactions entered in the reversal invoice will appear on any claims or statements.

3. Finally the system places a copy of the original invoice into a new (unfiled) invoice, and displays this invoice on the Enter Charges screen. You can change the new invoice and file it, or you can press <F7><Q> to delete it without filing the information. If you file the invoice, the system gives it a new invoice number. If the original invoice contained any payments, you must first correct the payment through Function 4, then perform charge correction through Function 2, action code ‘C’ and file the new invoice. You must then use Delete Transactions to delete all transactions in the invoice. Then you can repost the payments. If any discounts or adjustments were calculated in the original invoice, they do not appear in the new invoice. The discounts and adjustments will be calculated again when you file the invoice.

After you have filed the new invoice through the Enter Charges screen, the system redisplays the Charge Correction screen so that you can correct another invoice.

B/AR Charge Entry

UMCET Training 114

Using Charge Correction Follow these steps to use the Charge Correction feature of BAR:

1. Access Enter Charges in BAR, through Function 2. The system will display the Batch Control Form.

2. Complete the batch identification fields and control totals.

3. Type <C> at the Action prompt and press <F10>. The system then displays the following screen:

4. Identify the patient and the invoice.

5. At the Comment field, enter a free-text comment explaining why the correction is being made.

6. Press <F10>. The system displays an informational message while it creates the reversal and the new invoices.

7. The system then displays the new invoice on the Enter Charges form. At this time, you can enter any changes and press <F10> to file the new invoice, or press <F7><Q> to quit and cancel the new invoice.

8. The system brings you back to the Patient prompt in order to perform another Charge Correction. If you are done, press <F7><Q> to return to the Batch Control Form.

B/AR Charge Entry

UMCET Training 115

Module Summary Function 2 is used for Charge Correction purposes.

Charge Correction must be used when invoices have been filed to BAR and need to be corrected.

Charge Correction will create a reversal invoice to negate the incorrect invoice for month end reporting purposes.

Charge Correction will also create a new invoice on the screen and allows you to make the necessary changes.

The new invoice will have a new posting date.

If the invoice being corrected already has payments, you must correct the payment first through Function 4, then correct the invoice through Function 2, Action Code ‘C’.

B/AR Charge Entry

UMCET Training 116

Practice Exercise 1. Using one of the invoices created and filed into BAR for your patient, perform a Charge

Correction and quit out of the new invoice. This might be used when charges have been entered for the wrong patient.

2. Using another one of the invoices created and filed into BAR for your patient, perform a Charge Correction and make changes to the new invoice and file it. This would be used when the encounter was entered with incorrect information in TES and never caught until after it was filed into BAR.

B/AR Charge Entry

UMCET Training 117

Module 9 - Posting Patient Payments

Overview This module will provide you with the necessary information in order to post patient payments made in the department, such as time of service payments, copays, and advanced deposits that might be included in your charge batch. Self pay charges that go out on a patient statement will be sent directly to the centralized self pay office, and be posted to the system by the self pay office. However, there will be situations where the patient is making a payment at the time services are rendered. That payment will be posted by the billing staff using a “payment on invoice” payment code or an “advanced deposit” payment code.

Payments are not entered through TES, because TES is a suspense file and you would not want your payments sitting in a suspense file. Payments need to be immediately reflected in the A/R. So we will be using real-time BAR functions to post all payments. If the charges have already been entered in TES and have also been extracted into BAR, you can post patient payments through Function 4-Post Receipts. Please refer to the Post Receipts manual for more information.

Some patient payments, such as copays, advanced deposits, or time of service payments received in the departments will not have charges entered into the system yet. Those types of payments, when posted to the system, will actually be creating the BAR invoice number and then charges will have to be linked to the same invoice through TES. All patient payments received at the time of service will be posted through Function 25-Front Desk, Activity 1-Check Out.

B/AR Charge Entry

UMCET Training 118

Payment Codes Payment codes are 2 digit codes that either increase or decrease your accounts receivable. In this particular situation, we are going to use 2 payment codes that will decrease the accounts receivable, because they are different types of patient payments.

In order to post these types of payments, there are 2 payment codes from the Payment Code dictionary, #2, you will need to know:

Payment Code: Description:

12-Patient Payment on Invoice Used to post copays, time of service payments, or any other payment received in the department for department charges.

14-Advanced Deposit Used to apply an advanced deposit payment to the system.

15-Copays Used to apply a managed care copay to the system. Usually a small, even dollar amount, i.e. $10.00.

B/AR Charge Entry

UMCET Training 119

Step by Step Process The following list is a step-by-step process of the procedure that should be followed when posting patient payments in the departments:

1. Enter Function 25-Front Desk, Activity 1-Check Out.

2. Complete the Check Out Batch Control Form by generating a batch number in the Batch field.

3. Enter the patient’s name and the encounter header information, like you would in TES. Bypass the procedure information by pressing <Enter> at the Procedure Code prompt. Check Out will not allow you to enter charges. All charges must be entered in TES.

4. Enter the appropriate payment type, and the payment amount. Press <F10> to file the invoice. Record the invoice number. Continue until all your advanced deposits are entered. Some of these batches may only have 1 advanced deposit in them.

5. Exit your batch in Activity 1 and then balance your batch using the Cash Drawer activity.

6. Sign into the TES Function, Function 1000. Enter Activity 1-Encounter/Transaction Entry. Complete your TES Batch Control Form and file it.

7. Enter the patient’s name and the encounter header information. While you are still in the encounter header, view the action codes by pressing <F9>. Select action code V-BAR Info.

