The charge master/ Edit charges screen is the primary screen for editing of charges. It displays the list of Encounters grouped by cases for the selected patient. For each encounter, the list of diagnosis codes, the procedure codes and their corresponding charges, Billed amount, Paid amount, current status, etc., are displayed and can be edited if required.
In short, the Charge Master can be used in the following scenarios.
a. To edit the charges.
b. To add new CPT codes to an encounter.
c. To view all the activities related to an encounter(case level, encounter level, and line-level activities)
d. To add a new encounter.
To view the Charge Master screen, select Charges from the main menu and then click on Edit Charges. The Charge Master window will be displayed, as shown in Image 1.
Sect 1: This is the search parameter section (refer to Image 1).
1a. Enter either the first three characters of patient name or MR # in the Patient field. (This is a smart search field. To know more, click here.) To make changes in the patient demographic data, click on the Edit Button beside the Patient field.
1b. To filter the search results, provide case #, Claim#, etc. Use the DOS field to search for charges for a date range or a specific date.
1c. By default, only open cases will be displayed in the Encounters pane on the left. To display the closed cases as well, select the checkbox Open Case Only.
Succeeding paragraphs explain each of the highlighted and numbered sections of Image 2 in detail.
Sect 2: The Encounters section displays all the cases of the selected patient and the related encounters. Encounters are grouped according to the case.
Sect 3: The section marked 3 in Image 2 displays the Case, Patient, Guarantor, Insurance, and Diagnosis details for the selected Case.
3.a. Case tab (Image 3) displays the case details like case#, Case name, Case type, Start date, Last Claim Sent, Last Payment Applied, etc. Edit the selected case by clicking beside the case section. To view any activity on a case, click on icon. Click on to insert the case activity notes if required.
3.b. Patient tab (Image 4) displays the patient demographic information like patient name, MR#, DOB, Phone number, Address, email, etc. This section also provides an button. The button helps to create an installment plan if the patient wishes to pay in installments. The Installment Details screen also displays all previous installments availed by the patient.
3.c. The guarantor tab (Image 5) displays details of the guarantor of the patient in the particular case selected. Relation to the patient, name, address, phone number, etc. are some of the fields in this tab.
3.d. Insurance tab (Image 6) displays the primary, secondary, and tertiary insurances, and the corresponding plans, balances, copay amounts, etc. of the selected case.
3.e. Diagnosis tab (Image 7) displays the ICD codes included in the selected case. To add new ICD codes to the case, click on and select the ‘Others’ tab in the Case screen and add the required codes in the fields D1, D2, and so on. Up to 12 diagnosis codes can be inserted in a case.
Sect 4: The Encounter tab is as shown in Image 8. It is used to display/edit the information of encounters. It can be used to add new encounters to the selected case and also add new CPTs to an already existing encounter.
4.a. To add a CPT to an encounter, select the encounter from the left pane. In the Add New Line field (highlighted in Image 8), enter the required CPT code. Click on button; a new line gets created. Enter the rest of the fields such as Diagnosis and units and click button.
4.b. To add a new encounter to a case, click on the relevant case on the left pane. Add Date of Service Start, Time of Service, ICD-10 codes for the encounter. For all CPTs to be entered, repeat the following: In the Add New Line field (highlighted in Image 8), enter the required CPT code. Click on button; a new line gets created. Enter the rest of the fields such as Diagnosis and units and click button.
4.c Detail tab contains Main, Condition, Accident, Ambulance, Others, which include fields populated from the ‘Others’ tab of the case screen. Enter the Rendering Provider and update relevant fields as required.
4.d. Click on button. The encounter gets updated. If a new encounter is created, it will be displayed in the corresponding case in the Encounters section. Also, the encounter lines get created equal to the number of CPT codes entered.
Sect 5: The section marked 5 in Image 2 displays the Encounter Lines corresponding to the CPT codes. Each line shows the CPT code, DOS Start and End date, diagnosis pointers, modifiers, units, Charge, Total amount, Amount paid, Adjustment amount, adjustment reason, balance, etc.(See Image 9). All the fields are editable except Total and Paid. To know more about each column in the line, click here. After making the necessary changes, click on button. As in the charge entry screen, superbill forms such as HCFA 1500, CMS 1500 can be printed, and Claims Validation rule can be run while saving the encounter.
Line Activity Log
The Line Activity log is another essential feature of the Charge Master. All the updates and payments of each encounter line are logged in the Line Activity tab for later reference. This log also displays the Collection status, sub status, follow-up notes from the collection manager. Payment related updates to the encounter are displayed in green color. Furthermore, we can enter additional notes to the log through the Add Activity field. Shown below is a sample Activity log of the Charge Master screen.
The Payer Remark tab (shown in Image 11) provides denial Information on the charges. Also, line Sub Status can be set from the Payer Remark. Click on the Line Sub Status drop-down to set the status. Any remarks on the sub status can be provided in the Remark field. For lines set to BILL_TO_PT status, any remarks to be included in the Patient Statement can be provided in the Remark To Pat. Stmt field.