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Knowledge Base

Accessing the EnableDoc knowledgebase gives your quick answers to the information you want to know. We update it daily with new information and interesting tips.

About EnableDoc

About EnableDoc

Administration and Setup

A system administrator is responsible for configuring all the organization related settings, employee profiles,location, pricing, and provider specific profiles.

1st Time Setup

It is important to follow these steps to properly setup an organization:

  1. Setup an organization, which is also the first facility or location.
  2. Setup additional facilities.
  3. Setup Default Settings.
  4. Setup Visit Types.
  5. Setup Rooms.
  6. Setup roles and permissions.
  7. Add employees.
  8. Setup provider details.
  9. Setup appointment calendar and assign times to visit types.
  10. Add payers.
  11. Add any special service. If you want to add only your CPTs, we will turn off the master CPT® list.
  12. Add prices for payers. Use Link payers to set master price lists.

Employee Profile

Employee resumes or other important information about employees can be typed and saved here. Select the employee, type the information or cut and paste it in, then click the Save Button and it is saved.

Employees

All employees must have their own user ID and password for HIPAA compliance and security. Employees are added by clicking the Employee button and this screen appears:

Adding a New Employee
Click the New Button and begin to enter the following information:
Salutation: Select from the list.
Last Name: Enter the employee last name.
First Name: Enter the employee first name.
Middle Name: Enter the employee middle name.
Department: Select a department.
Employee Type: Select the type of employee.
Status: Select if the employee is active or inactive.
Medical Provider: Sets if this employee makes appointments.
Send Orders: Allows this employee to send or print an order.
Prescribe medication: Allows this employee to send or print prescriptions.
Upload: Click the upload button to select a picture of the employee.
Remove: Click remove to delete the employee picture.
Address 1: First line of address.
Address 2: Second line of address.
Home #: Home telephone number.
Mobile #: Mobile telephone number.
Email ID: Email address.
Country: Select the country office is located in, which defaults to the U.S.
State: Select the state.
City: Select the city.
Zip: Select the zip code.
Update Credentials: This check box appears once a user is added. Check this box to change the password and other user profile settings.
User Name: Type in any name and click the check user name button to see if this name is taken.
Password: The password strength is provided by EnableDoc. All passwords must contain at least one upper case letter, one lower case letter, one number, and one special character @#$%^&=*.
Confirm Password: Please re-enter the password to confirm it.
Hint Question: This is currently not used, but will be used for employees to reset password.
Or Create Other: This is currently not used, but will be used for employees to reset password.
Hint Answer: This is currently not used, but will be used for employees to reset password.
Default Page: This sets the first page that appears after login. The options are provider dashboard, appointment calendar, or patient registration.
Is Locked: By checking this box, a user is prevented from accessing the system.
Select User Group: Check which employee roles this user has access to. At login, the user can decide which role to use.
Select Facility: Check which facilities this user will work at. At login, the user logs in at that facility.

Edit Employee
To edit an existing employee profile, type the name of the employee and select the employee from the pull down. The employee information will appear on the screen.

Search for Employee
Click the link Employee Lookup to view all employees. Click edit next to their name returns to the edit Employee profile screen.

Facility

The first facility or location is the Organization location. All these fields are required except the fax number. It is important to enter a time zone, so that any time a user logs into that facility, they will use the proper time and date where that office is located.

The following describes the fields on this screen:

Name: Name of the facility location.
Entity: Select the type of facility it is.
NPI: The national provider ID (NPI) is required to file claim.
Phone #: Telephone number of the office.
Fax #: Main fax number
Address 1: First address line
Address 2: Second address line
Country: Select the country office is located in, which defaults to the U.S.
State: Select the state.
City: Select the city.
Zip: Select the zip code.
POS: The place of service is used for HCFA 1500 claim filings for each facility.
Click the Save button to add a new facility.
Click Select next to the entered facility to edit and update it.
Click the X mark to deactivate a facility.

Item of Service

Items of service allow services to be added or managed. Enabledoc can turn off the master CPT list, so that an organization can enter custom list of CPTS or services. This will remove the thousands of CPTs from the view and only show your own CPTS. You can also use the complete list of CPTS and add your own custom services. Once a service is added, it can then be priced under Pricing.

To add a service, type the Service Name, select a category and subcategory, enter a CPT Code, and click the Save button. The new service is then added to orders and superbill. A price can then be set for the service.

