Medical ManagerUnit 6

ICBS 170

Medical Manager Billing Routines

Generation of bills and statements sent to guarantors and insurance companies

Patient billing Patient statements Insurance billing worksheet Trial insurance billing Insurance billing process Electronic media claims

Medical Manager Insurance companies require specific

preprinted forms Most insurances accept the CMS 1500 Some may want it completed in a slightly

different way. Medicare requires a physician's Medicare

provider number Other insurance companies require a

Worker’s Compensation #, Medicaid #, or state identification number

Medical Manager

CMS 1500 Could have as many as 99 different

formats

Medical Manager Insurance Billing Worksheet

Allows you to verify that information was entered correctly

Procedure charges assigned to proper primary and secondary insurance companies

Procedure codes, diagnosis codes and ailment information matches

Last opportunity to edit insurance related information

Medical Manager The health insurance claim form must

be accurate and complete If improperly filled out

Returned unpaid Placed in a suspense file

Can be resubmitted, payment will take longer

Medical Manager

Posting Payments and Adjustments Payments may be posted three ways

Posting payments from the Procedure Entry screen

Posting payments from the Payment Entry screen

Patient Check-out Payments

Medical Manager Payment entry screen

Used whenever a payment, adjustment or refund is to be posted to the patient’s account

Transferring financial responsibilities Produce a claim for another insurance

plan or for the patient Payments for procedures can be split

between patient and insurance carrier

Medical Manager Partial Payments

Transfer responsibility to same or secondary insurance plan

Transferring responsibility to patient Accepting partial payment as settlement

of an account

Medical Manager Open Items

The apostrophe(‘) following the insurance plan # on a line indicates that a secondary insurance plan shares responsibility for the payment but has not yet been billed

Medical Manager Status Codes

Last column on the payment entry screen

Shows who is responsible for payment

Study the status codes on page 273 These will be on your Unit Test