Frequently Asked Questions of MBS

Page One

[Go to FAQ page II] [Return to FAQ]

How to enter a balance forward demographic:

Balance forward demographics are entered the same as normal demographics.First press F3 to clear the screen, set default field values, and assign the next patient number. Enter the data fields as available. Pay close attention to the Billing Schedule field for default patient information.

How to enter a patient forward balance:

Enter all the balance forward demographics first!! Divide your balance forwards (BF) in two categories, patient responsible balances, and insurance pending, do not bill patients yet balances. Use the charge entry facility to enter the balance forward, payment entry for credit balance forward. Use F3 to clear screen. Use F2 to locate the right account. Press [enter] to bring up Demographics defaults. The date of service must be the date of last financial activity of the account, for MBS to be able to age the BF properly. The invoice number must be:

• S01 for patient billable BF's
• S26 for insurance pending BF's

Use procedure code BF and diagnosis code BF. Enter the balance forward amount and press F1 to create.

How to make a list of patient statements to be printed:

From the MBS main menu, select options 4, 3. Highlight the desired statement file and press the enter key to select. Press the key to place the cursor in the "Print to :" field. Select to print to screen (S) or printer (P) or (B). Press the function key F2 to generate a list of patients whose statements are formatted and ready to print in the selected statement file.

How to edit a charge slip:

CHARGE.SLP is a text (ASCII) file used by the MBS log function (Shift F1) within the Patient Demographics, Integrator and Account Inquiry. This file can be customized with your specialty procedures and diagnosis. To customize, MBS provides you with the MBS editor within the MBS Configuration Facility (075E). You can also customize the charge slip through any word processor or text editor like DOS EDLIN. If you use a word processor to create/edit your charge slip, you need to be sure and use the "Print to file" option within the word processor to place the final version in the MBS programs directory in ASCII form.

How to correct/fix a duplicate account:

First check to see if the duplicate account has posted transactions. If not, them simply delete the transactions, first through the charge entry facility and then delete the patient demographics record.

Otherwise, there are two ways to fix a duplicate account with posted transactions: 1. Transfer the balance from the duplicate account with posted transactions. 2. Transfer each transaction from the duplicate to the original account.

To transfer the balance:

Use payment entry facility to enter a 98XX account balance transfer to the duplicate account number. In the TO invoice, type in today's date, this is to guarantee a unique invoice number in the TO account. When done, go back to the duplicate account and update the account name to reflect the duplication problem. Also verify that the duplicate account balance is zero. The original account balance should have increased by the amount of the transfer.

To transfer each transaction:

In the charge entry facility, type the duplicate account number and press F2 to search. Select the first posted charge by pressing [enter]. Type over the account number with the original account number, and press F1 to create the charge. Search again for the same charge in the duplicate account and select it to the top of the charge entry. Use to reverse the charge. Repeat the above for each charge in the duplicate account. When done, the duplicate account should have a zero balance. The origin al account should have an entry for each transaction. Remember to update the duplicate account demographics record to reflect the duplicate problem, so that no one would use it again. You should update the patient's account name, so there is a "-" sign before the name.

Why are my aged accounts receivables reports different?

There are three different formats of the Aged Accounts Receivables reports.

• Aged Accounts Receivable I report runs off of the demographic record. The demographic record ages by the date of last payment or the date of a charge to a zero balance account.
• Aged Accounts Receivable II report ages charges by the date of service, then takes the sum of all payments to the account and credits the account from the oldest charge to the newest charge.
• Aged Accounts Receivable III report runs off of the Claim Invoice Control record, which ages from the date a claim was sent.

  In terms of speed, the first report is fastest, the third report is fast, and the second report is slow.

How to print labels for patients:

Patient labels are available on a patient-by-patient real-time basis from the charge entry facility. Or bulk labels can be printed from the Reporting Menu, Account Reports, selected by procedure performed, diagnosis performed, date of procedure Label design for width and number of lines is available from the Wks Configuration.

How to find a patient with a specific procedure, Date of Birth:

From the Reporting Menu, choose the Accounts Reports menu, and then choose the Patient List Report. Patients may be selected by procedure performed, diagnosis performed, date of procedure, etc..

How to fix an account out of balance:

The account is out of balance when the dollar amount brought upon the demographic record, or posted dollar amount on patient integrator did not equal to the sum of all transactions. To fix this, go from the Main Menu to option 7 - System Maintenance, to Rehash Facilities (option 4). You can run the PAR rehash or Claim Rehash anytime you wish. However, you should never run another rehash without consulting your DST representative.

Why is the account out of balance?

Most frequent cause of out of balance accounts is database file damage due to power problems affecting your computer system. If you are turning OFF your server in the middle of MBS, or you are losing power in the middle of MBS functions or you are not shutting down your system during storms. You should recover the out of balance account patient demographics and then run a Demographics rehash. If the Shift F4 Invoice/Claim Control facility is out of balance, then recover that file and do a CLM rehash. I f the problem reappears you should have your office ground and power tested.Check your MBS.BAT "Btrieve line"/T parameter. If this value is invalid or all users are not using the same value, you could be corrupting your database files.