Link Payer

Use this screen to quickly link payers to master payers, so that prices only need to be entered for a few payers instead of all payers. Under Tariff Name, select the master payer to link to. Check the boxes next to the Insurance Companies to link. Select the facilities to link and the effective dates. Click Link and those insurance companies are linked to the master payer.

Organization

This screen allows the organization information to be entered and the first facility to be entered.
The following describes the fields on the Organization screen:
Organization: The Organization is the legal name of the physician group and the main location of the group.
NPI: The national provider ID (NPI) is required to file claim.
EIN: The employer identification number (EIN) is used for tax purposes.
Phone #: Telephone number of the office.
Fax #: Main fax number
Address 1: First address line
Address 2: Second address line
Country: Select the country office is located in, which defaults to the U.S.
State: Select the state.
City: Select the city.
Zip: Select the zip code.
License Acceptance: After reading the license, the user accepts the terms of the license for their organization by checking this box.
Click the Save button to update this information.

Payers

Payer is used to setup insurance company pricing and guarantor or patient self payment. If you are paying through a clearinghouse, Enabledoc will work with you to ensure that the payer IDs are correct for the selected clearinghouse.

Adding and Editing Payers Adding a new payer is performed by clicking the New button and filling in each field. To edit a payer, select the payer from the pull down menu. Fill in any of the following fields that apply:

Name: This is the name of the payer that will appear on the HCFA Form or is sent to the insurer via a clearinghouse.

Short name: This is the shortened name for the payer.
Address 1: This is the first line of a payer’s address. This line is not required.
Address 2: This is the second line of a payer’s address. This line is not required.
Country: Must select the country first.
State: Then select the state for the payer.
Zip: Then select the zip for the payer.
Billing Address 1: This is the first line of a payer’s billing address. This line is not required.
Billing Address 2: This is the second line of a payer’s billing address. This line is not required.
Payment Collection Address 1: This is the first line of a payer’s collection address. This line is not required.
Payment Collection Address 2: This is the second line of a payer’s collection address. This line is not required.
Parent Payer: If this payer is the same as a parent company, select the parent company from the list.

Insurance Plan Type: This field is used to set the insurance plan type at the top of the HCFA 1500 form. The options are: Medicare, Medicaid, Champus, Champva, Group Health Plan, Black Lung, and Other.

Payer ID: This is the Id used by the clearinghouse to route the insurance claim. This must be entered for electronic claims processing.

Under Insurance, Is Insurance payer, None: If the payer is under a parent, select that option. If the payer is an insurance company, then select that payer. If the company is not an insurer, then select none.

Default Payer: This sets the payer as your default payer. If a CPT price does not appear on a price list for a payer, this payer’s price list will be used.
Contact Name: Contact person at the insurer.

Standard Price: Click this button to assign the payer to a payer pricing that already exists. The following dialog box opens:

Click on a Tariff (existing payer pricing), Click the effective tariff date, and click select next to each facility to apply it to. When done, click the Save Button and the dialog closes.

Custom Price: Click this button to set a custom price for this payer or copy pricing from another payer and increase or decrease the prices. The following dialog box opens:

New Tariff allows an effective date for pricing to be set. Select a facility pricing. The option of blank tariff means that prices are entered under the Pricing and E&M Pricing screens. Copy from company allows an existing payer to be selected and copy that pricing. The pricing for a facility and effective date pricing must be selected to copy from. The prices for the selected payer can be copied and increased or decreased by an entered percentage. Click the Save Button to enter pricing for this payer or copy the payer prices to this new payer. All prices for this payer and facility are then managed under Pricing and E&M Pricing.

Pricing

Price is used to set prices for all the services and payers, except E&M codes. Price is set for each CPT and CPT/modifier combination for each facility. To filter the pricing, select a category, sub category or enter a CPT and click the Filter button.

Entering Prices Select the Payer, facility, and effective date. Find the CPT/service line and enter the price and a valid from date, then click the Save Button and it is saved. If you want to set a future charge or discount the charge, enter a new price or discount percentage, and change the valid from date to a future date.

Click the Print Button to print all the services displayed. To save, click the Save Button. If a future date is entered, that price will not take effect until that date.

If a CPT and modifier combination needs to be priced, click the Modifier button on the CPT row and this dialog box open to set the price:

Enter a price on the modifier row and enter a valid from date, then click the Save Button. To show all modifiers that have prices, click the Show All Charges Button.

E&M Pricing

Price is used to set prices for E&M codes only. E&M pricing can be set for all providers or a group of providers by specialty, or individual providers in a specialty. Price is also set by CPT/modifier combination for each facility.