8. Enter the BAR invoice number generated in Check Out and complete the rest of the encounter by entering in all the transactions from the voucher. File the TES encounter by pressing <F10>. If all the header information matches up with what was entered in BAR, the transactions entered in TES will be placed on the same BAR invoice with the payment.

Now let’s go through each of these steps in more detail.

B/AR Charge Entry

UMCET Training 120

Step 1-Enter Function 25-Front Desk The following is a copy of the BAR main function menu. Select Function 25 from the menu to access Check Out and press <Enter>.

Function 25 will only be used for posting payments made in the departments. Charges must never be entered through Function 25.

B/AR Charge Entry

UMCET Training 121

We will be using Activity 1-Check Out to post payments and Activity 2-Cash Drawer to balance Check Out payment batches.

The following is a copy of the Front Desk Activity menu:

Select Activity 1-Check Out to post payments.

B/AR Charge Entry

UMCET Training 122

Step 2-Complete the Batch Control Form You must complete the batch control form in Function 25 before it will allow you to enter any payments.

The following is a copy of the Batch Control Form in Check Out:

When the Batch Control Form is complete, press <F10> to file it and move to the Check Out screen.

B/AR Charge Entry

UMCET Training 123

Step 3-Enter the Patient and Header Information Fill out the patient information and the encounter/invoice header information, just like you would in TES. The screen is very similar to the TES Combination screen.

Skip over the Procedure Code fields (transaction information) by pressing <Enter> at the Procedure Code prompt. Your cursor should now be at the payment fields.

B/AR Charge Entry

UMCET Training 124

Step 4-Enter the payment information The following table describes the fields used to enter the payment information:

Field: Description:

Type “?N” To View, And Then Select The Appropriate Code

Enter the appropriate type of payment. Type <?N> to see a list of valid patient payment codes.

Payment Enter the amount of the payment.

Comment Enter a comment about the payment. This information will display in invoice inquiry. This field is usually used to identify the check number or the type of credit card.

Print Bill In the future, this field may be used to create a patient receipt off the system.

B/AR Charge Entry

UMCET Training 125

The following is a copy of the completed Check Out screen, including payment information:

Press <F10> to file the information. Record the invoice number. Continue with the rest of the patients until all payments in the batch have been entered.

B/AR Charge Entry

UMCET Training 126

Step 5-Exit and balance the batch Once you have entered in all the payments for the batch, type <F7><Q> to return to the Batch Control Form, and <F7><Q> again to exit the batch.

You must then balance the Check Out batch in Activity 2-Cash Drawer:

B/AR Charge Entry

UMCET Training 127

The following table describes the prompts in the Cash Drawer screen:

Field: Description:

Batch Enter the Check Out batch number you want to balance.

Number of Invoices Enter the total number of invoices created in the Check Out batch.

Advance Dep Units Enter the total number of advanced deposit payments, in units.

Co-Pay Units Enter the total number of copayments in the batch, in units.

Pmt on Invoice Units Enter the total number of payments on invoice, in units.

Advance Deposit $ Enter the total dollar amount of advanced deposits posted in the batch.

Co-Pay $ Enter the total dollar amount of copayments in the batch.

Pmt on Invoice $ Enter the total dollar amount of payments on invoice.

Controls OK? Say <Y> to have the system determine whether your batch is in balance with the control totals entered above.

Show Payment Detail For Enter <1> for Advance Deposits, <2> for Co-Pays, or <3> for Payments on Invoice. This will branch you to another screen and show all the payments entered in the Check Out batch for the payment type specified.

B/AR Charge Entry

UMCET Training 128

Field: Description:

Action Enter <X> to Exit the Batch once it has been balanced. Press <?> or <F12> to list other options available at the Action prompt.

B/AR Charge Entry

UMCET Training 129

Batch Actions The following table provides a list of options available at the Action prompt in the Cash Drawer screen:

Batch Action: Description:

Add/Edit Registration This action takes you to the Add/Edit patient Activity, where you can register new patient accounts, or edit existing accounts.

Budget Plans This action takes you to the Budget Plans Activity and allows you to add/edit budget plans, account statuses or dunning levels.

Delete Transactions This action takes you to the Delete Transactions form, where you can delete transactions from an open batch.

Exit Batch This action allows you to properly exit a payment batch and allows it to be processed by Night Jobs.

Financial Comments This action takes you to the Financial Comments screen, to add/edit a patient’s Financial Comments.

General Comments This action takes you to the General Comments screen, to add/edit a patient’s General Comments.

Hold Batch This action allows you to place a batch on hold and then exit the batch. Batches on hold will not be processed by Night Jobs. Out of balance batches will automatically be placed on hold.

Inquiry This action brings you into full Invoice Inquiry, where you can inquire into patient accounts.

B/AR Charge Entry

UMCET Training 130

Batch Action: Description:

Insurance Claim Request This action allows you to request an Insurance Claim form to print during the next run of claims.

Merge Invoices/Appointments

This action allows you to move patient appointments and invoices from one patient to another. Used for duplicate patient accounts, with pending appointments.

Move Invoices This action allows you to move invoices from one patient account to another. Used for duplicate patient accounts, with no appointments.

Print Batch Proof This action prints a batch proof detailing the transactions in a batch. A batch proof can be used to reconcile out of balance batches.

Statement Message This action allows you to request an itemized statement for the patient or enter a statement message for the patient’s next statement.

Temporarily Exit Batch Using this action to exit a batch will automatically bring up the same batch next time you enter Cash Drawer.

B/AR Charge Entry

UMCET Training 131

Step 6-Sign into TES, Function 1000, Activity 1 You now need to enter the encounters and transactions in TES. Access the TES Function, Function 1000 in the BAR main menu.

Press <Enter> to move to the TES activity menu.

