Tag: Practice Management

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

Medication Library

Matthew Richard

The medication library is a comprehensive list of all medication available to be selected for the individual patient medication list.

Chart Talk Medication Library
The Chart Talk Medication Library allows you to search, filter, and add medication and RxNorm codes
  1. Search Box- Type part or all of a medication name *NOTE – does not dynamically filter list
  2. Filter Button- Limits the list results to values containing text from the Search Box
  3. Add Medicine Button- If filter returns no results, this button will add the medication to the library and search for RxNorm values matching the medication name
  4. Recode Button –
    • When Medication is selected – Select a medication from the list by clicking on the row. Press recode while a medication is selected will search for a match in the NLM and return the RxNorm value.
    • When no medication is selected – Chart Talk will attempt to recode the entire medication library. *This can be data intensive and we advise you to only do this after business hours to keep other Chart Talk functionality responsive for all users.
  5. Medicine Name Column – Text value of medication
  6. RxNorm ID Column – coded value of medication
  7. List Navigation Controls – Page forward, backward, jump to page.

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

Locations

Judy Barnes

Many times your office or organization operates from multiple locations. The Locations table allows you to associate as many addresses with your organization as you need. Select Locations from the Practice Management Submenu.

PM_LocationAddress

  1. Add a Location

Add a location by clicking the Create button.

  1. Alias Name you know the location by. e.g. Rose Street Office, Billing Office, etc.
  2. Street1  – Address of the location
  3. Street2 -Address of the location
  4. City -City of the location
  5. State -State of the location
  6. Zip -Zip of the location
  7. Phone -Phone number for the location
  8. IsBilling – This location info will show up in box 33
  9. IsService – This location will show up in box 32
  10. Group NPI & Use This – If you need to have individual NPI numbers on the 1500 claim but a group NPI in Box 32a , put group NPI in this box and select use this. This is called Box 32a Override. ++1500 will pull NPI from top location only++
  11. Form 1500 Information 33a(Group NPI) -++1500 will pull NPI from top location only++

2.  Edit a Location

Change any of the above information.

Payer

Judy Barnes
NAVIGATION:
  1. Open Payers from Practice Management on the Main Navigation Menu
  2. To create a new record, enter the name and Insurance Type ‘Insured’ if you will file insurance claims electronically or on 1500 form.
    Non-Insured if you would bill the patient.
When setting up payers, it is best practice to use the exact name your cleaning house uses. See your clearinghouse for a list of payers and their ID# as defined by your Clearing House.
    Type in a new Payer name and click add. After clicking Add, the Payer edit screen will open. To edit an existing Payer record, click the pencil icon next.

  1. Payer Name – Use the name listed in the Clearing House DB
  2. Payer Type – Insured if claims should be printed on 1500 form or sent electronically.
  3. Insurance Type – This will determine which box at the top (BOX 1) of the 1500 form is checked on printed claims.
  4. Email ID – *Not Required* This is for office reference does not populate on printed 1500 form
  5. Address – Street address.Where printed/mailed claims would be sent to. (Box 7)
  6. City-  Populates in  (Box 7)
  7. State- Populates in  (Box 7)
  8. Zip Code– Populates in (Box 7)
  9. Telephone- Populates in (Box 7)
  10. FAX– *Not Required* This is for office reference does not populate on printed 1500 form
  11. Payer ID – Found through the clearinghouse Payer Search or list.
  12. Clearinghouse – Which clearinghouse these electronic claims should be sent to.
  13. DX Code Type – Which diagnosis codes this payer accepts (Will limit which codes provider can add to SOAP note) NOTE: After October 1, 2015 choose ICD-10 Codes.
  14. Additional Claim Info– see standard text below
  • Default Paper Claim – When checked, indicates this payer takes claims on printed CMS 1500 rather than electronically.
  • a: Taxonomy code- are administrative codes set for identifying the provider type and area of specialization for health care providers. Each taxonomy code is a unique ten character alphanumeric code that enables providers to identify their specialty at the claim level. If a taxonomy code is required by a payer it would show in (Box 33).
    *most chiropractic payers do not require this code
  • b: Include DTP 454 in EDI- When submitting to payer that requires loop 2300 DPT454. *Most Medicare payers require this when submitting electronically.
  • c: Include Standard Text- This will populate text into (box 19) for this specific payer. Type what would like in the “additional claim info” box
  • d:Use Rendering Provider in 33a: This option will override group and location settings for box 33a/loop
  • e: Include Accident Date in EDI – include the onset date from DOS when Visit Type ‘isAccident’ is true for payers when this option is selected- (BOX 14)
  • f: Include x-ray Date- When checked this will include x-ray date in (box 15)
  • g:Append 0000 to 5 digit zip code– ONLY Mark as true if a payer requires 9 digit zip code when only 5 numbers are entered will add 0000. Leave unchecked to use what you enter in as default for payer, patient and clinic.
  • h:Accept Assignment-When checked will mark yes in box 27 on 1500 forms and on the EDI