Entering E&M Prices Select the Payer, facility, and effective date. Find the CPT/service line and enter the price and a valid from date, then click the Save Button and it is saved. If you want to set a future charge or discount the charge, enter a new price or discount percentage, and change the valid from date to a future date.

Assigning E&M Prices to Groups or Provider and Providers To enter a price for a group of specialists, select the specialty and click the Filter button. To set pricing for only one provider, select an individual provider in that specialty and then click the Filter Button. Enter the E&M prices and click the Save Button.

Click the Print Button to print all the services displayed. To save, click the Save Button. If a future date is entered, that price will not take effect until that date.

If an E&M CPT and modifier combination needs to be priced, click the Modifier button on the CPT row and this dialog box open to set the price:

Roles and Permissions

Permissions are assigned to roles and each employee is assigned to one or more role.

Add or Edit a Role

  1. To add a role, type a role name. If this role has administrative permission, then click is group belongs to admin user.
  2. Click the Create Button.
  3. Select the new role from the pull down menu and click the Search Button.
  4. Select the Module permission you want to add by selecting the module name.
  5. Click on the screens this role has permission to use or click Select All.
  6. On the right, deselect any check box this role should not have permission to perform.
  7. If you want to remove permission, click on the X button for that row. 8. Click the Save Button to save all changes.

Rooms

Rooms are assigned to locations and used to manage facility utilization.

Select a facility, type a room name, and click the Save Button. To remove a room, click the X Button next to the room name. To edit a room name, click edit and the name appears next to room number.

Screen Navigation

EnableDoc’s main menu is displayed below. This menu can be displayed by clicking on the menu button. The small pushpin icon docks the menu to remain open. This menu can be resized to display more of the screen. The main modules appear with a plus sign next to them. The options that display under the module names are screens for entering or viewing information.

When first accessing the system as a provider, the Provider Dashboard is automatically displayed if configured in employee settings. Provider Dashboard displays Pending Tasks, In-Progress Notes, and Appointments. Clicking on the patient name will open the patient dashboard or the in-progress note.

Billing

Billing module describes how to create and manage claims, collections, payments, and accounts receivable using an electronic clearinghouse or manual HCFA forms.

Accounts Receivable

Accounts Receivable displays all the claims and charges for a patient and their associated guarantor. Payment for all of the patient’s guarantors is displayed. Select the guarantor to display the contact information for each guarantor.

Total Balance: This is calculated as total charges less total adjustments less payments less unposted balances. Unposted charges can be posted to claims using the Payment Management screen.

All claims and payments are displayed in the table. A new entry is made in the table for a claim with every payment and adjustment. So the same claim number may appear several times, but the adjustment field will reflect any adjustments and payments. The totals at the bottom of the table reflect the rows displayed and only count charges once for each claim. Adjustments are both adjustments and payments. Patient owes reflects what the guarantors owe for this patient. Patient’s do not owe on a claim until the patient owes amount is entered in the claim based on the EOB or COB information. Ins Owes is the amount the insurance company owes for approved claims. Days outstanding field is the total days from the date the claim was filed until the claim balance is zero. Collection Category shows what category the claim has been put in. Assign to displays the employee responsible for collecting this claim. To filter the table, type in the field under the column name and select a condition or press the enter key. To clear the filter, delete the entry and click the enter button.

Clicking on a claim displays any notes associated with a claim. A new note can be added for each claim.

To print and invoice click the patient invoice link on the upper right hand corner of the screen. To print a patient summary, click the patient summary link. The first time you print during a session may take a minute, but then generates faster after that.

Payment Plans Payment Plans are used to charge patients a set fee based on visit or monthly, quarterly, or annual charges. Payment Plans can either be set to adjust future claims to these fees or charge in addition to new claims.

Visit Payment Plans will decrement the total number of visits entered with each visit until the total visits equals zero. Claims patient amount owes will automatically be adjusted to the payment plan amount entered for each visit.

Month, Quarter, or All Payment Plans can be configured to set a monthly payment amount of a set number of visits or unlimited visits until the payment plan ends. Under this plan, all claims are adjusted to zero for the set number of visits and then a new charge is made for the monthly, quarterly, or annual plan. Payment plans can be set not to decrement only the current claims and setup the total balance to be paid over a set number of months.

Activating Time Based Payments Each month, quarter, or year a user must activate this payment plan by clicking the Start Payment Plan button in Claims Management. This button will display all patient claims that will be charged. Invoices can then be printed for all these charges by clicking the Select All check box.