B/AR Charge Entry

UMCET Training 132

At the TES Activity prompt, enter activity 1-Encounter/Transaction Entry.

Press <Enter> to move to the TES Batch Control Form.

B/AR Charge Entry

UMCET Training 133

Complete the TES Batch Control Form:

Press <F10> to file the TES Batch Control Form.

B/AR Charge Entry

UMCET Training 134

Step 7-Enter the patient and encounter header information Complete the TES Combination screen, by identifying the patient and entering the encounter header information from the voucher.

While your cursor is still in the header portion of the screen, press the <F9> key to display the header action codes.

Select Action Code V-BAR Info.

B/AR Charge Entry

UMCET Training 135

Step 8-Link the Invoice In order for the TES encounters and transactions to appear on the BAR invoice that was created in Function 2, you must link the invoice to the TES encounter using action code V-BAR Info.

Once you type <V> to access the BAR Info action code, you will be prompted with a bottom form:

The V-BAR Info action code has 2 places where you can link a BAR invoice:

Field: Description:

Existing BAR Charge Inv For Posting Use this field to link a TES encounter to an existing BAR invoice with charges on it.

Associated BAR UC Payment Invoice Use this field to link a TES encounter to an existing BAR invoice that has a payment on it. The invoice should have a credit balance.

B/AR Charge Entry

UMCET Training 136

If you know the number of the invoice, you can type it in the appropriate field. If you do not know the number of the invoice, you can type a <?> at the prompt to do a lookup to Invoice Inquiry for the specified patient.

For this example, we are posting a TES encounter to a credit balance invoice, so use the second field in the bottom form.

Complete the diagnosis fields and add TES transactions from the voucher. File the encounter using <F10>.

Finish entering the rest of the TES encounters and transactions in your TES batch. Return to the TES Batch Control Form to make sure your batch is in balance and exit the batch.

If all of the header information in the TES encounter match up with that on the credit balance invoice entered in BAR Function 25, then the TES transactions should end up on the same invoice during the nightly operations process.

B/AR Charge Entry

UMCET Training 137

Module Summary Patient payments cannot be entered through TES because TES is a

suspense file and you want your payments entered into your A/R right away.

Patient payments must be entered into Function 25/Activity 1 and should be done before you enter charges in TES.

Once the credit balance invoice is created in BAR, you can link it to the TES encounter by using action code V-BAR Info in the header or transaction level of the TES combination screen.

The BAR invoice with the payment on it must be entered at the field called Associated BAR UC Payment Invoice.

Once the TES encounter is filed into BAR, the invoice will show both the payment and the charges in Invoice Inquiry.

B/AR Charge Entry

UMCET Training 138

B/AR Charge Entry

UMCET Training 139

Module 10 - Appendix

B/AR Charge Entry

UMCET Training 140

Function Keys Function Keys when using a PC (Personal Computer)

Fixed Screen Functions (most fields)

Action Description <F7> <C> Deletes field group <F7> <P> Enables user to choose another screen/page <Enter> Enters data and moves cursor to next logical field <F7> <Q> Exits form without filing data <F10> Files data and exits form (O-kay) <F7> < > Moves cursor to last filed on a page or group < > Moves cursor to previous filed on page <F8> Toggles insert mode; enables user to insert text

Generic Key Functions

Action Description <Insert> Copies a column in the custom report formatter [Insert] <F4> Deletes character at cursor [Erase Char] <F1> Deletes content of current field [Erase Field] <Shift-F3> Displays function keys [More Keys] <Shift-F5> Displays help message [Help] <Shift-F2> Displays list of options [List] <Tab> or < > Jumps to next field on page <Page Down> Jumps to next page in a form or next screen of items in a selector

list [Next Page] <Page Up> Jumps to previous page in a form or previous screen of items in a

selector list [Prev Page] <F7> < > Moves cursor to first field on a page of group [First Field] <Shift-F4> Moves cursor to next major field on screen [Major] <HOME> Moves highlight bar to an item in a selector list [Find] <Shift-F11> Redraws garbles screen [Refresh Screen] <F2> Restores current field [Restore Field] <End> Selects an item in a selector list [Select] <Shift-F6> Selects and files an item in a selector list [Do]

Miscellaneous Key Functions

Action Description <=> Brings up the last provider you were working with <T> Inserts today’s date <T> - / + number of days

Inserts today’s date plus or minus number of days

B/AR Charge Entry

UMCET Training 141

Scrolling Prompt Functions

Action Description DEL Delete contents of current field ? Displays a list of options GO field number Enables user to jump to other fields in form <Enter> Enters data and moves cursor to next logical field STOP Exits from without filing data

Word Processing Functions

Action Description <F7> <J> Connect current line and next line <F4> Delete character at cursor [Erase Char] <F1> Delete current line [Erase Line] <F3> Delete to end of next word [Erase Word] <F7> <Q> Exit form without filing data <F10> Finish editing and jump to next field inform <F9> Insert blank line above cursor <F7> <=> Jump to beginning of line <F7> <-> Jump to end of line <F7> < > Move cursor to last field on a page or group <F7> < > Scroll back length of field <F7> <H> Scroll to first line of field <F7> <E> Scroll to last line of field <F7> <C> Search again for same text <F7> <S> <F7> <S> Search for specified text <F7> <L> Show number of lines in field <Tab> Space to next tab position <F7><B> Split line at cursor <Enter> Start new line of text <F8> Toggle insert mode; enables users to insert text

B/AR Charge Entry

UMCET Training 142

Patient Lookups The table below outlines the methods which may be used to retrieve a patient at any Patient: prompt:

Patient Lookups LOOKUP FORMAT EXAMPLE

Patient’s Full Name Last Name,First Name Doe,John Patient’s Last Name Last Name Doe Partial Name First few letters of the patients first and

last name Do,Jo

Partial Name;DOB First few letters of the patient’s last name, first few letters of the patient’s first name, a semicolon and the year of birth

Do,Jo;70

Partial Name;DOB;Sex First few letters of the patient’s last name, first few letters of the patient’s first name, a semicolon and the year of birth, semicolon, and sex

DO,JO;70;M

Partial Name;;Sex First few letters of the patient’s last name, first few letters of the patient’s first name, two semicolons, and sex

DO;;M

Social Security S followed by the patient’s social security number

S123456789

UMMG Account Number M followed by the patients account number

M9876543

Alias The name entered at the AKA prompt DOE,JUAN Soundex First few letters of the patient's last and

followed by a ? DOW,JON?

