ENTERING YOUR INSURANCE INFO:
G) SET UP/ Insurance
a) From the Top Navigational Menu, select ‘Set Up’, then ‘Insurance’.
b) Select ‘Add’ to open a blank ‘Edit New Insurance Data’ form.
c) Insurance Code: Create a shortcut/nickname to reference this
Insurance. (Used by the software in various screens and reports).
d) Name: Enter the insurance company name.
e) Type: Select the type of insurance company this is (i.e.: Blue
Cross,Medicare, Commercial, CHAMPUS, etc.).
f) Payor ID: For electronically submitted claims, the insurance’s Payor
ID number will be provided by your electronic billing Clearinghouse.
g) Enter the Address, Zip, City, State, Phone, and Fax numbers in the
fields provided.
h) Type of Billing: From the drop down menu, select Paper or Electronic.
i) Clearinghouse: If the ‘Type of Billing’ chosen is ‘Electronic’,
select the Clearinghouse to be used (refer to section ‘K) SET UP/
Clearinghouse’).
j) Accept Assignment: If you accept assignment of benefits from this
insurer, select ‘Yes’; if not, select ‘No’.
k) Insurance ID Type: If the insurance company has issued your provider
a specific ID number (refer to section ‘E) SET UP/ Providers/ Insurance
ID’), select the appropriate insurance category from the drop down menu.
l) Medigap: Check this box if the insurance company is a true Medicare
supplement (if the insurance is only valid if a Medicare plan exists).
m) Referring ID in box 19: Check this box if the insurance company
requires the referring provider’s ID number printed in box 19 of the
HFCA 1500 form instead of box 17a.
n) Name of Facility in box 33: Check this box if the insurance company
requires the facility’s name to be printed in both box 32 AND box 33 of
the HFCA 1500 form.
o) Do not print facility if PoS = 11: Check this box if the insurance
company requires that you do not print the facility’s name (in box 32 or
33) if your ‘Place of Service’ code is 11 (office).
p) Only Print 1st pointer: Check this box if the insurance company
requires only the 1st diagnosis pointer to print in box 24E of the HFCA
1500 form when more than one diagnosis per CPT code is billed.
q) Box 31 blank: Check this box if the insurance company requires that
you do not print anything in box 31 of the HCFA 1500 claim form.
CONT . . .
II.
PROGRAM SETUP ...................3-18
4).
COMPANY INFORMATION
5).
PATIENT ACCOUNT NUMBERS (PAN)
6).
DATES VALIDATION
7).
DIAGNOSIS SITES FIELDS
8).
NPI FORMATTING
9).
CALIBRATING YOUR PRINTER
10).
SECURITY
11).
PROVIDERS
12).
FACILITY
13).
INSURANCES
14).
ICD-9 DIAGNOSIS CODES
15).
CPT PROCEDURE CODES
16).
MODIFIERS
17).
CLEARINGHOUSE
18).
REFERRING PHYSICIANS