Adding A Claim

Add Claim is used to create, edit, and manage claims from the submission through the adjustment and payment process. Once an encounter is created by checking in a patient, a claim can be created. It is not required to enter the diagnosis or services on the Superbill. Follow this process to create and review a claim:

  1. Creating a claim: Click Create Claim next to the encounter on the Claim Management screen or click Add patient, type the patient’s last name, select the patient, then select the encounter. A claim is then created for the selected encounter.
  2. Checking Patient Information. If any of the information is incorrect in patient registration, you can update it here:
  3. Insurance: If no Case was set for a patient encounter, then no insurer will appear. Simply select the Payer Case. If any insurance information needs to be changed for this claim, then click Details next to that insurer. Make the change on this screen and click the Submit button.
  4. Claim Details. Claims pull in all patient, provider, and facility related information for the claim to be filed. The system automatically assigns the claim to the open batch for submission to clearinghouses. If the claim needs to be assigned to another batch file, click Claim Details and select a Batch or click the New link to create a new batch name. Click the Submit button once any information has been changed.
  5. Enter or Select Diagnosis. Diagnosis can be typed or selected from an ICD9 knowledge base. Click the select button and type the name or code to find the correct ICD9. Make sure you click the Save button before doing anything else. Not clicking the Save Button will cause the diagnosis to be deleted, when another screen is opened.
  6. Add/edit Service Line. Clicking the link Add Service link or the edit link next to an existing service line displays this screen. Select one or more diagnosis as DX1, DX2, DX3, and DX4. The Service Date, Place of Service, and Rendering Provider pull in from the encounter. To get a price, select a CPT or HCPCS code by typing the code or description. One or more modifiers can be selected. Make sure the primary modifier is the billable code. Click the Get Price Button to display the price. A price can be typed if there is a reason to change the price.
  7. Update Category and Approve. Select the category to put the claim into. This is used to manage the collection of claims. Click the Save Button to save the selection. To Approve the Claim, click the Approve Button. The claim is not added to the batch and is ready for sending to the clearinghouse. See Batch Management for information on managing the batches.
  8. More than One Payer. If there is more than one payer, each claim is approved as COB or EOB information is entered or electronically received. Once a patient owes amount is received for the primary payer, the claim must then be assigned to the current day batch, and approved. The claim will then be routed to the secondary payer.

Errors Any errors that are sent back by the clearinghouse or the insurer will appear in this box with a code and description. The claim status will appear as error. Once the errors are corrected, click the Approve Claim button and upload the batch. The status will be changed to Approved. Go to the Batch Management screen, click edit batch and change the send date and the status to reissue.

Payer Adjustments and Payments Adjustments can be received electronically or manually entered. If received electronically, the claim status will be updated and the adjustments will appear in the claim and Accounts Receivable. The following adjustments and payments made or entered for this claim will appear here:

If manually entered from a COB or EOB, use the Adjustment screen. Select the insurer, the group code, and adjustment code. You must decide if you are applying the adjustments to the entire claim or individual lines on the Add Claim. Line 1 is the first line on the Add Claim screen. Click Submit and the adjustments are added.

To add notes to the claim, select the claim and click Add Note. Type a note and click the Submit button. The note is attached to the claim and will appear in the Add Claim screen and Accounts Receivable.

Batch Management

Batches are created to send a group of claims to a clearinghouse. We recommend creating a new batch for each day, so that they are organized by the day they are sent. Click the Add Batch to create a batch name, set the status of the batch, the date to send it, the transaction purpose of original or reissue. Click the Submit button to create the batch.

A batch can be sent any anytime by clicking the Send button. To download the file for manual upload, click the download button and a file will be created to save to your desktop. The file can then be uploaded to a clearinghouse.

Click the greater than > sign next to the batch displays what claims are in this batch as shown here:

Click Open Claim to open that claim into the Add Claim screen.

Billing Dashboard

The billing dashboard gives you a snapshot of how a physician group is doing in collections and claims processing. Insurance billings are all claims filed. Account receivable shows the total charges less adjustments and payments. Denied claims are those claims rejected by the insurers. Unposted Claims are payments collected but not assigned to a claim.

Billing Process

Creating claims can be performed in three ways: (1) EHR Driven Billing, (2) Superbill Driven Billing, or (3) Claim Driven Billing.