How to enter a Medicare adjustment:

In the payment entry facility (0,1,3, or Shift F5 from Patient Demographics), use F3 to clear screen, press F2 to use Patient Locate window to locate the right account. Type the date of payment deposit, the Medicare payer code, use F2 in invoice # field to locate the right invoice #, type the amount of payment. Use shift F1 to bring up the auto-adjustment facility, type the Medicare adjustment code, the approved amount. When you press [enter], MBS calculates and shows the payment and adjustment. Make s ure the right payer and adjustment code shown are valid. Press F1 to create both the adjustment and payment at the same time.

How to fix a credit balance on Invoices:

• Reversing the posted payment which caused the credit balance on the invoice, and then re-entering the correct payment with the right invoice number of the claim it is supposed to be paying for.
• Use the split function in payment entry facility to move the specific payment(s) from one invoice to another. *NOTE: SEE HOW TO USE SPLIT FUNCTION*.

999999 Record not found/Statement process:

During Statement Formatting, there are two stages:

• Selects patients due for billing
• Calculates balances of billable invoices and adds that 999999 record with balance due to statements file. If user [Esc]apes out before stage 2 is completed, the user receives the "999999 record not found" message during the statement process. To correct, print the statements that do not give you this message, and start statement process again to generate the rest of the pending statements. Then print the statements formatted in this second run.

How to enter a patient forward balance

Enter all the balance forward demographics first!

Divde your balance forwards (BF) into two catagories, patient responsible balances, and insurance pending "do not bill patients yet" balances. Use the charge entry facility to enter the balance forward, payment entry for credit balance forward. Use F3 to clear screen. Use F2 to locate the right account. Press [enter] to bring up Demographics defaults. The date of service must be the date of last financial activity of the account, for MBS to be able to age the BF properly. The invoice number must be:

S01 for patient billable BF's

S26 for insurance pending BF's

Use procedure code BF and diagnosis code BF. Enter the balcnce foward amount and pressF1 to create.

How to setup the suggest function:

The Suggest Function appears automatically when the payment facility is entered or may be requested from the payment facility. The suggest calculates the amounts shown from the "T" charges on the invoice that the payment is being made to. The percentage for the suggestion is from the Billing Schedule Table. You may indicate a percentage or dollar amount for the suggestion. If two percentages are used and they do not add up to 100% the remaining amount will be indicated as an adjustment. The adjustment code used will be from the first payer code on the patient demographics record.

How to setup for auto-adjustment:

The Auto-Adjustment facility is accessed from the payment entry facility. You may manually access this facility with the shift F? key. Or, answer "Y" to the question "auto-adjust" during payment entry. (Turn on the "auto-adjust" question through the billing schedule table.) The auto-adjustment facility will assist in the adjustment calculation by finding the charges from this claim, adding the dollar amounts from the Profile Column in the Procedure Code Table. The Profile column is determined by the b illing schedule attached to the invoice/claim record that is being paid on by the adjustment facility. The auto-adjustment facility does not immediately create the payment and adjustment when you enter the facility. You have the opportunity to change the payment and adjustment amounts before they are created.

How to use the auto-adjustment function

The Auto-Adjustment facility is accessed from the payment entry facility. You may manually access this facility with the Shift F? key. Or answer Y to the question 'Auto-Adjust' during payment entry. Turn on the 'Auto-Adjust' question through the billing schedule table.

The Auto-Adjustment facility will assist in the adjustment calculation by finding the charges from this claim, adding the dollar amount from the Profile Column in the Procedure Code Table. The Profile Column is determined by the billing schedule attached to the invoice/claim record that is being paid on by the Adjustment Facility.

The Auto-Adjustment facility does not immediately create the payment and adjustment when you enter the facility. You have the opportunity to change the payment and adjustment amounts before they are created.

How to use the split function:

The split function is used when you wish to move transactions from one invoice to another invoice or to take an invoice and split it into two invoices. The split function is used by pressing Shift F2. The open invoices window will appear, highlight the claim that you wish to move transactions from. If you wish to move transactions to a different invoice number, write down that invoice number. Press F2 key to bring up transactions attached to that invoice number by highlighting different invoices and pr essing the [enter] key you will select the different records. This is indicated by a greater than (>) sign on the left hand side of the look-up window. After the transactions are selected, press the Shift F2 combination a second time, an invoice number will appear. It will be the same as the invoice number that we are moving transactions from with a different last alphabetic character at the end. Use this number, if you wish to move transactions to a new invoice number and create the claim record. If you wish to move transactions to an already existing invoice number, type in that invoice number here. Press [enter] and the transactions will be moved to the specified invoice.

How to change/update/modify/delete posted transactions/charges/payments:

If the transaction has a "T" status you 1. bring the record into the data entry fields by pressing F2-Search, the look-up window will appear, highlight the desired transaction and press [enter].

If you wish to change information, type over the data and press F8-update.

If you wish to delete information, press F7-delete, answer "Y".

