D.G.L. INFORMATION TECHNOLOGIES (UK) LTD.
Getting Started
Guide
Volume
D . G . L . I N F O R M A T I O N T E C H N O L O G I E S ( U K ) L T D .
Getting Started Guide
 D.G.L Information Technologies (UK) Ltd. 42 Celtic Court • Ball Moor
Buckingham Industrial Park • Buckingham •MK18 1RQ Phone 01280 824600 • Fax 01280 824700
Email : [email protected] [email protected] Internet:: www.dglit.com
Table of Contents
Introduction
4
Section 1: Getting Started
7
• Loading the Software 7
• Starting Up 8
• Logging On 8
• Using The Online Help System 10
• Setting Up A Practice 12
• Registering For EDI (Electronic Billing)
• The Main Menu 17
• The Toolbar 19
• Evaluating Additional Modules 20
Section 2: Patient Details
21
• Adding A Patient 22
• Amending A Patient 31
Section 3: Basic Accounts
32
• The "Service Invoice" screen 32 • The "Claim Information" screen 39 • Sending Electronic Claims 43
• Receiving a payment 45
• Multiple Payments 47
• Issuing Credit Notes 49
• Writing-Off bad debts 50
• Issuing Refunds 51
• Recording Deposits (pre-payments) 51
Section 4: Account Queries
53
• "Summary" Statement 53 • "Detailed" Statement 56
Section 5: The Correspondence Module
59
• Typing a New Letter 59
• Accessing Previous Letters 61
• Adding A New User 63
• Delete An Existing User 64
• Set Consultation Fees 65
• Set Operation/Procedure Fees 65
• Change Headed Stationery 66
• Other Customisations 66
Section
7:
Finishing
Off 67
• Backing Up Your Data 67
• Shutting Down 69
Section
8:
Additional
Modules 67
• Correspondence Module 71 • Recall Module 72 • Outgoings Module 73 • Banking Module 74 • Click'n'Store Module 75 • Diary Module 76 • Diagnosis Module 77 • Charting Module 78
• Multiple Consultant License 79
• Network License 79
Introduction
The benefits of electronic billing….
F
or over 4 years Insurers have been working to develop ways of improving the accuracy and speed of processing and paying Consultants claims. One way in which significant advances can be made is for the insurer to receive the claim electronically from the consultant using Electronic Data Interchange (EDI) - this eliminates possible human error inherent in Insurers having to re-key information received on paper. Faster payment, reduced time chasing outstanding invoices, less errors, reduced printing & postage costs are just some of the reasons why 90% of all hospital claims are already processed in this way.In January 2000, 5 major insurers formed a company "Healthcode Limited" to act as a 'clearing house' for electronic claims. DGL's Practice Manager software sends the claim information to Healthcode who then forward the claim onto the relevant insurer. The information is transmitted in a highly encrypted form to ensure confidentiality.
The DGL & Healthcode Promotion...
To promote the electronic transmission of invoices to participating insurers, Healthcode Ltd have kindly agreed to subsidise the cost of DGL supplying their HEDI (Healthcode Electronic Data Interchange) version of Practice Manager, which normally retails at £595+VAT.
Once you have completed the steps detailed in Chapter 1 of this booklet, your Practice Manager will automatically become "registered" and the "30 Day Evaluation" time-block will be removed. It will then act in the same way as if the £595 had been paid for the software, however you will not be charged a penny.
What's the catch ?
There is no catch. There is NO cost to yourself, providing that you agree to submit bills electronically as your preferred submission method to all participating insurers, for a minimum of twelve months. You may optionally purchase additional module to add to the functionality of Practice Manager, but everything you need to send claims electronically as well as all "day-to-day" account related facilities (such as recording payments received, printing receipts, sending reminder letters, and producing financial reports) is provided free of charge.
What equipment do you need to be able to send claims
electronically….
If you have a computer which is connected to the Internet then you can use Practice Manager to send claims electronically once the "Installation CD" has been loaded and you have followed the 'setting up' steps detailed in chapter 1. Electronic Claims can be sent using virtually any Internet Service Provider.
Note: If your computer does not have an internet connection, you must arrange
for one to be added to your computer before attempting to set up EDI. Please feel free to contact DGL for advise.
"What information do I need to be able to send claims
electronically?"
You will need:
• Your BUPA Provider Number
• BUPA Provider Numbers for the Surgeons you work with (Anaesthetists only) • The Hospital ID Numbers for any locations where patients are seen.
You will need from the patient :
• Their name, address and postcode.