EHR Driven Billing The billing process for accounts with the electronic health records is as follows:

  1. Begin with creating a patient encounter by checking in a scheduled patient.
  2. From Provider Dashboard or Find Patient, select a patient encounter to open, and open encounter.
  3. Click Diagnosis and select one or more diagnosis.
  4. Click Orders and select the CPT or HCPCS procedures, E&M, or medications to be charged.
  5. Click Superbill and select an E&M code and finalize the claim.
  6. Click Billing and the biller then can open the claim through Claim Management or Add Claim.
  7. The claim is then reviewed.
  8. The claim is then assigned to a batch.
  9. The claim is finalized.
  10. The batch is then sent at the end of day or any time or printed to a HCFA 1500 form or exported to a file for manual upload to a clearinghouse.
  11. Any errors will be sent back by the clearinghouse or insurer.
  12. All adjustments and payments are sent back electronically or mailed back as a COB or EOB.
  13. The patient owes amount is automatically entered.
  14. A patient invoice can then be printed for the patient.
  15. Patient payments can be made by cash, check or credit card.

Superbill Driven Billing The billing process for accounts that want to use the superbill to create claims is as follows:

  1. Begin with creating a patient encounter by checking in a scheduled patient.
  2. Click Find Patient, select a patient encounter to open, and click the Superbill button.
  3. Click Diagnosis and select one or more diagnosis.
  4. Click Orders and select the CPT or HCPCS procedures, E&M, or medications to be charged.
  5. Click E&M code to select an E&M and finalize the claim.
  6. Click Billing and the biller then can open the claim through Claim Management or Add Claim.
  7. The claim is then reviewed.
  8. The claim is then assigned to a batch.
  9. The claim is finalized.
  10. The batch is then sent at the end of day or any time or printed to a HCFA 1500 form or exported to a file for manual upload to a clearinghouse.
  11. Any errors will be sent back by the clearinghouse or insurer.
  12. All adjustments and payments are sent back electronically or mailed back as a COB or EOB.
  13. The patient owes amount is automatically entered.
  14. A patient invoice can then be printed for the patient.
  15. Patient payments can be made by cash, check or credit card.

Claims Driven Billing The billing process for accounts that want to use Claim Management to create claims is as follows:

  1. Create an appointment and check the patient in.
  2. Click Billing and the biller then can open the claim through Claim Management or Add Claim.
  3. The claim is then reviewed.
  4. The claim is then assigned to a batch.
  5. The claim is finalized.
  6. The batch is then sent at the end of day or any time or printed to a HCFA 1500 form or exported to a file for manual upload to a clearinghouse.
  7. Any errors will be sent back by the clearinghouse or insurer.
  8. All adjustments and payments are sent back electronically or mailed back as a COB or EOB.
  9. The patient owes amount is automatically entered.
  10. A patient invoice can then be printed for the patient.
  11. Patient payments can be made by cash, check or credit card.

Billing Setup

Billing setup sets categories, clearinghouse, credit card processor, and select print forms. The credit card processor and clearinghouse require Enabledoc to setup these interfaces. If a custom form is ordered, the forms can be selected for 1500 form, patient statement, and receipts.

Claims management uses categories to track the status of claims through the collections process. To add a collection category, click the New link. To edit a category, click the edit link next to the category to change. To delete a category, click the Delete link next to the category to delete.

Claims Management

Claims Management is used to filter and manage claims from claim creation to insurance and patient collections. Click on the Filter bar to display the filter options that are shown on the Claim Management Screen below. Select any combination of the following filters and click Apply. Click Clear Filter to clear filter selections.

Patient Name: Enter first and last name or just last name of patient. Facility: Select All or one facility to filter on. Encounter Date: Blank is All encounters or click on the field to select or enter a date range. Claim Creation Date: Blank is all claims or click on the field to select or enter a date range. Claim ID: Blank selects is all claims or enter a claim ID. Encounter number: Blank selects is all encounters or type an encounter ID in the field. Show Only Claims: Checking this box will show only finalized superbill charges, which are claims. If not checked, it will show all encounters, which can be converted to a claim by clicking the Create Claim link for that encounter. Provider: Select All Providers for all providers or an individual provider. Total Charges: Select from the list of conditions of greater than or equal to, less than or equal to or equal to and then enter the total charges amount. This is used to filter charges greater than or less than an entered amount. Total Payments: Select from the list of conditions of greater than or equal to, less than or equal to or equal to and then enter the total payments amount. This is used to filter charges greater than or less than an entered amount. Assigned to: Claims can be assigned to employee using the Assigned to feature. All claims can be filtered by selecting that employee. The default is All. Batch: Claims assigned to a batch can be viewed by selecting the batch name and clicking Apply Category: Claims can be assigned to a Collection Category. This is used to organize claims and track their progress through the collections process. The categories can be customized under Billing Setup. Days in Category: Select from the list of conditions of greater than or equal to, less than or equal to or equal to and then enter the number of days in a category to sort by. This filter is usually used with filtering on a category. Status: Select a status to filter claims by that status. Insurance: Select an insurance company to filter on. The default is All. Patient Balance: Select from the list of conditions of greater than or equal to, less than or equal to or equal to and then enter the patient balance amount. This is used to filter charges greater than or less than an entered amount. Insurance Balance: Select from the list of conditions of greater than or equal to, less than or equal to or equal to and then enter the insurance balance amount. This is used to filter charges greater than or less than an entered amount. Click the Apply button to generate the filtered list of claims. Clear Filter will remove all the filters.

