Category: Billing

Posts pertaining to billing, remittance, coding, etc.

Billing Codes

Kayce Cole
Billing CodesCode Groups
PM_BillingCode

  1. Code – This is the actual code. Numbers, letters, special characters. Do not include modifiers with this code.
  2. Description – This description shows up when looking up codes and on some reports.
  3. Code Type – Chart Talk supports many different code types ICD10, SNOMED, CPT, GCodes, LOINC, or your custome office codes.
  4. Charge – This value is only valid for GCodes CPT codes. (In the future this may be enabled for codes of type SNOMED if payers begin accepting SNOMED procedure coding in a pay-for-service model)
  5. Do Not Bill – Short for ‘Do Not Bill Insurance.’  Codes marked with ‘Do Not Bill’ can be added to visit records and included on charges but will not be included on any 1500 or submitted electronically to insurance.  The code will be included in the DOS and assigned immediately as patient responsibility.
  6. Is Taxable – This box will apply the tax rate (Set on the Clinic Setup configuration) to the charge.  This box if frequently used with charges set as ‘Do Not Bill.’

CPT Codes for Chiropractors
The American Medical Association (AMA) holds copyright and maintains all CPT codes. CPT codes are used to describe all medical procedures a provider performs on a patient. The CPT code informs the insurance company that the provider wants reimbursement for these procedures. Each CPT code contains five characters, which are numeric or alphanumeric, based on CPT code category. While there are three categories of CPT codes, most chiropractic providers primarily use Category I codes, which correspond to specific services or procedures. There are also two character modifiers attached to certain codes used to clarify any descriptions.

The AMA releases updated versions of CPT codes each October. Codes, even common ones, may change from year to year. Providers receive notification that such codes are scheduled to change in advance. Service providers must pay licensing fees to obtain code access.

A provider should complete a license request form with the AMA to recieve CPT code lists for that year. Transcribe the necessary codes manually into Chart Talk and a CPT code lookup is simple.
Lorem

Code Groups simplify entering multiple diagnosis or service codes. Select the Group option above the selected table and select the proper group. The codes will be added to the table if it is empty or appended to the existing list. You can delete individual codes or rearrange the codes after they are entered into the table.

Code groups can only have one category of code in them like ICD-10 for example.

Creating and Using Groups

Visits

Kayce Cole

PATIENT VISIT LIST SCREEN

Lists all Patient Visits in descending order.

Use the selection box to select and print multiple SOAP notes without needing to open the screen.

If claim staus is BLANK then Visit has not been marked complete.

Active Delete functionality (Trash Bin Icon) is available based on user role permissions. Edit (Pencil Icon) opens record for review and editing.

Chart Talk Visits Screen update 2024.02.24

Header/Basic Information

This information is brought forward from the last encounter.
basic soap info

  1. Date – Date of service (DOS) can be edited. Does not need to be the same as appointment date record is associated with.
  2. Date of Onset – Will be included with billing for DOS
  3. Visit Type– Visit Type is used to manage different cases for individual patients. A patient can have Dx, SOAP, and Procedures associated different visit types. When you use ‘Get Previous’ commands, Chart Talk will import information from the previous encounter of the same visit type.
  4. Payer Name- Allows you to select the preferred payer for that DOS and visit type. This will direct the billing to the selected payer, even if it’s not their primary.
  5. Alerts – Displays text when scheduling appointments for patient
  6. Message – Follows patient. Displays contents of the Notes field on Patient General Information
  7. Seen by – Provider seeing patient. NPI will be associated for billing.
  8. Claim No.- Insurance claim number associated with case
  9. Accident Reason – Enabled only when Visit Type has property “is Accident”
  10. State – Enabled only when Accident Reason is Auto

 

SOAP Body

SOAP SMART Command – Right Click on any S,O,A,P field to ‘Get Previous’ results from the immediate prior visit of the same Visit Type. On iOS,, tap the field labels to ‘Get Previous’
tools-visit-2