Recall last displayed patient

R R

B/AR Charge Entry

UMCET Training 143

Entering Dates The system accepts dates entered in any one of the following formats. The table below outlines the methods used to enter a date.

Ways to Enter the Date Symbol Definition/Example

MM/DD/YY 02/01/96 MM/D/YY 02/1/96 MM.DD.YY 02.01.96 MM-DD-YY 02-01-96 T Today’s date T-n Where “n” is a number of days in the past

Example: T-7 = today minus 7 days T+n Where “n” is number of days in the future

Example: T+7 = today plus 7 days

Entering Time Enter time into the system in any one of the following formats:

Ways to Enter the Time Symbol Definition/Example

HH:MMAM 8:00AM HHAM 8AM HH:MMPM 3:00PM HHPM 6PM Military Time 1300 N If entering data at 11:01am - 11:01am will be the recorded time

B/AR Charge Entry

UMCET Training 144

List of TES System Edits Edit #: Description: How to Correct: Applicable

Departments:

2 Missing UPIN Number for Referring Physician

Check voucher for UPIN # or call Referring Physician for # if not available. Complete Referring Physician screen to notify IS. Once IS updates dictionary, encounter will be released to BAR.

All

3 Procedure Gender Mismatch

Procedure code does not match sex specific rules. Check procedure code on voucher and verify patient gender. Once procedure code or patient gender has been updated, encounter is released to BAR.

All

4 Missing Referring Physician

A referring physician is required for this procedure. Check voucher for referring physician name. Check patient chart. Be sure to also include UPIN #. Complete Referring Physician screen if not in dictionary. Once encounter and/or dictionary is updated, it will be released to BAR.

All

5 Missing City State Indicates patient’s city and state is missing from patient registration. Review patient chart for missing information. If not available, contact patient. Once address is updated, encounter will be released to BAR.

All

B/AR Charge Entry

UMCET Training 145

Edit #: Description: How to Correct: Applicable

Departments:

6 Missing Subscriber Name

If the patient is not the insured, then a Subscriber name is required for the claim form. Check patient’s chart for appropriate subscriber information. If not available, contact patient’s insurance company. Once patient’s insurance record is updated in the system, encounter will be released to BAR.

All

7 Diagnosis is Missing

A diagnosis code is required with the encounter. Check voucher for ICD-9 code and ICD-9 manual, if necessary. If not available, check with Rendering Physician. Once encounter is updated, it will be released to BAR.

All

8 Missing Provider Medicare Number

If this edit is received, the provider does not have the appropriate Medicare billing code completed in the dictionary. Contact Third Party Reimbursement and ask them to complete the on-line Provider Maintenance form. Once IS updates provider dictionary entry, encounter will be released to BAR.

All

9 Missing Provider Medicaid Number

If this edit is received, the provider does not have the appropriate Medicaid billing code completed in the dictionary. Contact Third Party Reimbursement and ask them to complete the on-line Provider Maintenance form. Once IS updates provider dictionary entry, encounter will be released to BAR.

B/AR Charge Entry

UMCET Training 146


Departments:

11 Diagnosis Gender Mismatch

Indicates patient gender does not match the diagnosis code. Verify voucher and patient’s chart. If information is still correct, contact rendering physician for correct diagnosis code. Once gender or diagnosis code is updated, encounter will be released to BAR.

All

12 Rendering Provider Missing

Indicates transaction is missing the provider’s name. Check voucher for provider number or name. If not indicated on voucher, contact division to obtain physician from medical record. Once physician name is added to transaction, encounter is released and sent to BAR.

All

13 Diagnosis Age Mismatch

Indicates that the patient age is not valid for the diagnosis code. Check voucher for correct diagnosis code and check patient chart for correct date of birth. Verify diagnosis with rendering physician, if necessary. Once information is updated, encounter is released to BAR.

All

14 Radiology Department Parameter

Indicates missing department parameter information. Check voucher. If Billing Area = RAVI, then enter a corresponding department parameter of VASP.

Radiology

B/AR Charge Entry

UMCET Training 147


Departments:

15 Departmental Parameter Missing

This edit is for the departments which require a department parameter to be entered with each encounter. Once information is updated, encounter will be released to BAR.

Anesthesia, Medicine, Radiology, Ophthalmology, Neurosurgery, Pediatrics, and Surgery.

16 Anesthesiology Dept Parameter

For the department of Anesthesia, if the Billing Area=ANOR, one of the following department parameters is required: MAIN OR, TRAUMA OR, TOWER OR, AMB OR, OR OB, LABOR OR, CLINIC PAIN, CLINIC PAIN BEDSIDE, TICU ICU, RECOVERY PACU, SICU ICU, RECOVERY TACU or CLINIC PERIOP. Once information is updated, encounter will be released to BAR.