Understanding the Claim Table Encounters that have been opened will display in the Claim Management table, but claims are not created until the Create Claim link is clicked or the claim is created through Add Claim. Encounters that are Finalized on the Superbill will display Encounter Finalized as the encounter status. Claims that are already created will display the link as Edit Claim. The claim table displays the Total charges, Patient Balance, Total Payments, and Insurance Balance. These columns of data can be sorted in ascending and descending order by clicking on the column title. To view details about the claim, click the great than symbol (>) in the left most column next to each row and the details of the claim will display, as shown here:

All the payment and adjustment details and status are shown with dates of the transactions. Update Claim Assignments To assign claims to employees, simply click on the claim to assign, select the employee to assign it to, and click the Update Button. To assign multiple claims, filter the list and check the Select All check box or press and hold the Ctrl Button and click on the each claim to highlight the claims and then assign them. Update Claim Category To assign claims to categories, simply click on the claim to assign, select the category to assign it to, and click the Update Button. To assign multiple claims, filter the list and check the Select All check box or press and hold the Ctrl Button and click on the each claim to highlight the claims and then assign them.

Payment Management

Payment management is used to assign unposted payments to claims, display recent payments, and manage patient and insurance payment plans. Unposted claims are used for entering payments that cannot be assigned to a claim, because the claim has not yet been created.

Applying Unposted Payments To apply an unposted payment, click Apply Payment and this screen appears. Enter the amount to apply to each claim listed. Click the Apply button to assign the payments to the claims.

Enter the amount to apply from the amount paid to each bill then click the Apply Button.

Superbill

Superbill displays all the charges for a patient encounter. A patient encounter must be selected to view the Superbill. Click the Find Patient button, click Encounters, search for the patient encounter you need to open, and click Open Superbill. This Superbill screen will open. If a diagnosis needs to be added, click the Add Diagnosis. To edit a diagnosis, click the Edit link next to the existing diagnosis. The Diagnosis screen will open – see the Provider Guide for information on using this screen.

Add a CPT, E&M, and Medication to the Superbill, click those buttons and this dialog appears:

Click the All Services Button to search through all the E&M codes. Click the Select link next to code you want to add. If there is a payer charge for the code or if there is a master price, it will appear below. If not, the price can be entered. Click Add to List and the code charge appears below. Click the Close Button to exit or the New Button to enter a new code. To Add a CPT or Medication Code, click on either of those links at the top of the screen or from the Superbill menu.

Click Finalize button to release the charges for Claims processing. If Finalize is not pressed, then no charges will appear in the claim

Things to Know

This list describes important information on how the software works:

  • To create a claim, a patient encounter must be created. An encounter is created by entering a appointment and checking the patient in.
  • A claim is created by clicking the Create Claim link for a patient encounter on the Claim Management screen or by selecting a patient and encounter on the Add Claim screen. No charges or insurance company will appear on the Claim Management Screen until a claim is created.
  • To submit a claim, a claim must be assigned to a batch, approved, and the batch sent to the insurer.
  • Submitting to more than one payer requires that the coordination of benefits (COB) information be entered for the first insurer unless electronically received. The claim must be assigned to a new batch and approved again, so that the claim is submitted to the second insurer.
  • To send charges from Superbill to Claims, the Superbill for an encounter must be Finalized. If the encounter is not finalized and the claim is open, no charges will appear. Simply close the claim, finalize the encounter in Superbill, open the Claim, and click Rebill to pull in the charges.

Front Desk Operations

Front Desk employees manage patient registration, appointments, payment collections, tasks and messages, orders, and prescriptions. All of these features and operations are described here.