  1. Subjective – Related Posts: Patient Reminders, Chief Complaint Form
  2. Objective
  3. Assessment
  4. Plan

Billing Information

*CODE GROUPS: Please see page How to Create and Use Code Groups to find out more about this feature.

billing info

  1. Add Dx – Button opens the Add Dx tool. Dragging list items will reorder Dx list. Top Dx is Primary Dx.
    1. Code
    2. Description
  2. Add CPT – To modify an existing procedure delete the item and add again
    1. Code
    2. Description
    3. Units
    4. Modifier
    5. Rate
  3. Exam Checkbox – Tick if exam performed on DOS
  4. XRay Checkbox – Tick if XRay exists corresponding to DOS

Completing Documentation

Save.complete bar1

View 1- prior to completing the visit, user will only have the above 4 options

  1. Floating Save, Save and Complete, Cancel, Compare button group
    1. Save- saves the SOAP without completing the visit or creating the charge
    2. Save & Complete – One click will: Mark visit complete and create charges for visit
    3. Cancel
    4. Compare – View three consecutive SOAP notes sided by side

save.complete bar2

View 2- after completing the visit, user now has additional choices

  1. Floating Save, Cancel, Compare, Print, Add Patient Signature button group
    1. Save- saves any changes made within documentation portion of the SOAP
    2. Cancel
    3. Compare – View three consecutive SOAP notes sided by side
    4. Print- Prints the SOAP notes
    5. Add Patient Signature- Prompts a pop up for adding a patients signature directly to that SOAP

 

get previous

Smart Commands

Can be accessed by right clicking any text field

    1. Previous Subjective – Overwrites subjective field with value of previous subjective field of the same visit type.
    2. Previous Objective – Overwrites objective field with value of previous objective field of the same visit type.
    3. Previous Assessment – Overwrites assessment field with value of previous assessment field of the same visit type.
    4. Previous Plan – Overwrites plan field with value of previous plan field of the same visit type.
    5. Previous SOAP – Overwrites all SOAP fields with value of previous SOAP fields of the same visit type.
    6. Active Meds – Appends a list of active medication where the cursor is located.
    7. Vitals – Appends a list of most recent vital values blood pressure, height, weight, and BMI where the cursor is located
    8. Allergy – Appends a list of active allergies where the cursor is located.

Charges

Judy Barnes

    Filters- use to search for specific visit(s) in the ‘Charges Screen’

  1. Insured/Non Insured – Display list for patients with insured type primary payers/Display list for patients with non-insured type primary payers
  2. Charge ID
  3. Last Name, First Name

    4. Actions

  4. Filter – Apply filters
  5. Reset – Clear all filters
  6. Process for billing – Process selected claim(s) for billing

    7. Data Columns

  7. Expand details
  8. Charge ID
  9. Visit Time
  10. Duration
  11. Patient Name- click it will bring you to the patients dashboard
  12. Staff Name/ Seen by
  13. Payer Name
  14. Trash Bin – Delete charge and reset appointment status or process single charge to billing.

Clinic Dashboard

Judy Barnes

  1. Filter – By Patient Last Name, First Name
  2. Filter –  By Provider
  3. Filter – Date of Service
  4. Clear – Resets Search Values
  5. Today- Will bring you back to present day
  6. Left Arrow- Navigate to previous dates
  7. Right Arrow- Navigate to future dates
  8. New Patient (walk in or phone – quick access to add new patient to database)
  9. New Appointment
  10. Appointment Time – Clicking time takes you directly to SOAP note
  11. Patient Name- Clicking Patient name takes you directly to their general information page.
  12. CC- Chief Complaint- Click K to launch, once finished a green check mark will appear
  13. Type – Appointment Type
  14. Provider
  15. Status – Appointment Status
  16. Room – Designated area for appointment
  17. Action Button – Accept Copay (Can only be used when appointment status is ‘In Clinic’)

Column Sort – If you click the header in any of the columns, the view will sort alphabetically/numerically. If you click again, the sort will be reversed. This is to allow users the freedom to navigate more easily to where they would like to be.

