Carriers

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The carrier table is designed to hold all medical insurance carriers in the United States.  The carrier is used as a default address for plans and is used as a reporting control break.

 

CARRIER TAB

 

Lookup

Lookup value

Carrier Name

Legal Carrier Name

Additional Name

Additional "doing business as" name

Carrier Type

Carrier type such as Commercial, Medicare, Medicaid, etc.

 

 

Address Information

 

Name

Facility name

Address

Address (frequently a PO Box) consisting of:

Street Address
Street Address (Add'l)
City
State
Postal Code

 

The tab order will skip from Street Address (Add'l) to the Postal Code.  The Postal Code lookup will complete the City and State.  In addition, the Postal Code lookup will default the Area Code of the telephone numbers if the Area Code is defined in Postal Code Maintenance.

Country

A foreign country may be entered if needed.

Street Address

Street Address consisting of:

Street Address
Street Address (Add'l)
City
State
Postal Code

 

The tab order will skip from Street Address (Add'l) to the Postal Code.  The Postal Code lookup will complete the City and State.  In addition, the Postal Code lookup will default the Area Code of the telephone numbers if the Area Code is defined in Postal Code Maintenance.

 

Prov/Country

A province and/or foreign country may be entered if needed.

Phone

Main telephone number.

Fax

Fax telephone number

Phone Other

Other telephone number

 

 

Setup Information

 

Is Generic - Demo Dowwnload (Use Hospital Info)

This used in Demo Downloads when the PLAN IS ALSO GENERIC to indicate if MedSuite should use the name and address from the hospital or the name and address from the carrier table in the patient policy (insurance demographics).

 

If the flag is "OFF" (un-checked), the download will use the carrier name on the carrier file in MedSuite. If it is "ON" (checked), then the download will use the carrier name from the hospital.

Self Insured

Indicates if the carrier is self-insured

3rd Party Admin

Tax ID number of the referral provider's practice

Medigap

Universal Provider Identification Number

HMO

Nation Payer Identifier

Workers Comp

Up to four (4) user-defined fields may be defined on the practice for use at the facility level

HCPCS


Prior Authorization

Indicates if the carrier requires service to be pre authorized

Medical Claims


Electronic Claims

Indicates if the carrier supports electronic claims

EMC No

Electronic claims number assigned to the carrier

 

 

Setup Information

 

E-Mail

Carrier email address

Home Page

URL of carrier's home web page

Link Page

URL or carrier's private web page from practices and physicians

Login

Login to Link Page

Password

Password for Link Page

 

 

Electronic Claims

 

NAIC No

NAIC number assigned to the carrier

PerSe Code

PerSe number assigned to the carrier

Max Items

Maximum number of line items that may be sent in a single claim via electronic claims

Other EMC Code

This field is only used if you are using a 3rd party vendor not Per-se.  Leave blank if using Per-se as your clearinghouse.

Emdeon No

Insurance payer code for Emdeon Clearing house claim submission.

Eligibility Emdeon Code

Insurance payer code for Emdeon Clearing house Eligibility request.

 

 

IMAGING TAB

 

MedSuite supports both Workflow Indexing and Manual Indexing.  Workflow Indexing may index images to Patients, Visits, Payments, and Claims.  In addition to Patients, Visits, and Payments, Manual Indexing allows images to be indexde to the following list of "entities":

 

Account

Visit

Visit Batch

Payment

Payment Batch

Claim

Company

Practice

Division

Carrier

Staff

Referral

Facility

Plan

Fee Schedule

Rate Structure

 

An Imaging Tab has been added to the Patient, Visit, Payments, Ledger, as well as the Setup functions of the above entities so that images indexed to the entity may be viewed by the user.

 

This tab contains a common frame that is used throughout MedSuite.

 

 

Image Tree

A "tree" structure containing a list of the images tied to the displayed entity (Patient, Visit, Plan, etc.) is displayed on the left side of the window.

 

The "tree" contains five "branches" although all five are never displayed at the same time.  The "leaves" on each branch represent images indexed to the branch.  The branches are:

 

Patient - Images indexed to the patient (Action = Patient)

Visits - Images indexed to visits (Action = Visit-New)

Payments - Images indexed to visits (Action = Payment Insurance -

  New or Payment Self - New)

Claims - Images indexed to claims (Action = Claim Followup)

Miscellaneous - Images indexed via Manual Indexing to some other

  entity from the list above

 

Refresh

Refreshes the Image Tree

View

Views the selected image from the Image Tree

 

 

The "image" portion of the window covers the right-most 3/4 of the window.  It contains a copy of the selected image as well as button that permit manipulation of the image.

 

Desc

The description assigned to the image by MedSuite is displayed.

Toolbar

MedSuite's Imaging Workflow screen contains a toolbar that contains buttons that perform image manipulation.

 

Zoom-In

Zooms-In (enlarges) the image

Zoom-Out

Zooms-Out (reduces) the image

Rotate Left

Rotates the image 90-degrees to the left

Rotate Right

Rotates the image 90-degrees to the right

Show / Hide Annotations

Enlarges the image by hiding the annotations on the right side of the screen

Actual Size

The image is displayed at its actual size.  This is the default setting upon entering the imaging screens.

Fit Page

The image is re-sized so that the entire image is displayed on the screen.  If you change to the Fit Page setting and don't go back to Actual Size, subsequently viewed images will display with this setting until you change it back to Actual Size.

Fit Width

The image is re-sized so that the width of the image fills the image area.  If you change to the Fit Width setting and don't go back to Actual Size, subsequently viewed images will display with this setting until you change it back to Actual Size.

 

 

 

Buttons

 

Several buttons are displayed across the bottom of the screen and are used as follows:

 

Print

Prints the displayed image

Un-Index

Displays the Move Images to Imaging Station screen.  You should enter/select the Imaging Station that you want the document moved to.  When you press Ok on the Move Images screen, the selected image is removed from the Image Tree and any indexes on the image are removed from the image.

 

In effect, the image is placed in an Imaging Station in a "ready to be processed" state.

 

Un-Index can be used any time that an image is index to the wrong entity.  Although it may be used on Patients, Visits, Payments, or Claims, this is not typical.  The Workflow will generally create these entities so it is unlikely that they will be incorrectly indexed.

 

 

 

 

 

Library Change Logs

 

The Change Log button at the bottom of any MedSuite Maintenance File will track the following:

 

$ Date Changed - The date the change was made to the file.

$ User Name - The name of the user that made the change.

$ Item Changed - The file name of the item that was changed.

$ Old Value - The system value before the change was made.

$ New Value - The system value after the change was made and saved.

 

NOTE:  Items not tracked are description fields such as degrees and titles.