Appointments

Clicking Appointments on the Main Menu allows patient appointments to be added and managed for each provider and location. In the appointments menu, the left hand side allows you to filter by date, provider name and facility or show a provider calendar in all facilities. The right hand side of the appointment screen offers three levels of detail view – day, week and month. To find a future appointment use the Find Next feature. To see when providers are working at each location, click the Provider Timing button.

Adding a New Appointment from Appointment Schedule Follow these steps to make appointments:

  1. For appointments today, select the day of the appointment, facility, click update, and click on a time cell under a provider’s name and select New Appointment, then the Appointment Detail screen appears.
  2. To locate next available appointments, click the Find Next button and this screen appears:
  3. Select the facility, then the future time frame in days, weeks, months, years, or specific date. Select how many vacant slots to show and for which providers, then select the time of day and days of the week. Clicking Find Next displays the next available appointments. Click Select next to the time and day of the appointment, then the Appointment Detail dialog opens.
  4. Type the patient’s name, date of birth, or home telephone number (include dashes) or type in the information if it is a new patient.
  5. Select an Insurance Case, if none is defaulted. If it is a new patient, a Case will need to be added at the time and check in and then updated here to assign it to the visit.
  6. Select the Appointment Type and the time period is automatically allocated for that appointment.
  7. Select a room assignment, if desired.
  8. If the patient is a walk-in, check this box to automatically check them in.
  9. Type a reason for the visit.
  10. Select a referring physician, if none is defaulted from patient registration.
  11. Click the Make Appointment and the appointment is added to the Provider’s calendar in the unconfirmed status.

Editing an appointment Edit an appointment by clicking on the existing appointment and select Edit from the pull down menu. If you need to find the patient appointment, click the Find Patient button, type the patient’s name and click the Filter button. Click the Select button next to the appointment and click the Edit Appointment button at the bottom of the screen. The appointment status can also be changed on the edit appointment screen.

Change Appointment Status To change the appointment status, click on the appointment and select the new status – confirmed, checked In, checked out, no show, or cancel. The appointment changes color to indicate the appointment status. If you need to find the appointment, see Edit an appointment.

Finding New Appointment Appointments can either be browsed by a timeline, or be searched by a patient. Browsing by timeline is available in the appointments menu. To search by patient name, type the patient name in the search bar as shown in the picture.

Once a patient name is displayed, select that patient, and click the New Appointment button to display the Appointment Details screen or click the Repeat Appointment button to book multiple appointment in a row.

Provider Availability To determine when providers work and at which location, click the Provider Timings button to see the schedule of each provider at each facility. The appointment calendar will display days of and non working hours as shaded cells. Appointments can still be booked during those times should a physician need to see a patient.

Checking in and Taking Payments At the time of patient check in, Payment can be taken from the patients via “payment” option as shown in section 3.3 above. Selection of payment option opens up a payment window that allows for payment by check, cash or credit card. Process credit cards by either swiping the credit card if you have the swipe attachment or by manually entering the card information, and then clicking the “process” button. Finally click “submit” to submit the payment and record it in the system. If it is a check, enter the check number.

To check the eligibility of the patient to receive insurance cover, click the Eligibility tab. Benefits are checked a few days ahead of the appointment. If the insurer does not support eligibility checking, then the eligibility screen is blank. Some insurers support real time checking. Just click the Check eligibility link in the upper right hand corner of this screen.

Find Patient, Appointments, & Encounters

To open an encounter, edit an appointment, add an appointment, book repeat appointments, edit the patient registration, open a patient dashboard, or enter a payment use the Find Patient feature. Click Find Patient button to display a list of appointments, encounters, notes, and patients.

Find Patient Appointments To find a patient appointment, type their name and/or select a provider, facility, status, or date and then click the Filter button. Click on the name of the patient and the appointment. The buttons at the bottom of this menu are not active and can open an encounter, edit the patient registration, edit the appointment, book a new appointment, book a repeat appointment, open the patient dashboard (chart summary) or collect a payment.

Find Patient Encounters To find a patient encounters, type their name and/or select a provider, facility, status, or date and then click the Filter button. Click on the name of the patient and the encounter. The buttons at the bottom of this menu are not active and can open an encounter, edit the patient registration, edit the appointment, book a new appointment, book a repeat appointment, open the patient dashboard (chart summary) or collect a payment.

Find Patient Notes To find a patient notes, type their name and/or select a provider, facility, status, or date and then click the Filter button. Click on the name of the patient and the encounter. The buttons at the bottom of this menu are not active and can open a note, edit the patient registration, edit the appointment, book a new appointment, book a repeat appointment, open the patient dashboard (chart summary) or collect a payment.