• Their GP details (optional for Anaesthetists)
• Their insurance company name and membership number
• Date of first GP Visit for this condition, and date symptoms noticed. (optional) • Signed consent
For each invoice, you will also need:
• The procedure code for any services performed
• Dates of any services performed, along with admission and discharge dates for in-patient
• procedures (not necessary for Anaesthetists).
Which Insurers can I send claims to electronically ? …
At this moment in time only BUPA are accepting claims electronically, however other insurers (PPP, Norwich Union, Royal & Sun Alliance & Standard Life) are very close and should be accepting claims electronically shortly.
What are the "optional extras"?
These optional add-on modules are designed to add greater functionality beyond the normal "day-to-day" accounts related features. These include options such as Correspondence and Outgoing Expenditure. A complete list of these modules should have been included with the Installation CD, along with the relevant prices. If you wish to try these optional modules, you can click on the "Evaluate Modules" button along the bottom of the Practice Manager main screen, and tick the modules that you wish to evaluate. These modules will then be fully working for 10 days. Please note that you can only evaluate each module a maximum of 3 times.
Section
1
Getting Started
Loading the Practice Manager Software
When you insert the enclosed Installation CD into your computer, you should be presented with a menu screen (shown below). If not, double click on the "My Computer" icon on your desktop screen, then double click on the "Practice Manager" icon.
Now click on the "Install Practice Manager Software" button to begin loading.
During the installation process you will be asked to confirm that you wish to begin installation. Click on "Next" to continue. You will then be shown a copy of the "Software License & Copyright Agreement". If you agree to the license, click on the "Yes" button to continue. Finally you will be asked to select which hard-disk drive you want to install Practice Manager on to. Unless you have a particular need to change this, we recommend leaving this set to "C" drive. Click "Next" to continue. The installation should only take a minute or two to complete.
Starting Up
To start Practice Manager, click on your button. At the top of the list should be a "Practice Manager" icon – click on it once. Practice Manager will then begin to load. This should only take a few seconds, during which time a copyright notice will be shown.
Logon Screen
For security, before entering Practice Manager you must enter a valid User Name and Password. Without a recognised name and password, you will be denied entry.
When first installed there are no user names or passwords set up. The first time you enter a user name and password, these will be added to the user name list for future use. Note that this will only be the case when Practice Manager is first run. Once a user name has been entered the system will not allow you to add user names from this screen. To add further user names you must use the Add New User option (located in the Misc Menu, Preferences, Users) once you have successful logged on. (see section 6 for more details) Each person who requires access to Practice Manager should be given their own name and password. This not only prevents unauthorised access to confidential information, but also allows you to grant access to different parts of the system to different users. For example, you may decide not to grant temporary staff access to financial reports. Please refer to the on-line help system for more information on user access rights.
User Name
Practice Manager, enter a user name that you wish to use from now on.
Password
As you type your password, it will NOT be displayed on screen. Instead, each letter you press will be shown as a "*" to prevent it from being read. If this is the first time you have run Practice Manager, enter the password you wish to use from now on. Please type carefully, and ensure you use a password which you will remember, but others will find hard to guess.
Date
This box is used to ensure that your computers internal date is set correctly. Today's date should automatically be displayed, but if it is wrong you should click on the symbol correct it. It is vital that the system date is set correctly, as this will affect any date-dependant functions, such as the dates on which reminders letters are sent.
Consultant
This box allows you to select which "Consultant" you want to be working for. In a "Single Consultant" Practice Manager installation you will have the choice of either "Training Mode" or "Live Mode". The "Training Mode" is a completely separate system containing fictitious patients, accounts and letters that can be used for training purposes. If you are going to be entering any REAL information, ensure that you select "Live Mode".
In a "Multi-Consultant" installation, the list will include "Training Mode", followed by the name of each consultant. It is important that you select the correct consultant that you want to work for, as it is not possible to transfer information between consultants once entered. Once logged in, you can use the "Change Consultant" facility to switch between consultants. Access to Customer Support is also included free of charge for the first 90 days.
Once the above details have been entered, click on the "OK" button to continue. If you receive a message saying "Unknown User Name" or "Incorrect Password", re-type them and try again.
Using The Online Help System
Whenever you see a "Help" button on any of the Practice Manager screens you can click on it to activate the on-line help system. This gives you access to a vital source of information regarding all aspects of the Practice Manager system. If you are at the Main Menu, then the Help Index will be displayed. If you click the Help button from within a different screen, then a help topic relating to that screen will be shown.
Example of clicking "Help" from the "Patient Details Screen" :
The help screen can be re-sized to be as large as you require. You may need to scroll down the page in order to read the entire contents. If the window does not fill the entire screen, then it can be maximised by clicking on the icon in the top right corner. As with an Internet page, the Help screens allow you to click on keywords (normally shown underlined) in order to just to related topic.