Clearing Houses

Judy Barnes

pm_clearinghouse

    Connection Details

  1. Clearing House Name
  2. Sender Id- Clearinghouse specific
  3. Receiver Id- Clearinghouse specific
  4. Interchange qualifier- Clearinghouse specific
  5. FTP URL- Set up by clearinghouse
  6. FTP Port- Set up by clearinghouse
  7. FTP UserName- Set up by clearinghouse
  8. FTP Password- Set up by clearinghouse

    9. FTP Folder Setup

  9. Submit Claim To- Folder for 837
  10. Read Ack From- Folder for 999
  12. Read Resp. From- Folder for 835

    13. Other

  13. Default for Batch Submit-
  14. Set Test Account- Works for Office Ally to test claims

Manage Payments

Judy Barnes
*Tabs for Cards on file and Guarantor Payments not pictured
  1. Launch Accept Payment Tool
  2. Issue a charge for product or service without creating a DOS record
  3. Shows current account summary
  4. Original Charges Tab
    1. DOS – date of service/appointment
    2. Date billed – date the claim was generated for the DOS
    3. Total Amt – The sum total of the services and procedures for claim
    4. Ins owes – the sum amount of all charges not marked as patient responsibility
    5. Patient Paid – the sum amount of copayments and payments and adjustments  from the patient or a patient guantor
    6. Insurance Paid –  Amount auto posted or entered that has been marked a Payer as the payment source.
    7. Ins Adj – Amount attriubeted to Payers that is either marked adjustment or write off
    8. Pt Owes – Sum amount of claims totals marked as patient responsibility.
    9. Balance
    10. More Info – View/edit details of the specific transaction
  5. Cash Charges Tab (see below)
  6. APT Payments Tab (see below)
  7. Payment History (see below)

5. Cash Charges Tab

The Cash Charges Tab lists all sales made using the Cash Charges Tool.

    1. Date of Sale
    2. Total Amt
    3. Ins Owes – OBSOLETE
    4. Patient Paid –
    5. Ins Paid
    6. Ins Adj
    7. Pt Owes
    8. Balance
    9. Action – More Info – View/edit details of the specific transaction

6. APT Payments

View edit payments accepted and applied using the Accept Payment Tool (APT)

Column b – j show the payment details including total a,mount accepted and total amount applied from the payment. Expanding this row shows the itemized breakdown (columns k – o) of how the payment was applied.

    1. Filters
    2. Hide/Unhide Details
    3. DOP – Date of Payment. Date the payment was accepted
    4. Payment Type
    5. Amount – Total amount of payment
    6. Paid Amount – total of the funds from the payment that have been applied to patient charges
    7. Payer
    8. Guarantor
    9. Edit payment
    10. Print payment receipt
    11. Delete payment – A payment cannot be deleted if any of the transaction has been used to pay patient charges.
    12. DOS – Date of service payment was applied to
    13. Date of payment
    14. CPT Code – code payment was applied to
    15. Amount – money that payment was applied to
    16. Delete payment – Deleting a payment here will return Amount to the patient account credit balance.

To apply payments from an entry with a blanace, click the Dollar Bill icon. You are presented with a selection of non-zero dollar charges for the selected patient and anyone they are the guarantor for.

APT Payments can be applied to the patient and anyone the are linked to as being the guarantor for.

7. Payment History

Payment applied using the more info tool, insurance check entry tool, or Auto Posted are listed on this tab

    1. Date of Service
    2. Date of Payment
    3. CPT
    4. Amount
    5. Payment Type
    6. Payer (if Insurance payment)
    7. Guarantor (If patient/guarantor payment)
    8. Notes
    9. View/edit details
    10. Delete payment

8. Guarantor Payments

Lists all payments that were applied to patient account using funds from a transaction made by someone other than the patient. Deleting the payment on this tab will return the funds to the guarantors credit balance.

9. Cards on File

    1. Cards on file – Only one can be active at a time.
    2. Add – Add a new card on file record
    3. Actions – Edit or delete a card on file.
    4. Guarantors – Any guarantors linked to other patient accounts show up here. If the Guarantor information is entered without linking to a patient, the information is not conveyed in this table.