Anesthesia

17 Medicine Dept Parameter

For the department of Medicine, if the Billing Area=MGEN, one of the following department parameters is required: ACC WEST, ACC EAST or NULL.

Medicine

18 Neurosurgery Dept Parameter

For the department of Neurosurgery, if the Billing Area=NSGE and the Provider=RAGH, then the department parameter must be ACC WEST.

Neurosurgery

19 Ophthalmology Dept Parameter

For the department of Ophthalmology, if the Billing Area=OPHT, then the department parameter must be one of the following: FRST, SCND, THRD or FOUR.

Ophthalmology


B/AR Charge Entry

UMCET Training 148

Departments:

20 Dr. Benenati Multiple Division

For Dr. Benenati, if the billing area = Medicine Allergy clinic, then the division must be medicine. If the billing area = Pedi Immunology, then the division must be Pediatrics.

Medicine, Pediatrics

21 Dr. Ofir Pedi Parameter

If the division is Pediatrics, and the billing area is Pedi Comprehensive health, and the provider is Dr. Ofir, and the charges are for the STEP Program, then the department parameter must be STEP Program. If charges are not for the STEP Program, then the department parameter must be equal to NULL.

Pediatrics

22 Pedi General Grant Account

If the division is Pediatrics, and the billing area is Genetics, and the facility is Mailman, and the charges relate to a grant, then the department parameter must be GRANT. If the charges are not related to a grant, enter NULL in the department parameter field.

Pediatrics

23 Pedi ADD Clinic Parameter

If the division is Pediatrics, and the billing area is Pedi HD Medicine, and the provider is Broscow, or Worley, or Hirshorn, and the charges are related to the ADD Clinic, then the department parameter must be ADDC. If the charges are not related to the Add Clinic, then the department parameter must be NULL.

Pediatrics

24 Dr. McIntosh Multiple Division

If the provider is Dr. McIntosh, and the billing area is MGEN, MCON, or MINS then the division must be equal to Medicine.


Edit #: Description: How to Correct: Applicable Departments:

B/AR Charge Entry

UMCET Training 149

25 Dr. Sosenko Multiple Division

If the provider is Dr. Sosenko, and the billing area is MGEN, MCON, or MINS, then the division must be equal to Medicine. If the billing area is Adolescent Medicine, then the division must be Pediatrics.


26 Dr. Moreno Multiple Division

If the provider is Dr. Moreno, and the billing area is MCIG, MNHS, or MINS, then the division must be medicine. If the billing area is OTOL, OTSA, or OTDM, then the division must be equal to Otolaryngology.

Medicine, Otolaryngology

27 Dr. Roth Multiple Division

If the provider is Dr. Roth, and the billing area is MNEP, then the division must be Medicine. If the billing area is STRP, then the division must be Surgery.

Medicine, Surgery

28 Dr. Shebert Multiple Division

If the provider is Dr. Shebert and the billing area is muscular disorder, then the division must be Neurology. If the billing area is Pathology Reference Service or Professional Services, then the division must be Pathology.

Neurology, Pathology

29 Rine PT Multiple Division

If the provider is Rine Therapist, and the billing area is Ortho Physical Therapy, then the division must be Orthopaedics. Or if the billing area is Pedi Physical Therapy, then the division must be equal to Pediatrics.

Orthopaedics, Pediatrics

B/AR Charge Entry

UMCET Training 150


Departments:

30 Surgery Dept Parameter

If the division is Surgery, the following billing areas require a corresponding department parameter: trauma, nutrition, oncology, thoracic, burn unit, pediatrics, general, transplant, oral, colo-rectal, vascular, or plastic.

Surgery

33 UMHC Place of Service

If the facility is UMHC, then the place of service must be 22 (outpatient) for the following procedure codes: 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214 and 99215.

All

34 Facility and Place of Service Conflict

If the facility is HSMB, KMCU, DAYS, DOMI, EDEL, JMTW, or PAC, then the place of service must be equal to 11.

All

35 FSC and Type of Injury Conflict

If the FSC is Work Comp, then the type of injury must be equal to WOR. If the FSC is ACC, then the type of injury must be equal to AUTO or OTHER. If the FSC is equal to CRI, then the type of injury must be OTHER.

All

37 Admission Date Discrepancy

Checks if service date is prior to admission date. Should verify dates with voucher, hospital system and medical record. Once date of service is corrected, edit will be released.

All

38 Discharge Date Discrepancy

Checks if service date is after discharge date. Should verify dates with voucher, hospital system and medical record. Once date of service is corrected, edit will be released.

All

B/AR Charge Entry

UMCET Training 151


Departments:

39 Facility Number Missing

Indicates that there is no Medicare Facility number in facility dictionary. Contact facility to obtain facility number and forward to IS. Once IS updates dictionary entry, edit will be released.

All

40 Month to Month Dates of Service cannot span over two months. Data entry must be separated by month.

All, except for Rad Onc and Radiology

41 Date of Birth Discrepancy

Indicates date of service is before patient’s date of birth. Verify date of service and patient’s date of birth and update. Once change has been made, edit will be released.

All

58 Ophthalmology Dept Parameter2

If the division is Ophthalmology, and the billing area is PALM, then the department parameter must be one of the following: PALM, ANCI, PBLASE, or PBSURG.

Ophthalmology

59 Ophthalmology Dept Parameter1A

If the division is Ophthalmology, and the billing area is OPHT-MIAMI, then the department parameter must be one of the following: CHILD, LASE, MINO, SURG, or ANCI.

Ophthalmology

60 Diagnosis Fifth Digit

If the diagnosis is marked incomplete in the dictionary, then it requires further specification by using a 5th digit code. Refer to the ICD-9 manual to obtain a more specific code. Used for Medicare or Medicaid.

