The "Service Invoice" option allows you to enter the billing details for an invoice.
It can be accessed in the following ways:
Main Menu, Billing, Service Invoice Patient Details Screen, Invoice Clinic List, Accounts, Invoice
Click the Invoice icon on the toolbar.
The Service Invoice screen consists of 4 separate "pages" which can be selected by clicking on the relevant "tabs" along the top of the screen.
Invoice To... Used to record the name of patient the invoice relates to, who the invoice is to be sent to, the invoice number, account date, and (optionally) the name of the surgeon and anaesthetist involved.
Invoice Items Used to record details of the types of service provided, the dates and location they took place, and fee.
Notes/Comments Used to record any additional comments that you feel are relevant to this invoice. (optional)
Claim Information Additional claim information, if the invoice to be sent electronically via EDI.
Once the relevant screen have been completed, you may then raise the invoice.
The "Invoice To..." screen
Enter the correct information into each of the following boxes, pressing [Enter] after each to move to the next box. Once the last box has been completed you will be taken to the
"Invoice Items" screen.
Surname
The first item that must be selected is the name of the patient to whom this invoice relates. The correct patient can be selected in usual way by typing the few letters of the surname followed by pressing the [F2] key. This will take you to the Patient Search screen, where the correct patient can be selected.
Note: If you selected a patient who is insured by one of the companies
accepting electronic billing, you will be asked if you wish for this invoice to be sent electronically or not. If you answer "Yes" then the invoice (once
completed) will be validated to ensure that it has all of the necessary
information required for electronic submission, and will then be added to the list of invoices awaiting transmission.
Invoice No.
The next available "Invoice Number" will automatically be entered for you. Usually you would not need to change the number given, but it can be amended if necessary. If you try to enter an invoice number that has already been used, you will be given a warning message and you will not be allowed to proceed until a unique number is given.
Note: Invoice numbering can be customised via the Billing Preferences screen.
Account Date
The "Account Date" box is used to record the date of the current invoice. Please note that the Account Date is usually todays date, and not the date of the service that you are billing for. However, the system will allow you to forward date and back-date accounts if necessary.
Charge Band
The "Charge Band" box allows you to select which of the insurance companies pricing schemes you wish to base this invoice on. Each insurers pricing scale is given a number, such as '0' for BUPA, '8' for Norwich Union etc. Clicking on the magnifying glass icon will show you a list of all of the available charge bands to select from (not all of which will apply to your country).
Charge Bands can be automatically selected in two ways. Each insurance company can assigned a charge band via the Insurance Company Directory. Then, each time a patient with that insurance company is invoiced, the charge band will automatically be set.
Alternatively, a default charge band can be set in the Billing Preferences Screen.
Then, if the insurance company does not have a specific charge band assigned to it, the default band will be used.
Anaesthetist (optional unless in a Group Anaesthetist System)
If the "Record Anaesthetist" option is enabled (via the Misc Menu, Preferences, Billing Preferences screen) you can record the name of the anaesthetist relating to this invoice. This is of use mainly for Group Anaesthetist practices, where the anaesthetist involved will be needed to calculate financial breakdowns.
Surgeon (optional unless in a Group Surgical System, or an Anaesthetist system) If the "Record Surgeon/Controlling Specialist" option is enabled (via the the Misc Menu, Preferences, Billing Preferences screen) you can record the name of the surgeon or controlling specialist relating to this invoice. This is of use mainly for Anaesthetist systems, or for Group Surgical Systems where the surgeon involved will be needed to calculate financial breakdowns.
Invoice To:
The "Invoice To" box allows you to select who the invoice is to be addressed to.
The choices include Patient, Alternative Address, Solicitors, GP, Insurance Company, Hospital or Clinician. Not all options will be available for all patients, depending of the information entered into the Patient Details screen. For example, you can not invoice an insurance company unless one was specified on the Patient Details screen.
By default, the option specified on the Invoice To Box of the Patient Details screen for this patient will automatically be selected. However, this can be changed for each invoice if required.
Copies
Set the number of copies of the invoice that you wish to print. By default, the number of copies is set to the number specified in the "Copies" option of the
If you are entering old invoices into Practice Manager (for example, invoice that have already been sent before you started to use Practice Manager) you may wish to set the number of copies to "0". This will allow the invoice to be raised, but will not waste paper by printing an unwanted copies.
Balance
The "Balance" box shows the account balance for the currently selected patient. If the balance is shown in red, then it is a negative balance indicating that the patient is in debit, and they already owe money on other invoice. If the balance is shown in green, then the patients balance is in credit.
Note that the "Balance" box is shown for reference only, and the figure shown can not be manually changed.
Last Invoiced
If the currently selected patient has been sent invoices in the past, then the date of the last invoice will be shown here. As with the "Balance" box, the "Last Invoiced"
date is show for reference only and can not be manually changed.