1. Accept Payments Tool

Take a single payment from a patient and apply it to multiple outstanding charges. Payments made with the APT that are not applied to a charge are added to the Patient Account Credit balance.
*The APT applies payments using the oldest funds available first.

  1. Who Paid – Lists all payers and guarantors.
  2. Description – Will always be Payment
  3. Pay/Adj/Code – Cash, Check, or credit card
  4. Open Balances – the sum of all selected charges from the box below
  5. Charge selection – all charges with non-zero balance set to ‘Patient Responsibility’. Chacking the box will apply payments to the charges from oldest to most recent
  6. Patient Account Balance – Available funds from prepay/credits on the patient account
  7. Check # Auth – A field to enter CC transaction info or check number
  8. Amount – Total of transaction
  9. Notes – Open text field
  10. Save button – Apply the payments from 1 – 10 to the selected charges
  11. Apply From Balance – If applying from a balance then only charges need to be selected. Boxes 1-4 & 6 – 10 not necessary.
More on the Accept Payment Tool
  • If you accept payment greater than the sum from field 4, the balance is applied to Patient Account Balance
  • If you accept a payment without selecting any charges, funds will be allocated to Patient Account Balance
  • After you save or Apply From Balance, you will be asked if you want to print a reciept.
  • All the details from boxes 1 – 10 will be listed when you examine individual claims using the More Info Tool.
  • If the Patient or selected guarantor has an active card on file, ‘Use Card on File’ will be an option to charge the detialed payment.

2. Cash Charge Tool

    1. CPT/Billing Codes – Enter the code for the product or service
    2. Enter the number of units
    3. Enter a dollar value discount if applicable
    4. Save will add the record the the transaction box below. There is no limit of items that can be saved into the transaction box.
    5. The code you entered above appears here.
    6. If there is a fee already associated with the CPT code it will appear here. You can also double click on the fee and change it by typing in an amount or by clicking the arrows up or down.
    7. Units can be entered in when entering in the CPT code before you save or can be changed by double clicking. It can be changed by typing in a new unit quantity or by using the arrows up or down.
    8. Total automatically adds up to subtotal before any tax if applicable. Charge x Units= Total
    9. Any discount (in dollar amount) will be deducted from the subtotal if put in here.
    10. Tax will automatically be calculated if it was configured to have tax but if you need to add tax manually double click on the box and enter in value.
    11. Remove line item from transaction box
    12. Finish- will save it to your “Cash Charges” tab in Manage Payments.
    13. Finish and pay- will save it to “Cash Charges” tab in Manage payments and will bring up the Accept Payment Tool to apply payment to the cash charge.

    Related Page: Apply Payments

Auto Post

Judy Barnes
How to: Use Autopost

Chart Talk Autopost 835 Claim Remittance
Post insurance checks recived electronically or use the check entry tool. Multiple patietn payments can be added from here without needing to navigate to every patient.

    Filters

  1. Claim ID
  2. Patient Name
  3. Check No
  4. Check Status

    5. Action Buttons

  5. Filter – Apply filters
  6. Reset – Clear filter list
  7. Check Input- Opens Check Input Tool
  8. Pt Pmts – Opens the patient payment tool. This allows you to enter a payment for the patient without needing to go to the patient page and upen manage payments.
  9. Submit – Processes any items marked Done.

    10. Column Data

  10. Claim ID
  11. Response Date Date 835 received
  12. Date of Service
  13. Patient Name
  14. Payer Name
  15. Is Processed
  16. Check No
  17. Action: Info – Display contents of the 835 electronic EOB
  18. Done – Done will make the item disappear from the default view of this screen.