All

B/AR Charge Entry

UMCET Training 152

List of IDX Divisions-Dictionary #102

Division Name: Division Number: Division Mnemonic:

PEDIATRICS 1 PEDI

SURGERY 2 SURG

OBSTETRICS & GYNECOLOGY 3 OBGN

OTOLARYNGOLOGY 4 OTOL

ORTHOPAEDICS & REHAB 5 ORTH

MEDICINE 6 MEDI

PSYCHIATRY 7 PSYC

UROLOGY 9 UROL

RADIOLOGY 10 RADI

FAMILY MEDICINE 11 FMED

RADIATION ONCOLOGY 12 RONC

EPIDEMIOLOGY 13 EPID

NEUROLOGY 14 NEUR

DIABETES RESEARCH 15 DIAB

COMPREHENSIVE PAIN & REHAB CTR 16 PAIN

COMPREHENSIVE OUTPATIENT REHAB FACILITY

17 CORF

DERMATOLOGY 18 DERM

OPHTHALMOLOGY 19 OPHT

ANESTHESIOLOGY 20 ANES

NEUROLOGICAL SURGERY 21 NSUR

PATHOLOGY 22 PATH

B/AR Charge Entry

UMCET Training 153

List of Facilities/Hospitals-Dictionary #101

Facility Name: Facility Number: Facility Mnemonic:

7000 BUILDING 1 SEVE

ANNE BATES LEACH EYE HOSP 2 ABLE

ATLANTIC SHORES HOSPITAL 3 ATLA

AVENTURA HOSPITAL-COLUMBIA 4 AVNH

BAPTIST HOSPITAL 5 BAPH

BASCOM PALMER EYE INSTITUE-PALM BCH

7 BPPB

BROWARD GENERAL MEDICAL CENTER 8 BGMC

CAC FLAGLER #30094 9 CACF

CAC SHERATON CENTER (BRWD) #1118 10 CACS

CAC SPECIALTY CENTER (HIALEAH) #1125 11 CASP

CAC SUNSET PEDIATRICS #1127 12 CACP

CAC WEST HIALEAH #1110 13 CACW

CEDARS MEDICAL CENTER-COLUMBIA 14 CMDC

CHRISTIAN HOME FOR THE ELDERLY 15 CHRH


16 CORF

CORAL GABLES HOSPITAL 17 CGBH

DAYSTAR HEALTH CENTER-UM 18 DAYS

DEBBIE SCHOOL CLINIC-UM 19 DEBB

DEERING HOSPITAL-COLUMBIA 20 DEER

DIABETES RESEARCH INSTITUTE-UM 21 DRI

DOCTORS HOSPITAL 22 DOCT

DOMINION TOWERS-UM 23 DOMI

EARLY DETECTION PROGRAM-UM (MOBILE UNIT)

