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1. Getting started with Insurance Billing

2. This tutorial will provide the basic steps to follow in setting up your database
to create and track CMS-1500 insurance billing. This process is vital to
ensuring that your CMS-1500 forms are completely and accurately filled out
for you when the time comes to print or submit the forms.

3. The first step will be to Add insurance companies you will be working with.
More insurance companies may be added at any time.
To begin, Click on Maintain | Insurance Carriers.

4. Next, click New to enter an insurance company into the database. When you are
finished, click Save (or Save & New to add a new record). You can add in as many
insurance carriers as you need initially. Later (when entering Patient information),
you will be given a chance to select a Primary Insurance carrier and add in other
specific information.

5. Now, close the Insurance Carrier window. If you are working with a
Referring Physician, now is a good time to enter the physician information.
Click on Maintain | People | Physicians click New to add the physician. If
not working with a referring physician, you can skip this step.

6. Click New to add the physician. If not working with a referring physician,
you can skip this step.

7. Next, click on the Maintain Patients icon. Choose the patient you wish to
setup insurance billing for. Of course, you may need to add that client,
and if so, just click on New and enter the client information. When you
need to change or add additional data to the Client, click on the Edit
button. Then click Save to retain any changes made.

8. note the bottom-left area where the Primary Insurance
information is stored.

9. This section is where you will enter specific information about your client’s Primary and,
when needed, Secondary insurance.
See the following example:
This information will transfer to the CMS (HCFA)-1500 for billing insurance.

10. Once the client’s Primary Insurance data is saved, click on the Insurance Billing
button. This will bring up the Maintain Events window. It is necessary to create
an “Event” in order to create the CMS-1500 billing. The Event keeps billing
segregated for each accident, illness, etc.

11. Click New to enter a new Event, using the Date of CURRENT as the Event date.
You will need to choose the Event type. Description is optional for internal
reference. You should see the client’s Primary Insurance carrier displayed, if
one was selected on the Maintain Client window. When needed, you can click
in the Referring Physician box to select the proper name.

12. Additionally, this is where you will enter any Claim Number needed for your
CMS-1500 form. Along with the Prior Authorization Number, choose any
required Insurance and Signature Dates. Click Save button when ready and you
will see the Date of CURRENT shown in the listbox. This serves as the Event
Date and will keep all billing done for this Event associated with it.

13. Now we can move into actually creating the CMS-1500 forms. While there are a
few different ways to produce the CMS-1500 within the software, there is one
method that we deem a “best practice” and should be right for most users. Starting
from the Maintain Clients window, click on the Session button. This will bring up
the Maintain Sessions window where you will create Sessions (Appointments)

14. As you will note, the box (on the left side of the window) displays a listing of all session
dates/times that have been booked for this client. Review the bottom portion of the
window shown and you will see the Status: OPEN. This is important to note because as
long as any session is OPEN, you may make changes to the session (e.g. Start time). You
can also Delete a session that is in OPEN status.

15. Once the session has been completed, you may choose Create Invoice.
This action will display the window below for you to confirm finalizing the
session or appointment.
After pressing OK to Finalize the session, the session information will be
pushed forward to the Billing screen.

16. The screen below shows the date of service for the session under the Charges
area (in the pale green highlight). Should you need to adjust any of the units or
pricing information, you can do so by clicking on the Price (e.g., $27.25) field.
Just highlight the amount and type in your change. Press your Tab key or click
out of that field, and you should see the adjustment. This works the same way
with the Units column (e.g., 2).

17. After verifying the data is correct, click on the Post Billing button. This will
“lock-in” the invoice data so that you can create a CMS-1500, as indicated
in the window below.

18. Because everything has been setup for us, click on the Create CMS 1500
button and you will encounter this box. Choose the correct Event date (if
more than one exists), and then you will see the CMS-1500 form appear.

19. When the CMS-1500 appears, verify that the information is accurate. If
there are any additions or changes that need to be made, you may do this
right on the form. You may also choose to Queue the form for electronic
submission rather than printing. Click Save when finished.

20. Now the CMS-1500 form is available to be printed using the pre-printed
forms. Click on the Print button and then the Start button to preview the
form.

21. Load the blank CMS-1500 forms in your printer and click the printer icon at
the top of the screen to print.

22. This concludes the basics of creating CMS-1500 insurance billing

23. If you research all of
the software available
for our industry and
compare the features,
ease of use and
price, there is only
one clear choice.
Healthcare Office
Professional!
We are here to assist you in understanding and using the software.
Just call us toll-free at
877-384-0295