You can print a topic by clicking on the "Print" icon along the top of the screen, or to close the help screen click on the "Close Window" button
.
The help screen is split into two halves. The right hand side shows the help itself, where as the left hand side shows other options (such as Contents, Index and Search). Note: if the left hand side is not visible, you may need to click the "Show" icon.
Contents
The "Contents" screen allows you to view various help topics grouped together by their function. For example, all options relating to the Patient Details screen are grouped together. Click on any other category to view its contents.
Index
The "Index" screen shows a complete list of all available help topics. You can then select the one required, or type in a word to look for. All topic names containing that word will be displayed.
Search
The "Search" screen allows you to search the content of ALL topics for a particular word or phrase. For example, searching for the words "Electronic Billing" will show a list of all topics containing those words.
"Knowledge Base"
The On-Line help system also contains a "Knowledge Base" system, containing the answers to many common questions, and an explanation of various error messages. This covers not only Practice Manager, but many related programs such as Microsoft Windows and Microsoft Word. The Knowledge Base can be accessed from the "Help" menu.
To use the Knowledge Base, type one or two keywords into the "Search For" box, then click "Full Text Search". A list of any matching entries will be listed below. Double-click on the entry that best describes your question. A "summary" of the problem will then be shown, along with any relevant "details" and a "Resolution".
Setting Up A Practice
The first time you run Practice Manager you will be asked if you wish to set up the Practice details. It is strongly advised that you do so, as it will take only a few minutes to complete and will help Practice Manager adapt to your requirements.
Please note that any information entered into these screens is not "set in stone". All of the information can be changed at a later date should you wish.
The "Practice Setup Wizard" consists of five pages: Practice Type
Practice Details Patients
Billing
Data Protection Act
Once each page has been completed, click on the "Next" button to advance to the next page. If you wish to go back to a previous page, click on the "Back" button instead.
Practice Type
This screen allows you to select which type of setup best describes your practice. Click on the option that best fits, then click on the "Next" button to proceed to the next page.
Practice Details
Enter either the name of the consultant, or the name of the practice, followed by the address, telephone and email address (if available). Click "Next" to move to the next page.
Patients
If you would like Practice Manager to automatically assign each patient their own unique Patient Number, ensure that there is a tick in the "Automatic Patient Numbering" box. You may also enter the number you would like the next patient to be allocated. You may also optionally enter a "prefix" and/or a "suffix" to be added to each patient number. For example, you may wish to prefix the patient numbers with "01/" to denote the year in which they were added.
You may also change the "Adult Age". If you enter a new patient who's age is below the "Adult Age" you will automatically be asked to enter "alternative billing details" for the parent or guardian. In the UK this option is normally set to 18, but you may change it if required.
Billing
Practice Manager will automatically assign each invoice a unique "Invoice Number", starting with whichever number you type into the "Next Invoice No." box.
You may also enter a "Prefix" and/or a "Suffix" to be added to each invoice number. If required, enter the details into the relevant boxes.
The "Financial Year Dates" can be changed to match your Financial Year dates.
Also on this screen is a "Set up Electronic Billing" button. This will take you to a separate set of screens in order to active Electronic Billing on your computer. It is VITAL that you complete the "Set Up Electronic Billing" screen in order to send claims via EDI.
Set Up Electronic Billing
This screen stores information about how Electronic Claims are transmitted from your computer to Healthcode Ltd. for processing.
Note: If you have not yet registered electronically with Healthcode, you will be
presented with a screen asking if you wish to register now. If you answer "Yes" you will be taken to the "Register Software With Healthcode" screen. This process only takes a minute or two, but must be completed before you are allowed to send any electronic claims.
Healthcode Ref
Once registered, your "Healthcode Reference Number" will be displayed in this box. This number should be noted and quoted in all communications between yourself and DGL or Healthcode. This number is shown for reference only and should not be changed.
How many printed copies of invoice
Enter the number of paper copies to be printed for invoices sent electronically. Whilst it is not necessary to print out paper copies of electronic invoices, this option can be used if you require copies for your records. If you do not want paper copies, set the number to zero.
EDI Hospital Numbers
Clicking on this button will take you to the "EDI Hospital Numbers" screen, which allows you to set the correct reference numbers for each of the hospitals you work from. If you do not have any hospital on the list, use the "Add Hospital" button.
Consultant / Practice Provider No's.
Clicking on this button will take you to the "Consultant Provider Nos" screen, where you must enter the correct BUPA Provider Numbers for each consultant in your Practice.