24 EDPU

B/AR Charge Entry

UMCET Training 154


EDELMAN BUILDING-UM 25 EDEL

ELLIOTT BUILDING-UM 26 ELLI

FLORIDA MEDICAL CENTER 27 FLOR

GOOD SAMARITAN MEDICAL CENTER 28 GOOD

HEALTHSOUTH MEDICAL BLDG 29 HSMB

HEALTHSOUTH REGIONAL REHAB CENTER 30 HSRR

HEALTHSOUTH REHAB CENTER 31 HSRC

HIALEAH HOSPITAL 32 HIAL

HIGHLAND PARK HOSPITAL 33 HIGH

HOLY CROSS HOSPITAL 34 HOLY

HIS AT GREENBRIAR 35 IHSG

JACKSON MEDICAL TOWERS-UM 36 JMT

JACKSON MEMORIAL HOSP 37 JMH

JACKSON NORTH MATERNITY CENTER 38 JNMC

JUPITER MEDICAL CENTER 39 JUPI

KENDALL MEDICAL CENTER-COLUMBIA 40 KMCC

KENDALL MEDICAL CENTER-UM 41 KMCU

LARKIN HOSPITAL 42 LARK

LAS PALMAS HEALTH CENTER 43 LASP

LINDA RAY INTERVENTION CENTER 44 LIND

MAGNETIC RESONANCE CENTER-UM 45 MRC

MAILMAN CENTER FOR CHILD DEV-UM 46 MCCD

MEDICAL ARTS BUILDING 47 MAB

MEDICAL PARK DIAGNOSTIC CENTER 48 MPDC

MEDICAL SPECIALTIES BUILDING 49 MSPB

MEMORIAL HOSPITAL WEST 50 MHWT

MEMORIAL HOSPITAL WEST OFFICE BLDG 51 MHWO

MEMORIAL REGIONAL HOSPITAL 52 MEMR

MERCY HOSPITAL 53 MERC


B/AR Charge Entry

UMCET Training 155

MERCY PROFESSIONAL BUILDING 54 MERP

MIAMI CHILDRENS HOSP 55 MCHH

MIAMI HEART INSTITUTE-COLUMBIA 56 MHIN

MIAMI JEWISH HOME & HOSPITAL 57 MJHH

MOODY MANOR 58 MOOD

MOUNT SINAI MEDICAL CENTER 59 MOUN

NATIONAL PARKINSON FOUNDATION 60 NPF

NORTH SHORE MEDICAL CENTER 61 NSMC

OPALOCKA WOMEN’S HEALTH CENTER 62 OPAL

PALACE AT KENDALL 63 PALA

PALM BEACH NEUROLOGICAL GROUP 64 PBNG

PALM SPRINGS GENERAL HOSPITAL 65 PSGH

PALMETTO GENERAL HOSPITAL 66 PALM

PALMS WEST HOSPITAL-COLUMBIA 67 PAWH

PAPANICOLAOU RESEARCH BUILDING 68 PAPA

PARKWAY REGIONAL MEDICAL CENTER 69 PARK

PEDIATRICS MOBILE UNIT-UM 70 PDMU

PERDUE MEDICAL CENTER 71 PERD

PLANTATION GENERAL HOSPITAL-COLUMBIA

72 PLGH

PLASTIC SURGERY CENTER 73 PLAS

PLUMER BUILDING, 4TH FLOOR 74 PLUM

PROFESSIONAL ARTS CENTER 75 PAC

PROJECT OUTREACH-UM 76 PROJ

ROSENTIEL MEDICAL SCIENCE BLDG 77 RMSB

SAINT MARY’S MEDICAL CENTER 78 SAIN

SIERON BUILDING 79 SIER

SOUTH MIAMI HOSPITAL 80 SMHO

SOUTH SHORE HOSPITAL 81 SSHH


SURGICAL PARK-COLUMBIA 82 SURG

B/AR Charge Entry

UMCET Training 156

TRANSITIONAL HOSPITAL CORP 83 TRAN

TRINITY MEDICAL CENTER 84 TRIN

UMHC/SYLVESTER CANCER CENTER 85 UMHC

VENCOR HOSPITAL 86 VENC

VETERAN’S ADMIN MED CTR 87 VAMC

CAC GEN JEFFERSON REEVES HLTH CTR 88 CAGJ

SOUTH MIAMI CARDIOLOGY CLINIC 89 SMCC

HOLLYWOOD MEMORIAL HOSPITAL 90 HDMH

JMH REHABILITATION CENTER 91 JMRC

JACKSON MEMORIAL MENTAL HEALTH 92 JMMH

JFK MEDICAL CENTER 93 JFKM

AVENTURA MEDICAL CENTER 94 AVMC

REN CENTER/JACKSON MEDICAL TOWERS 95 RCJM

FLORIDA CLUB CARE CENTER 96 FCCC

WESTCHESTER GENERAL HOSPITAL 97 WRGH

NAPLES MEDICAL CENTER 98 NPMC

NORTH COLLIER HOSPITAL 99 NCLH

MAYO CLINIC 100 MAYO

DOCTORS HOSPITAL (BAHAMAS) 101 DCHB

HOLMES REGIONAL MED CTR 102 HRMC

ARNOLD PALMER HOSPITAL 103 ARPH

SACRED HEART HOSPITAL 104 SACH

LOWER KEYS HEALTH SYSTEMS 105 LKHS

AIKEN REGIONAL MED CTR 106 ARMC

ORLANDO REGIONAL HOSP 107 OBRH

PALM BAY COMMUNITY HOSP 108 PBCH

SHANDS HOSP AT UNIV OF FL 109 SHUF

MEMORIAL MEDICAL OFFICE CTR 110 MMOC

B/AR Charge Entry

UMCET Training 157

List of Place of Service Codes/Locations-Dictionary #100

Location Name: Location Code: Location Mnemonic:

DOCTOR’S OFFICE 11 DOC

PATIENT’S HOME 12 PAT

INPATIENT HOSPITAL 21 INP

OUTPATIENT HOSPITAL 22 OUT

EMERGENCY ROOM HOSPITAL 23 ERH

AMBULATORY SURGICAL CENTER 24 AMB

SKILLED NURSING FACILITY 31 SNF

NURSING FACILITY 32 NUR

CUSTODIAL CARE FACILITY 33 CCF

INPATIENT PSYCHIATRIC FACILITY 51 IPF

PSYCHIATRIC FACILITY PARTIAL HOSPITALIZATION

52 PPH


62 COR

INDEPENDENT LABORATORY 81 LAB

OTHER UNLISTED FACILITY 99 OTH

B/AR Charge Entry

UMCET Training 158

Invoice Lookup Commands Module 7 of this manual talks about using invoice lookup commands for the ? Filter action code, or at any Invoice prompt. The following tables will provide you with a list of all the possible invoice lookup commands.

There are 5 types of commands that you can enter:

Case Level Commands These enable you to display information about cases.

Account Level Commands These enable you to display information about patient accounts.

Invoice Header Level Commands These enable you to select and sort invoices by criteria from the fields in the invoice header.

Transaction Level Commands These enable you to select and sort invoices by criteria that you choose from transaction fields.

Selection Criteria Commands You use these commands to modify other commands.

You can only use the account level commands by themselves. You can, however, use all of the other commands in combinations. To combine commands, list them one after the other with no spaces or punctuation between them. When you combine commands, the system selects invoices that meet all of the specified criteria. In most cases, you will enter commands one at a time.

You can also specify ranges for some of the Invoice Inquiry commands. For example, ?S=1/1/96:3/1/96. This command causes the system to display an account’s invoices that have service dates between January 1, 1996 and March 1, 1996. The colon (:) separates the two dates in the range.

B/AR Charge Entry

UMCET Training 159

Case Level Commands

To Display: Use the case level command: Description of Command

A summary of cases ?X Displays a summary of all cases in the account.

A summary of invoices in a case

?X=nnn Displays invoices assigned to case #nnn

A summary of packages and cases

?XP Displays all packages for the patient and the cases to which they are assigned.

A summary of cases with a specified MRN

?XMRN=nnnnnnnn Displays all cases for which the patient’s MRN is #nnnnnnnn.

A summary of cases with a patient name

?XPAT=name Displays all cases for which the patient’s name starts with name.

A summary of open cases

?XO Displays a summary of open cases.

A summary of closed cases

?XC Displays a summary of closed cases.

The number of open and closed cases

?XN Displays the number of open and closed cases.