Check Input Tool

Check Input Tab

Chart Talk Check Input Tool 2.0
Chart Talk Check Input Tool 2.0

Check/Charge Detail

    Filters

  1. Insurance selection drop down menu
  2. Check Number
  3. Total payment amount – This amount will be used as a final check when applying payments. If total does not reconcile with individual payments, the function cannot be completed
  4. Payment Type- Insurance Check, Direct Deposit, Insurance CC
  5. Date: Date on Check

    6. Data Input Fields

  6. Patient – Select patient name
  7. DOS – All charges not set to patient responsibility are available from oldest to newest
  8. Payment – Total payment for charge
  9. Adjustment – Adjustment for charge
  10. APT Balance- Amount of patient credit to apply to charge.
  11. Finished – Will assign the remainder of balance as patient responsibility
  12. Add – Adds record to box below
  13. Total- Total payment amount made to selected charge
  14. Balance due remaining on the selected charge
  16. Credit Bal- Any amount of credit the patient is carrying when patient account was loaded.

    17. Cloumn Details

  17. Patient Name
  18. DOS/Charge
  19. Payment amount
  20. Adjustment
  21. APT Credit
  22. Finished- ‘finished’ box checked will assign the remainder of balance as patient responsibility
  23. Delete charge – use this if you need to edit a line item and re-apply it
  24. Total Payment – Sum of all payments in the payment list
  25. Total Adjustment – Sum of all adjustments in the payment list
  27. Total Apply APT Amount – Sum of all patient credit payments applied in the patient list
  28. Save Progress- Save the details of the check to the ‘Saved Checks’ tab to be completed later.
  29. Apply Payments – Once the Total Payment(15) is equal to the check amount (3) payments will be applied to all accounts when clicking this button.

Saved Checks Tab

Check Input Tool
Check Input Tool – Saved Checks Tab
    Filters

  1. Check No – Filter list by check number
  2. Payer – Filter list by Payer
  3. Check Staus – By default, filter is set to Not Applied

    4. Buttons

  4. Filter – Apply filter value to list
  5. Reset – Clear filter values

    6. Columns – Values from saved check data

  6. Check Date
  7. Check No.
  8. Amount
  9. Payment Type
  10. Total Patients
  11. Applied
  12. Pencil – Loads check details to Check Input tab to continue editing

PROCESS Collecting Co-Pay at Check In

Judy Barnes

Indicate a patient has a co-pay when setting up Primary Payer from Patient Insurance list
Change Appointment status from ‘Check In’ to ‘In Clinic’
Co-Pay Alert* Accept or Cancel
Accept – Enter amount and click ‘Save’ or ‘Save & Print’

Note: If a patient prefers to pay their copay after the visit, when they are checking out, the payment MUST be taken prior to Completing the appointment. Once an appointment has been completed the payment will need to be applied through the Manage Payment screen once a bill has been created.

PROCESS Payments

Judy Barnes

This section covers manually and automatically applying payments to claims:

AUTO POSTING A CLAIM: When claims have processed through the Clearing house, the clearing house will automatically send the electronic remittances back to the clinic. Accuracy of the payment aligning with the date of service of each claim is assured through the use of a unique Claim ID# which is assigned to each date of service as the claim is uploaded and it appears on the left side of each line item. By looking at the “Is Processed” column it will state if the claim has processed and payment is ready. To automatically download the payments to each claim that says “yes” in this column, click the APPLY PAYMENTS key. To review “how” the payment and adjustment was applied to each line item, click on the icon in the Action column and it will display the RESPONSE screen which will show the reason codes for this item.

To MAUALLY POST A PAYMENT:

To manually post a payment go into the individual patient and click on the Manage Payments tab. Select the date of service to apply the payment and or adjustment to and click on “More Info” which will bring up the Visit Payments screen. For each line item to apply the payment/adjustment to click on the ACTION icon on the right side of the screen. This will display the Payment Detail screen where each line item can be accessed and payments/adjustments applied. If there is a balance remaining that is the Patient Responsibility, check the box that appears to the right of the balance column and the amount will be transferred to the Patient responsibility column. If the Patient Responsibility box is NOT checked the patient responsibility WILL NOT appear in the proper column for billing the patient.

PROCESS Reviewing the Status of a Claim

Judy Barnes

On the Billing screen there is a Filter Button on the top which allows you to type in the patients last name, first name, and a date range, select the Filter Button, and any claims that have not been processed will appear. Once review of claims is complete for this patient, click the RESET button and the screen will return to the original list of claims.