Surgeon Provider No's
(Anaesthetist Groups Only) Click this button to assign the correct BUPA Provider Numbers to each surgeon who you work with. These can be added later.
Anaesthetist Provider No's
(Anaesthetist Groups Only) Click this button to assign the correct BUPA Provider Numbers to each anaesthetist who you work with. These can be added later.
Delivery Method
This option is used to specify how you transmit claims to Healthcode. Normally this should be set to "Internet (FTP)". You should not change this option unless instructed to do so by DGL.
Destination
This options specified the location of where the claims are stored on your computers hard disk. This should not be changed unless instructed to do so by DGL Customer Support.
Dial-Up Connection
If your computer has more than one Internet Service Provider configured, you should use this option to select which one you wish to use to send the claims. This can be changed at any time, and can be virtually any Service Provider you care to use.
Note: If your computer is connected to the Internet via a network, and if the
network has a "firewall" security system installed (as used within many hospitals), your network administrator may need to make a slight alteration to the security settings to allow your computer to communicate with DGL and Healthcode. If this is the case, please ask your network administrator to contact DGL for more details. This is NOT necessary is you connect to the internet via a modem.
If you have any security software installed on your computer, such as Norton Personal Firewall or ZoneAlarm, you may receive a warning message when Practice Manager attempts to connect to the Internet to exchange data with Healthcode Ltd. Please refer to your security program's documentation in order to allow Practice Manager access.
Data Protection Act
The "Data Protection Act" screen is a reminder that you are legally obliged to register with the Data Protection Act in order to store patient information on a computer system. Details of who to contact are given.
This screen is provided purely for your information and does require any alteration.
The Main Menu Screen
The "Main Menu" screen is the heart of Practice Manager, allowing you to navigate around the different menus and select any of the various options. To move around between the menus, either use the left and right cursor keys to move to the next or previous menu, or the up and down cursor keys to move through the options in the current menu. Alternatively, use the mouse to point at the desired menu. Once you have located the option you require, either press the [Enter] key, or click the mouse.
Some menu options have an arrow pointing to the right. This indicates that it contains a sub-menu. When the item is selected, the sub-menu will be displayed. For example, clicking on the "Statements" option shows a sub-menu containing "Summary Statement", "Detailed Statement" and "Statement Notes/Comments Report".
The top right-hand corner of the screen indicates if you are currently logged into the Training Mode or not. If you have a multi-consultant system, the name of the current consultant will be displayed here. Also, if your computer is already configured for electronic billing your Healthcode Reference number will be displayed for reference.
The Main Menu is split into the following heading :
Patients Options relating to patient information
Lists Clinic Lists and Theatre Lists (requires the optional Diary Module)
Billing Options to do with the sending of invoices
Accounts Options relating to the collection of money from invoices
Banking Allows you generate paying in slips, and to reconcile your bank statements (requires the optional Banking Module)
Directories Access to the various directory lists (GPs, Clinicians, Hospitals, etc)
Outgoings Options relating to outgoing expenditure from the practice. (Requires the optional Outgoings Module)
WP Various Word-Processing related option
Misc Options not falling into the above headings.
Help Access to the on-line help facilities.
Quit Exit out of Practice Manager and return to Windows.
Note: Menu options always have one letter underlined. Eg Billing. You can also
access these menus by pressing the [Alt] key and the underlined letter (in this case B). Similarly, many Practice Manager screens contain buttons, again with one letter underlined. These can also be selected by pressing [Alt] and the underlined letter.
The Toolbar
The "Toolbar" on the Main Menu gives you shortcuts to most of the day-to-day option in Practice Manager.
Clicking on the icons will take you to the following screens:
Patient Details Allows you to Add / View / Amend patient details
New Letter Create a new letter regarding a patient (requires the optional Correspondence Module)
Clinic List Access the clinic diary (requires the optional Diary Module)
Service Invoice Creates a new invoice for services.
Receive Payment Received a payment against an invoice
Summary
Statement Shows a summary statement of a patients account
Messages Allows you to leave "sticky note" style messages on your screen.
Print Envelope Print address envelopes
Print Label Print address labels
Backup Allows you to backup your work as a safeguard
Lock System "Lock" the system to prevent access whilst away from the computer
The "Toolbar Preferences" option (found in the Misc Menu, Preferences, Main Menu Preferences) allows other icons can be added to the toolbar or removed.
Evaluating Additional Modules
Some options from the Main Menu screen may appear "greyed out", meaning that they are not available. Initially, Practice Manager is set to run with only the "Starter Module" available.
The functionality of the Practice Manager Starter Module can be added to buy purchasing any of the available add-on modules. These modules are optional and are not required for day-to-day account functionality.