Details about a case ?XD=nnn Displays details for case number nnn.

B/AR Charge Entry

UMCET Training 160

Account Level Commands

To Display: Use the account level command:

Description of Command

Account data across groups in a multi-group system

?M Displays the account’s balance for all groups in a multi-group system.

You must have security access in order to see account balances in other groups.

Account payment and statement history

?PA Displays the account’s payment and statement history, including a summary of the last 10 patient payments. And it can also display a separate summary of all payments.

The system will display the prompt Payment Summary? Enter Yn to display a summary of all payments posted in the last n days, or enter Y* to display a summary all payments.

Account Registration Data

?R Displays a summary of the account’s registration data.

A statement reprint ?ST Replicates a previously-produced patient statement.

The insurance table ?VF Displays the FSC table for the patient.

The patient’s financial data

?VFD Displays the same information as ?VF, only shows more detail.

PCS History ?PCS Displays the patient’s PCS history.

B/AR Charge Entry

UMCET Training 161

Invoice Header Level Commands

To Display: Use the invoice level command:


Invoices by entry number

nn Displays entry number nn from a list of invoices on the screen.

Invoice by invoice number

nnnnnn Displays invoice number nnnnnn.

All invoices Press <F12> or <?>

Displays all the account’s invoices from newest to oldest.

Invoices by dollar amount

?$$=dd.cc Displays the account’s invoices with the specified total charges, where dd is the number of dollars and cc is the number of cents. You can specify a range of dollar amounts by separating the amounts with a colon.

Invoices by admission date

?A=mm/dd/yy Displays the account’s invoices with the specified admission date. You can specify a range of dates by separating the two dates with a colon.

Invoices by discharge date

?D=mm/dd/yy Displays the account’s invoices with the specified discharge date.

Invoices by billing area

?B=ba Displays all the account’s invoices for the specified billing area, where ba is the full name, number or mnemonic of the billing area.

Invoices by invoice balance

?BAL or ?BAL=dd.cc

Displays the account’s invoices with an unpaid balance. ?BAL will display invoices with any unpaid balance, including credit balances. ?BAL=dd.cc will display invoices with the specified balance. You can also specify a range for the ?BAL=dd.cc command by entering a beginning and ending dollar amount, separated by a colon.

Invoices by discounts ?D or

?D=% amt

Displays the account’s invoices with a discount. ?D will display invoices with any discount percentage and ?D=% will display invoices with the specified percentage.

Invoices by FSC ?F=FSC# Displays the account’s invoices in the specified FSC, where FSC# is the number of the FSC. You may display invoices for several FSCs by separating the FSC numbers with commas.

B/AR Charge Entry

UMCET Training 162

To Display: Use the invoice level command:


Invoices by Hospital/Facility

?I=hosp/fac Displays the account’s invoices for the specified facility, where hosp/fac is the full name, number or mnemonic.

Invoices by Location ?L=loc Displays the account’s invoices for the specified location or Place of Service, where loc is the full name, number or mnemonic.

All open invoices ?O Displays the account’s open invoices from oldest to newest. Open invoices are those created in the current accounting period for which a claim has not yet been produced.

Invoices by Provider ?P=prov Displays the account’s invoices for the specified provider, where prov is the provider’s name, number or mnemonic.

Invoices by accounting period

?PD=yymm Displays the account’s invoices that were created in the specified period, where yy is the year and mm is the month. You can specify a range for this command by separating the accounting periods with a colon.

All invoices in reverse chronological order

?U Displays all the invoices from newest to oldest.

Invoices by service dates

?S=mm/dd/yy Displays the account’s invoices for the specified service date. You can specify a range of dates by separating the two dates with a colon.

Invoices by division ?DIV=division Displays the account’s invoices for the specified division, where division is the name, number, or mnemonic of the division.

B/AR Charge Entry

UMCET Training 163

Transaction Level Commands

To Display: Use the transaction level command:


Invoices with transactions in a specified batch

?BN=batch # Displays the account’s invoices with transactions in the specified batch number. You can also enter a range of batch numbers.

Invoices with a specified transaction comment

?TC=comment Displays the invoices that contain the specified transaction comment.

Invoices with a specified payment code

?TP=paycode Displays the account’s invoices with the payment code you specified.

Invoices with transactions in reverse chronological order

?TU Displays the transactions in reverse chronological order. This command is useful when looking for certain payments within an invoice. You can also specify transactions in a single invoice by entering ?TU=invoice number, where invoice number is the number of the invoice whose transactions you want to display in reverse chronological order.

Invoices with activity on a specified bank deposit date

?TDEP=date Displays the account’s invoices that contain at least one transaction with the specified bank deposit date.

Invoices with specified overriding procedure code descriptions

?TDES=

description

Displays the account’s invoices that contain overriding procedure code descriptions with the specified description.

Invoices with a specified procedure code

?TPX=

procedure code

Displays the account’s invoices with a specific procedure code.

B/AR Charge Entry

UMCET Training 164

Selection Criteria Commands

To Display: Use the case level command:


Save a selection command string

?.S Saves the command string so you can reuse it (with the ?.R command) at subsequent Invoice prompts. This command is particularly useful when you are looking up the same types of invoices for multiple patients. For example, ?F=21?.S saves the ?F=21 command. The saved command string remains in effect until you save a new string or you exit from the activity.

Repeat a selection command string

?.R Repeats the string that was last saved with the ?.S command. You may use this command by itself or in combination with other commands.

Display selection command string

?.D Displays the string that was last saved with the ?.S command.

b/ar charge entry - university of miamicet.med.miami.edu/documents/bar charge entry 4.0.pdf · b/ar...

Documents