If the transaction has a "0" status you can not delete the record. Instead you may reverse the record.

Bring the record into the data entry fields by pressing F2-Search, the look-up window will appear, highlight the desired transaction and press [enter]. If you wish to delete information, press F7-Delete. You will be asked "Reverse Transaction Y/N" and answer "Y". MBS will create and equal an opposite dollar amount transaction and mark the original transaction as "R"-reversed. The reversed and reversing transactions will not appear on any statement or claim. Do not try to delete a "T" status reversing transaction..

How to enter a patient payment:

From the MBS Main Menu, select options 1, 2 for Charge Entry Facility.

1. Press F3
2. If necessary, press F2 to bring up patient locate window and locate the patients account number by name. (Type partial last name and press F2, highlight desired name and press [enter] to select, Use [Esc] to bring back to charge entry). Or type the account number...Press [enter]to display account information. Verify the right account is in use.
3. Complete the information for pertinent fields. The date of service should reflect the date the services were provided. The invoice number should indicate the billing schedule to be used to handle the charges. You can use F2 in the Inv#, procedure, attending physician, location fields to bring up or locate valid field values. The procedure charge amount is brought up automatically when you type a procedure code and press the [enter] key. This amount can be overwritten if needed.
4. Verify the information on the screen. Press F1 to create the record.
5. If there is missing or incorrect information, MBS places the cursor in the field where the error occurred and displays an error message on the top of the screen.
6. If there were no errors, you will see the message "record created" at the top of the screen.

How to enter a charge

From MBS Main Menu, select options 1 then 2 for Charge Entry Facility.

• Press F3
• If necessary, press F2 to bring up patient locate windows and locate the patients account number by name. (Type partial last name press F2, highlight desired name and press [ENTER] to select, Use [ESC]to bring back to charge entry) Or type the account nubmer...
• Complete the information for pertinent fields. The date of service should reflect the date the services were provided. The Invoice number should indicate the billing schedule to be used to handle the charges. You can use F2 in the INV#, procedure, attending physician, lcation fields to bring up or locate the valid field values. The procedure charge amount is brought up automatically when you type a procedure code and press the [ENTER] key. This amount can be overwritten if needed.
• Verify the information is correct on the screen. Press F1 to create the record.
• If there is missing or incorrect information MBS places the cursor in the field where the error occurred and displays an error message on the top of the screen.
• If there were no errors you will see the message "Record Created" at the top of the screen.

How to enter Recall Notes/Patient Statements Notes:

The recall facility is available from the Charge Entry Facility. A short message may be entered into the charge facility and a procedure code for the next procedure to be performed may be indicated.

Recall Card Printing facilities are an option under the Reporting Menu.

If an "l" is indicated as the note type, it can be used for internal notes and not printed on recall cards.

If an "S" is indicated, the note will appear on the patient statement.

How to use RVRBS codes:

The new payment reform for Medicare in 1992 dramatically affects the billing practices of Medicare Doctors and Medical facilities. This payment reform is the product of years of study and assigns doctor fee based on the relative value of different procedures and resources, like overhead and education, needed to provide the procedure. The RBRVS reforms do not come fully into effect until January 1, 1996. In 1992, physicians are allowed to bill certain procedures at 1991 fees. But every year following th e allowable billable at the previous year fees decreases and a bigger percentage of the RBRVS comes into effect. Your decision to participate increases your need for an efficient billing system, to enable you to increase the claim volume, better track write-offs and adjustments and readily refile claims as needed.

The RBRVS codes were not set up to allow a one-to-one correlation to CPT-4 codes. To accommodate this efficiently there are several steps to setup our suggestions for RBRVS code use:

• We suggest that you set up new Procedure Codes in MBS with the RBRVS code in the Procedure Code field.
• Select a X-Over code column in the procedure table. Then update the Medicare Payer Codes to use this X-Over column for RBRVS codes.
• On those RBRVS procedure codes select a "best fit" CPT-4 code and enter it in the CPT-4 code field.
• For the CPT-4 codes that are replaced by RBRVS codes select a best fit RBRVS code and enter it into the X-Over CPT code field. You do this as a safeguard against accidentally using the CPT-4 codes for a RBRVS carrier.

How to use Cross Over CPT Codes:

Cross-Over (x-over) CPT codes are selected for claim forms from the Procedure Code Table for the Specific Insurance company as indicated in the Payer Code Table. The payer code table has a field "X-Over CPT". This field defaults to 1, which means that the CPT code field will be used when the insurance company is billed.

How to enter prior authorization codes:

Pre-Authorization codes can be entered for procedures by using the 'Notes' field. Place a AT followed by the autorization code in the notes field.

The 'F9-Help' information for the note field will show many of the functions of the notes field.

For information on HealthData products and services, please send e-mail to webmaster@hdata.com, phone us at (512)306-1916, or FAX your request to (512)306-1926. Our main site is located at www.hdata.com. This page, and all contents, are Copyright (C) 1998 by HealthData Resources, Inc. All rights reserved.

HDR, INC 1998 VER 4.0