You may evaluate any of the available modules for up to 10 days at a time, and each module can be evaluated a maximum of three times. To evaluate a module, click on the "Evaluate" button on the main menu toolbar.
For a list of available modules, please refer to Section 8 of this booklet (Page 70) , the Price List that accompanied your Practice Manager Installation CD, or the DGL Website at www.dglit.com
Should you decide to purchase any of these additional modules, use the "Register Additional Modules" button. Additional modules may be purchased at any later date.
Section
2
Patient Details Screen
The Patient Details Screen can be used to add on new patients or to view and amend existing patients details. On a Multi-Practice system this option can also be used to copy patient details between practices.
To access the Patient Details Screen, click on "Patient Details" in the "Patient" menu.
It can also be accessed by clicking on the "Patient" icon on the main menu toolbar. This is how the Patient Details screen will appear on Surgical versions of Practice Manager. Other versions may differ slightly.
Adding A New Patient
Enter the relevant information regarding the new patient into the appropriate boxes (see below for more details). Use the [Enter] or [Return] keys to move down through each of the boxes. If any information is not known it may be omitted and filled in at a later date. Once the patients details have been entered, either click on the button to save the changes, or click to lose the changes. Clicking either button will return you to the Main Menu screen. The "Next" button is basically the same as clicking on "OK" (ie, any changes will be saved) but you will be taken back a blank Patient Details screen ready to enter another patient instead of returning to the Main Menu.
When saving a patient you may be asked if you wish to send this patient an invoice, a letter, or if you wish to print patient information labels. This depends on the settings in the Patient Preferences screen (located in Misc Menu, Preferences, Patient Preferences).
Surname
Enter the surname of the patient being added here. As will all names, the first letter will automatically be shown as a capital letter.
Forename
Enter the forename of the patient.
Salutation
Enter the salutation (title) of the patient, ie Mr, Mrs, etc. You can either type the salutation you require, or select one from the list. If the salutation you require is not listed, simply type the correct salutation and press [Enter]. Practice Manager will then ask you if you want the new salutation adding to the list for future use.
Patient No.
The next available patient number is automatically entered. Normally you would just press [Enter] to accept this number and move to the next field.
The way in which patient numbers are allocated can be changed to suit your needs. For more information see Patient Preferences in the on-line help system.
If you try to enter a number that has already been allocated to another patient, Practice Manager will warn you that the number has been duplicated and ask if you want to use another number.
NHS
If known, enter the patients NHS number. If not needed, press [Enter] to leave the field empty. If a number is entered, Practice Manager will check to ensure that the number is valid. A warning message will be shown if an incorrect number is entered.
D.O.B.
Enter the patients Date Of Birth. If Practice Manager detects that a patient with the name surname and date of birth already exists on the system, you will be shown a warning screen asking you to check that the patient is not being duplicated. You can then either proceed to add another patient with the same surname and date of birth, to edit the original patient's details.
Note: At this stage, Practice Manager checks to ensure that there are no other patients already entered into the system with the same surname and date of birth as the patient you are currently entering. If a possible duplicate is discovered, you will be asked if you wish to continue adding the new patient, or edit the existing one.
Age
If a date of birth was entered in the previous field, the patients age will automatically be calculated and displayed. If the patient is under 18 years of age, the number of months will also be shown (ie, 7 years and 4 months). You can normally press [Enter] to accept the age shown and proceed to the next field.
Sex
This box records the patients gender, and can be set to either 'M' for Male, 'F' for Female or 'O' for Other. Practice Manager will attempt to insert the correct sex automatically, based on their salutation (ie: male for 'Mr' or 'Master', female for 'Mrs', 'Miss' or 'Ms' ).
If Practice Manager can not identify the patient's gender from their salutation (if, for example, they are a 'Dr') then the box is left empty an you will have to press 'M', 'F' or 'O' followed by [Enter].
Address
There are two lines for the beginning of the patient's address, although it is not necessary to use both. Try to ensure that you do not use these two lines for entering the town, county or postcode, as there are separate lines especially for these further down.
If the address is short, use only the first address line and leave the second line blank. Although this will leave a gap in the address on screen, the gap will not appear when printed out on invoices, receipts, letters etc.
Town
As you start typing the name of the town, a list of known towns will appear. If the town you require is highlighted on the list, press [Enter] to accept it, otherwise keep typing. If the town you require is not on the list, type it in fully and press [Enter]. You will then be asked if you want to add this new town onto the list for future use. If you do, select 'Yes', otherwise select 'No'.
County
If you entered a town into the address, Practice Manager may be able to determine which county the selected town is in, and will enter the county for you. If this is the case, then simply press [Enter] to proceed to the postcode line.
