The charge entry process is the initial and one of the crucial stages in the billing cycle. To access the charge entry screen, Select Charges from the main menu and click on Enter Charges.
This article explains the different fields in the charge entry screen. Image 1 is a sample screenshot of the charge entry screen.
I. Appointment View
The left pane displays the appointments for the current day (see Image 2). The pane helps in the easy identification of patients for charge entry. All the appointments (except the canceled ones) for the selected Legal entity and providers for the current day are displayed here.
I.a. To view appointments for all legal entities and providers, select ALL from legal Entity and provider drop-downs.
I.c. The appointment view can be hidden by clicking the Hide button (highlighted in Image 2). Press the Hide button again to show the appointment View.
I.d. To search for any particular patient from the appointment list, type the name of that patient in the search field.
I.e. We can create an appointment from the charge entry screen as well. To do so, click on the appointment (highlighted in Image 3), the Schedule Appointment screen will pop up.
I.f. Table 1 explains the color legend of the appointment charge status.
II. Charge Entry
II.a. Select a patient from the appointment list or enter either the MR # or patient name in the Patient field. (Patient field is a Smart search field. To know more, click here.). To add a new patient from the charge entry screen, click on button beside the Patient field. Once a patient is selected, patient details such as Name, DOB, Gender, etc. and Insurance Case Information such as case#, Primary, Secondary, and Tertiary insurance get populated in the appropriate fields with Patient Alert(s) if any. Image 4 is a sample screenshot.
II.b. By clicking on the Case# box, a list of present cases for the patient will be displayed, if any. Click on the button if we need to edit the case selected in the case # field. If none of the cases are appropriate for the particular visit, add a new case by pressing the button beside the Case# drop-down & the Case setup window will open up. Enter the case details and make sure that all the information is correct and updated.
II.c. After selecting a case, enter the correct diagnoses in the Diagnosis fields. You can enter up to twelve diagnoses for a patient in the D1, D2, D3, … D12 boxes in the decreasing order of importance. To search a diagnosis by description, enter the description and press the down arrow key and select from the list or enter the diagnosis code and hit tab. Enter three or more characters to search. Practicesuite also provides ICD-10 LookUp for easy selection of ICD10 codes. See Image 5.
II.d. In the Procedure section, enter the CPT codes for the diagnoses that you have entered. When you choose a CPT code, the corresponding details for each CPT code will be displayed below (See Image 6). If we need to enter a New CPT code that is not listed in our standard Fee schedule, we can enter it directly from this field by clicking on the ‘’ button beside the CPT code field. Enter the details in the Encounter Procedure page that opens up. Enter each diagnosis pointer value in the Diagnosis code pointer Boxes specified according to the importance in the four boxes of Diagnosis pointer. Use pointers in the declining level of importance to the service line. Acceptable values are 1 through 12.
II.e. Next to diagnosis pointer Boxes are the Modifier Boxes marked as M1, M2, M3, and M4. Enter the Modifiers if required, in the Modifier Boxes. Enter the values of Units or Minutes in the Units field & select appropriate values from the drop-down under the UOM field. The charge of the typed-in procedure code will automatically populate in the Amount Field. Select the provider from the provider drop-down.
II.f. Before clicking on Save, appropriate action to be taken on the encounter can be selected from the drop-down beside the Save button such as BILL_TO_PR, BILL_TO_PT, BILL_TO_GR, NEW, or VOID. The chosen action would apply to each CPT entry in the encounter. An override drop-down is provided for each CPT entry (see Image 7) to override the encounter action and to set the CPT’s charge action separately. If ADMIN_CODE is selected from the drop-down, the line entry will be set to WO_CLOSE(Write Off Close) irrespective of the action taken on the encounter while saving.
II.g. For reference purposes, notes can be entered for each line. We can enter the Notes by clicking on the ‘Notes Icon’ next to Override drop-down. Next to Notes icon is ‘Clear icon’ (refer to Image 8), which will delete the line created. To add another line, click on ‘Add Line’ After Clear Icon.
III Additional Information
This section specifies the Superbill details, classified under five different tabs, ‘Main,’ ‘Condition,’ ‘Accident,’ ‘Lab’ & ‘Other.’
Details like Place of Service, Service Location, Rendering Provider, and Referring Provider, etc. are provided here. If authorizations exist for the insurance of the selected case, then those Authorization numbers will populate automatically, when we click on the authorization field. To add a new Authorization, press the button beside the Authorization Field. Clear Field Icon will clear the entry of authorization Field.
In the Patient Payment Field, the total account balance of the patient is displayed (see Image 9).
We can post the on-account balance payment directly from here by pressing the Post link marked in the Account Balance. The Copay and Deductible status can also be set here. We can perform the payment entry for Copay & Deductible amount by clicking the button aligned against Copay & Deductible fields. If the Auto Post checkbox is checked and a Copay payment entry is already created for that copay, then copay will automatically post while generating the charges. If we need to enter the percentage of coinsurance, provide the same in the ‘Co-ins%’ field.
III.b. Condition (F8):-
Under this tab (see Image 10), details regarding the condition of the patient like Date Patient Unable to work from, Onset of Current Illness, Date of Pregnancy, Last X-ray date, etc., are to be entered as appropriate. The initial treatment date gets defaulted in charge entry from the case screen.
For accident cases, relevant details can be entered in this section (refer to Image 11). In the case of an Auto Accident, the accident State has to be provided. Enter the Claim # of the worker’s compensation claims in the Worker Comp. Claim # field.
CLIA # & lab charges can be entered here if necessary. See Image 12.
Details of Supervising Provider, Ordering Provider, PCP, Service Auth. Ex. Code etc. can be entered (see Image 13) under this tab if required. The Service Authorization Exception Code is necessary when Providers are required by law (e.g., New York State Medicaid) to obtain authorization for specific services, but for the reasons listed in REF02, performed the service without obtaining the authorization. Check with your State Medicaid to see if this applies to your state.
Click the Notes icon to add Provider Soap Notes, Diagnosis Notes, or Procedure Notes. Refer to Image 14.
If we need to view or print a Superbill, HCFA / 1500, or CMS / 1500 forms, check the appropriate boxes and click on print.
After entering all the necessary information, pick the appropriate action from the drop-down list (i.e.) NEW, BILL to PR, or HOLD (see Image 15) and then click the Save button.
Note: If the EHR Note in Practicesuite is not complete, a warning dialog is displayed when the user attempts to save the charge; see Image 16