Insurer
The insurance company of the currently selected patient is shown in the "Insurer"
box. This is normally set in the when the patient was originally entered into the
"Insurer" field of the Patient Details screen. If no insurer is shown, if the insurance company has changed, a different company may be entered. This will in turn update the Patient Details screen.
The "Invoice Items" Screen
The purpose of the Invoice Items page is to allow you to enter exactly what services you are billing for. For example, the details of any consultations or operations. Unless otherwise changed in the Billing Preferences Screen, the maximum number of items on an invoice is 9.
These "services" are split into one of four categories.
Consultation
Operations and Procedures Multiple Procedure
User Defined items
Regardless of the type of service, the same "service details" must be entered.
Desc Description of the service. This can be as long as you like, as the box will expand accordingly.
Code The insurance company code for this service (if applicable). If know, the system will automatically insert the relevant code for you.
Date The date that this service was performed. The date defaults to today's date, but can be forward dated or back-dated as required.
Hospital The location where this service was performed. Locations can either be selected from the list, or typed in manually. New locations can be added to the list for future use by simply typing them out in full, then answering "Yes" when asked if you wish it to be added to the list.
Episode Type The "Episode Type" (if applicable) - O/P (Out-Patient), I/P (In-Patient), D/C (Day-Case).
Fee The amount that you wish to charge for this service. If known, the system will suggest a fee to you, based on the "charge band" you selected for this invoice. This fee can be changed to any amount you choose. If no fee has yet been specified, you will be shown the following message:
Clicking "Yes" will allow you to set your "default" fee for this procedure.
Billing For Consultations
To bill for a consultation, click on the "Consultations" button. You will then be given a list of consultation types to select from. Either double-click on the required type, or move up and down using the cursor keys followed by [Enter] to select.
This screen also allows you to edit the names of the consultation types. For example, clicking on "New Consultation" followed by the "Edit" button will allow you to rename it to "Initial Consultation" if you prefer.
Once the type of consultation has been chosen, you will be taken to the "Service Details"
section of the screen. Here you can amend the description of the service if necessary.
Practice Manager will automatically enter the insurance company code for the type of consultation you selected. This can be manually changed if necessary.
The date of the consultation can also be entered, as can the hospital or consulting rooms where it took place.
When asked to select the "Episode Type", you would normally select "O/P" for
"Outpatient".
The default fee for this type of consultation will automatically be entered into the "Fee"
box for you, but this can be changed manually if required.
Once all of these details have been entered, and you are happy that they are correct, click on the green tick to the right of the service details to accept the details and transfer them to the invoice grid below. If you wish to cancel the current service details, click on the red cross instead.
The service details will now be added to the invoice grid at the bottom of the screen, and the invoice total in the bottom right hand corner will be updated accordingly.
Billing for Operations and Procedures
There are several different ways of selecting the name of the operation or procedure that you wish to bill for.
Operation/Procedure
This button will bring up a copy of the fee schedule for the current insurance company, showing each of the chapter names. Double-clicking (or pressing [Enter]) on a heading will open it to show its sub-heading, which can also be double-clicked to reveal the list if operations and procedure in that section.
Double-click (or press [Enter]) on the name of the operation or procedure required. Practice Manager will then automatically fill in the description, code and fee.
OPCS Code Entry
If you already know the code of the procedure required, click on the "OPCS Code
Entry" button. Here, you can enter the code into the "Code" box. If more than one procedure is found matching the code you entered, you will be able to select the one you require.
If you do not know the OPCS code, instead you may enter a key word into the
"Search Text" box. For example, entering "knee" will list all procedures containing the letter "knee" in their description.
Once the procedure has been selected, Practice Manager will automatically fill in the description, code and fee.
Multiple Procedure
If you are billing for more that one procedure performed at the same time, you may wish to use the "Multiple Procedure" facility instead of billing for each procedure separately.
The "Multiple Procedure" option will automatically calculate the correct fees based on the currently selected Charge Band. For example, if the charge band is set to "0 - BUPA Rates", then Practice Manager will automatically bill add 25% to the highest procedure if there are two items, or 40% if there are three or more items.
As each of the insurance companies has different methods of calculating multiple procedures, the correct formula will be applied.
User Defined
If the item you wish to bill for is not a consultation and does not appear in the insurance company price list (for example, medical reports), you may select it from your own list of "User Defined" items.
To add new items to the User Defined list, click on the "User Defined Code Maintenance" option along the top of the screen (or use the "User Defined Billing Codes" option from the Misc Menu, Table Maintenance).
Deleting Service Items
If an item is incorrectly added to the invoice, it can easily be removed by clicking on the unwanted item in the invoice grid at the bottom of the screen, then pressing the [Delete]
key on the keyboard. You will be asked if you are sure that you want to remove it. Click 'Yes'.