If no county appears, start typing the name of the required county and a list of known counties will appear. If the town you require is not on the list, continue to type the name of the county and press [Enter]. You will then be asked if you want to add this new county onto the list for future use. If you do, select 'Yes', otherwise select 'No'.
Postcode
Enter the postcode into the 'Postcode' box if known, otherwise press [Enter] to leave it blank.
If you do type in a postcode, it will automatically be shown in capital letters for you.
Telephone
You have two lines in which to enter telephone numbers for the patient. You may enter the telephone numbers is any format you desire (with or without dialing codes), and you may also enter words as well as numbers (such as EXT, WORK, HOME etc.).
There is also a button which, when clicked, will allow you to store additional details such as Mobile, Pager, Fax, and email address.
Alternative Billing Address
If the patient you are entering is under the 'adult' age (usually 18, but this can be changed via the Patient Preferences option) then you will be asked if you wish to record an alternative name and address for invoices and correspondence to be sent to.
If you answer 'Yes' then you will be asked to enter the name and address for the correspondence.
having their treatment paid for by a son or daughter.
The 'Alternative Billing Address' box will be ticked if there is a alternate address recorded for this patient, otherwise it will be left empty. If ticked, you may also click on the magnifying glass icon to view or amend the alternative address details. This can also be accessed by clicking on the "Alt Address" option along the top menu bar.
The 'Alternative Billing Address' box should NOT be used to record solicitor or hospital details. There are separate boxes to record such information.
Balance
Next to the word "Balance" will be shown the patients current account balance. For a new patient, this will be empty or zero.
A negative balance (shown in red) would mean that the patient owes you money, where as a positive balance (shown in green) indicates that their account is in credit, and effectively you owe them the money.
Clicking on the magnifying glass icon will take you to the Summary Statement screen for this patient, showing details of all of their invoices.
Deceased
This tick-box is used to record if the patient is deceased or not.
To record a patient as deceased, click the box to place a tick in it. You will be given a warning box saying "Warning - You are about to record this patient as deceased. Are you sure? Yes/No" . If recorded as deceased, you will be warned before writing any letters or sending reminders regarding this patient. Also, any correspondence will automatically be addressed to "Executors to the Estate of The Late…."
GP
If you wish to record a GP, type in the SURNAME of the required GP, then press [Enter].
You will now be taken to GP Search Screen, in which you may either select an exiting GP from a list, or add new GPs onto the list.
If the name of the patients GP is not known, just press [Enter] to leave the box empty.
Solicitor
acting on his/her behalf, then press [Enter].
You will then be taken to the Solicitor Search Screen, in which you may either select an existing solicitor from the list, or add a new one onto the list.
If you wish to record more than one solicitor, click on the button. This will take you to an additional Medico-Legal Information Screen which will allow you to record two solicitors (Claimant and Defendant) plus any case reference numbers and the name of the Court. You can also record if the case has been settled or not, and if so the date of settlement.
Example of the Medico-Legal Information Screen
If the patient is not a medico-legal patient, press [Enter] to leave the Solicitor box empty.
Clinician
You may record one or more "Clinicians" against each patient. (ie, any other person with an interest in this patients treatment, such as a referring consultant, physiotherapist etc).
Type in the SURNAME of a clinician and press [Enter]. You will then be taken to the Clinician Search Screen, in which you may either select an existing clinician from the list, or add a new one onto the list.
each patient, this option can be activated in the via the Patient Preferences option called "Record Multiple Clinicians".
Example of recording multiple clinicians
If you do not wish to record a clinician, press [Enter] to leave the box empty.
Note: Anaesthetists may wish to use the Clinician box to record the name of the surgeon.
Also, it is possible to rename the clinician boxes, usually just called 1 to 10, to having names such as "Dentist" or "Physiotherapist". This is done via the Directory Preferences screen (Misc Menu, Preferences, Directory Preferences).
Insurance
If you wish to record the patients Insurance Company, type in the name of the company and press [Enter].
You will now be taken to Insurance Company Search Screen, in which you may either select an exiting company from a list, or add new company.
If you select an insurance company who accepts electronic invoices and your computer is set up to send EDI invoices, you will be asked if you wish to enter Insurance Claim Information. If you click 'Yes' you will be taken to the Claim Information Screen, where you can fill out the electronic claim form. This topic will be covered in more detail in the Billing section.
Invoice To
Use this box to select who (in general) you would like invoices relating to this patient to be sent to. Press the initial letter of the option required ('P' for Patient, 'S' for Solicitor etc).
Note that only options applicable to the current patient will be listed. ie, you will not have the option of invoicing to a Solicitor if this patient has no solicitor recorded. You will be given the option to change this setting each time an invoice is sent.
The rest of the Patient Details screen is divided up into 5 sections, accessed by clicking on one of the following headings:
Visits
Date Added
This field records the date on which the patient was entered onto the computer. It defaults automatically to today's date. Unless there is any specific need to change this, just press [Enter] to accept it.
Last Visit
Initially blank, this field will automatically be updated to show the date the patient last visited for treatment or consultation. It is updated each time the patient is invoiced. Press [Enter] and leave this field blank when entering a new patient.
Next Visit
The 'Next Visit' box shows the next appointment date for this particular patient, based on any appointments made in the Clinic List.
To see more details about the next appointment (and any other appointments for this patient) click on the calendar button .
Click this button to make a new appointment for the current patient.
User Defined Fields
The "Patient Details Screen" can store up to five additional information fields of your choice.
You can change the type of information to be stored via the "Misc Menu, Preferences, Patient Preferences" screen.
Suggested uses for these fields include hospital numbers, etc. Type in the information relevant to these fields, the press [Enter].
Addition Information
Referral Source / Occupation / Ethnic Origin
Select an appropriate option from the lists provided, or type a new entry. If a new entry is give, you will be asked if you want to add the new entry into the list for future use.
Is the patient's visit the result of an accident?
If this patient has been referred to due an accident, tick this box. You will then be able to enter the date of the accident.
Marital Status
Select a marital status from the list, or free-type a new entry.
Maiden Name (Females only)
If the patient is married, enter their maiden name separately.
Location Of Notes
In order to keep track of where this patients notes are stored, select the current location of the notes from the list provided. If the notes are moved for any reason (ie, moved into storage), update this entry accordingly.
Next Of Kin
Use this section to record the Next Of Kin (N.O.K.) details for this patient.
Comments
Type any comments relating to this patient here. Any comments typed into the "Urgent" section will flash on screen each time this patient is selected. This may be of use if there is important information that you want to be reminded about each
time the patient is seen. Non-urgent comments can be entered into the "Other Comments" section.
Amending Patient Details
The Patient Details screen (accessed via "Patient Details" in the "Patient" menu) can be to add on new patients and also to amend existing patients details.
To amend a patient, you must first select the patient to be edited. To do this, type in the surname of the patient (in the "Surname" field) then press the [F2] key or click on the icon.
Practice Manager will now show you the Patient Search Screen, and present you with a list of patients with similar surnames, listed in alphabetical order. Highlight the patient you require and press [Enter]. That patient will now be displayed and can be edited.
When finished, click on the button to save the changes, or click to loose the changes.
Note: The only information that can NOT be edited is the patients surname and
forename. To change these, use the rename option on the top menu.
For more detailed information on searching for patients, please see Patient Search.
Copy Patient Details
This facility is only available if you have more than one Practice set up, ie: either several different practices for different people, or a "Private Practice" and a "Medico-Legal" practice set up for yourself.
To copy a patients details between practices, you must first have that patients details displayed in the Patient Details screen (either when adding a new patient on, or when amending their details).
Once the patient is shown, click on the 'Copy Patient' button. A list will be shown, allowing you to select which practice you wish to copy the patient to. Click on the practice required.
Note: Only the patients name, address, date of birth and telephone numbers are copied
Section
3
Basic Accounts
Service Invoice
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.
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
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.
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 details are correct.
several options.
"YES" will simply raise the invoice and print it. It will immediately become an outstanding
invoice, and will be due for payment. If your computer is set up for EDI (Electronic Billing) you may be asked at this stage if you want to "Send claim electronically?". If you answer "No" then the claim will be printed as a normal paper invoice. If, however, you answer Yes" then the claim will be added to the claims awaiting transition. These can then be sent as a batch at the end of the day using the "Send Electronic Claims" option.
"Leave In Progress" will turn the invoice into an In Progress invoice - meaning that it
will not be raised yet. Instead, it will remain "open" and then be added to and raised at a later date. Use this option if you know that the patient is coming back in a week or so for further treatment, and you want to invoice for everything in one go.
"Defer" (if enabled via the "Billing Preferences" screen) allows you raise the invoice on a
particular day. For example, if you were to defer an invoice for 7 days, the invoice would not be raised until that date. After seven days, Practice Manager will automatically inform you that there are deferred invoices due to be raised, and will offer to show you the Print Deferred Invoices screen.
"Patient Is Paying Now"
If ticked, when "Yes" is clicked to raise the invoice, you will be taken directly to the "Receive Payment" screen with this invoice already selected in order to allow you to quickly pay the invoice off. This is of particular use if your patients regularly pay at the time of consultation/treatment.