Amending Service Items
If you wish to amend any of the details of an item on the invoice, double click on the relevant item on the invoice grid at the bottom of the screen. The details will then be transferred back to the top of the screen, and can be amended. Click on the green tick next to the details to confirm the amendments.
The "Notes/Comments" tab allows you to record additional notes and comments to be recorded, and optionally printed on the invoice.
Anything typed in the "Notes/Comments (not printed)" side will not be printed on the invoice, where as anything typed in the "Notes/Comments to be printed" side will be printed. Adding notes and comments to invoices is optional.
The "Claim Information" Screen
The "Claim Information" screen allows you to enter additional information required if the invoice is to be sent via EDI (electronic billing). It is basically a copy of the "Claim Information Screen" accessible from the Patient Details screen.
The "Claim Information Screen" allows you to record information necessary to send invoices electronically to insurance companies (know as EDI), and is basically an replacement of the paper claim form. The screen can be accessed from the Patient Details Screen, either by clicking on "Claim Info" from the top menu, or by entering the name of a participating insurance company into the "Insurance" box (if that insurer has been set to allow electronic billing via the Insurance Company Directory screen).
Note: Some field on the Claim Information Screen are optional, others are mandatory. Mandatory fields are highlighted in blue. However, not all of the fields have to be completed at this stage. Any missing information can be filled in when actually creating the invoice. Mandatory fields may vary from insurer to insurer.
If the current invoice is not going to be sent electronically, then it is not necessary to complete this screen.
Pre-Authorisation Number
If the patient's insurance company has issued a Pre-Authorisation Number for their treatment, it can be recorded in this box. If no pre-authorisation has been issued, you may leave this field blank.
Diagnosis / Presenting Condition 1 & 2
You must enter at least one diagnosis per claim, however two diagnoses can be recorded if required. A diagnosis consists of a description and a code. If you know the correct code, enter it into the first box (see "Common Diagnosis Codes" for a
list of the most common codes used). If you do not know the correct code, type in one or more key-words (such as "KNEE") into the box, then press [Enter].
Practice Manager will then bring up the "Select Diagnosis" screen with a list of all diagnoses containing those words, along with the correct codes. Click on the description that best fits the diagnosis, then click "OK". If none of the descriptions are appropriate, try typing different words to search for.
The codes used for diagnoses are taken from the "ICD9" coding system, used by all UK insurance companies as well as the NHS.
Note: Some ICD9 codes have more than one description. For example, code 79000 is "Abnormal Blood Chemistry" as well as "Hyperglycaemia" and
"Excessive Blood Levels Of Alcohol". If you enter a code and a different description is show this will not matter. Only the code is included when the claim is submitted, not the description.
Symptoms
If known, enter an approximate date that the patient was first aware of any symptoms.
1st GP Visit
If known, enter the approximate date that the patient first saw their GP with regards to their current condition.
Admitted/Discharged
If the patient was admitted to hospital as an in-patient or as a day-case, you must record the date of admission and the date of discharge. This is a mandatory field, unless you are billing as the Anaesthetist.
If the patient was seen on an out-patient basis, these two boxes can both be left blank.
Discharge Code
If you entered a discharge date, you must also select a "Discharge Code" from the drop down list. Normally, this would be set to "Routine", but the options include:
Against Medical Advice Deceased
Routine Transferred
Membership No.
Enter the membership number (policy number) for the patients Insurance
Details screen) it will check to ensure that the membership number is valid. If the number you enter is too short, too long, or doesn't match that insurance companies rules, the system will reject the number and give you a warning message. A valid number must be entered for the claim to be sent using EDI.
Note: BUPA patients require a 10 digit membership number. If you have a 12 digit number, then this refers to a corporate policy and you must contact BUPA to obtain the individuals 10 digit policy number. Also, if the number is prefixed by "09/" or something similar, only enter the numbers after the '/'.
Request Membership No.
Some insurers allow you to "request" a membership number. If the "Request Membership No." button is shown in black, then the current patients insurance company does support this facility. If not, it will be shown in grey.
Valid Until
Some patient's policies have a "Valid Until" date. If so, you may record it in this box.
3rd Party Insurance
Place a tick in this box if the patient is claiming on the insurance policy of a 3rd party, such as a claim for a child's treatment on the fathers policy. You will then be prompted to enter the third party details.
Double Ins.
If the patient has more than one private insurance policy, place a tick in this box.
You will then be prompted for additional information regarding the other insurer.
Signed Consent Obtained
You MUST tick this box to confirm that the patient has given signed consent for his/her information to be sent electronically.
Patient Wishes To See Medical Report
If the patient has requested sight of his/her medical notes, please tick this box.
Raising The Invoice
Once the invoice details have been entered, click on the 'OK' button to confirm that the
Once the invoice details have been entered, click on the 'OK' button to confirm that the