The "Patient Is Paying Now" option will only be available if it has been enabled from the "Billing Preferences" screen.
If you tick the "Patient Is Paying Now" box, no invoice will be printed, regardless of the number shown in the "Copies" box.
Validating the Invoice
If you opted to send this invoice electronically, the claim will be "validated" to ensure that all of the required information has been entered. This will help to ensure that the Insurer will not reject the claim because of missing or incomplete information.
If there are any problems found, you will be taken to the "Fix Claim" screen, which will show you the problems and allow you to correct them.
Send Electronic Claims
This option allows you to send any electronic claims that are waiting to be transmitted. It is found in the Billing Menu.
Any claims that are awaiting transmission are checked to see if they are valid claims.
A claim must be considered "Valid" before it is allowed to be transmitted. ie, all of the necessary information must have been entered, and the invoice details must conform to the EDI requirements. If any of the claims are not valid, the following error will be shown:
If you answer "Yes", then a list will be shown detailing which claims have problems, and what must be done to rectify them. This list can be printed for later reference.
Fixing Claims
A list of all claims (invoices) waiting to be transmitted will be shown. For each invoice the Invoice Number, Patient Name and Insurance Company will be listed. Also, next to each invoice, will be shown two tick-boxes, one called "Send", the other called "Valid".
If a claim is valid, then a tick is automatically placed in the "Valid" column, and also in the "Send" column, indicated that it is OK to be transmitted. If the claim is NOT valid, then neither column is ticked, indicating that there is a problem.
If a claim is not valid it will be shown in red. You may click on the "Fix Claim Info" button. This will activate the "Fix Claim Information" screen, which will allow you to see what the problem is, and then rectify it.
If for any reason you wish to delay sending a claim, you may un-tick the "Send" column of the relevant invoice.
Sending The Claims
Once the claims that you wish to transmit are marked as "Valid", click on the "Send Claims" button.
If your computer uses a modem to connect to the internet, it will automatically attempt to dial up the internet and connect itself. If you only have one telephone line which you share between your computer and your normal voice telephone, it is important to ensure that the telephone is not in use. Equally, if your computer shares a telephone line with a fax machine, ensure that the fax machine is not in use before clicking "Send Claims".
Once connected to the Internet, Practice Manager will transmit the claim information to Healthcode Ltd, who will collate the claims and pass them on to the relevant insurance companies for processing.
Depending on the number of claims to be transmitted, this process normally takes between 1 and 5 minutes to complete. During this time a "progress bar" will be shown on-screen indicating how much time is remaining.
Once transmitted, your computer will automatically disconnect itself from the Internet. NOTE: Practice Manager will transmit any "Training Mode" claims to a dummy mailbox at Healthcode. Any such claims will be ignored and will NOT be forwarded to the Insurers. Please ensure that you are in the Training Mode before sending any test claims.
Receive Payment
The "Receive Payment" screen can be accessed via the "Accounts" menu, and allows you to record a payment against an outstanding invoice. It can also be accessed by clicking on the "Payment" icon on the toolbar.
If you receive a single cheque to cover more than one invoice, you should consider using the "Multiple Payment" option instead.
First, you must select the invoice that you wish to receive the payment against. This can be done in one of two ways :
1. If the invoice number is known, click into the "Invoice No." box and enter the exact invoice number. The correct invoice will then be selected.
2. If the invoice number is not known, enter the patients surname into the "Patient" box, then press the [F2] key to active the "Patient Search" screen. If the selected patient has more than one outstanding invoice, they will be listed. Double-click (or highlight using the cursor keys, then press [ENTER]) on the invoice to be paid off. If the patient has only one outstanding invoice, it will be selected automatically. Once the correct invoice is identified using either of the above methods, the following boxed must be completed: Amount Paid, Date Paid, Payment Method, Paid By, and Details. Each of these is explained in more detail further below.
View
The 'View' button will take you to the "View Invoice" screen for the currently selected invoice.
Insurance Co.
The "Insurance Co." box will display the insurance company recorded for the currently selected patient (as entered in the Patient Details screen). If the insurance company was not known at the time the patient was originally entered into the system, the correct insurance company can be entered at this stage. This will update the Patient Details screen.
Amount Paid
Enter the amount that you wish to pay off the current invoice. If the "Default Amount To Full Amount" option is activated in the Account Preferences screen, the full outstanding amount of the invoice will already be entered for you (which you may manually change if the invoice is being shortfalled). If the box is empty, you must enter the correct amount being paid manually.
If you enter a payment for more that the patient actually owed on the invoice, the system record the over-payment as a deposit against any future invoices.