Find Patient List To find a patient with a registration, type their name and/or select a provider, facility, status, or date and then click the Filter button. Click on the name of the patient and the encounter. The buttons at the bottom of this menu are not active and can open a new encounter without an appointment, edit the patient registration, edit the appointment, book a new appointment, book a repeat appointment, open the patient dashboard (chart summary) or collect a payment.

Editing an Encounter Detail for a Checked in Patient To modify a patient’s encounter details, such as their insurance, provider assigned to the patient, or referring physician, after they have already checked in can do so through Find Patient. Click Patient List, select the patient, click open encounter, and the dialog box below opens. Click edit on the encounter that needs to be modified, make the changes, and then click the Update Encounter button.

Patient Registration

Clicking on Registration on the main menu displays two options: New Patient and Existing Patient. A new patient is generally created from the appointment calendar and then updated when the appointment arrives for their appointment. However, a new patient can be added and edited from the New Patient menu option.

Adding or Updating Patient Registration Adding a new patient from patient registration begins by entering a salutation, the persons last na,e, first name, and middle name. Select a gender and enter a date of birth. Select the country, state, city, and zip code in that order. We have a database that is updated regularly with state, city, and zip codes to prevent incorrect entry. We recommend completing all the fields. The Identify type field is used only for government agencies. Select the patient’s race is now tracked for ARRA meaningful use reimbursement.

Uploading a Picture We recommend taking a digital picture of all patients and saving it as a JPG file to a folder. Click the upload button to select this picture and save it. This picture will help employee recognize patients.

Referring Physicians and other physician or imaging centers or labs are pulled in from the contacts database. These contacts must be entered to link to the patient’s registration. See the Contacts section.

Patient Registration – Other Details Other Details screen captures the patient’s work related information, special patient information, locks a patient record, and sets notification methods.

Patient Employment Details Select the student status, employment status, and occupation. Type the name of the employer and address. Select the country, state, city, and zip code. Work telephone and email are important to capture.

Patient Other Details In this section, very important persons (VIP) can be identified. Exclude from registry will exclude this patient from the quality measures and other patient base analysis. Should the patient pass away, this is where that information is entered and used for billing purposes.

Lock Password A patient record can have further security by requiring a password be entered prior to viewing a patient’s dashboard.

Notification Options There are three methods of notifying a patient of appointments: email, voice call, and text messaging. A number is select or entered to reach the patient. This function connects to the Enabledoc automated notification service.

Patient Registration – Contacts Contacts screen is used to enter contacts associate with this patient. At a minimum, an emergency contact should be entered. Start by clicking the New Group button to create a group, such as Family. Type in the contact information and click the Save button. To edit a contact, click on their name, modify the information, and click the Update button.

Patient Registration – Responsible Party The responsible party or guarantor can be set as the patient by clicking the Self button or by selecting the name of another patient or by typing in the guarantor information below. Click the Save button and the guarantor appear in the table at the bottom.

Patient Registration – Payer Once a Guarantor has been selected, a payer must be created. A payer can be an insurance company or a patient/guarantor. The payers must be setup in Administration Payers prior to selecting them here.

Cases are used to group insurances together for a patient. It allows different insurance or payers to be selected for each encounter, if needed, such as for workman’s comp claims or auto claims. To create a case name, click the New Case button. Select the case name and click the Default Case check box. If the payer is an insurance company, click the box Is Insurance Company. Select the Insurance Company or Payer if not an insurance company. Select the insurance company priority (Primary) and the guarantor. If the payer is an insurance company, the plan name, policy number, group name, and group number. If the patient has signed the assignment of benefits form, patient release on file, and PPH/HMO indicator, then check all that apply. If there is a copy amount, enter one. Click the Save button and the insurance company appears in the table below. Add another insurer or case, if needed.

Patient Registration – Attachments Patient attachments are used to store a copy of the patient insurance card, HIPAA form, and Patient Assignment of Benefits.

Create a Category: Click this button to add a new category to save files to.

Add Attachment: Select a Category, click choose a file from your hard drive, and select the file. Type a description and any remarks, and then click the Upload button. The file will appear below.

Screen Layout

Enabledoc is designed with the following buttons:

Menu: The menu can be tacked open or closed. If closed, the Menu button displays the menu. Each module in the system that the provider has access to is displayed in the menu.

Find Patient: This button displays appointments, encounters (patients that checked in), notes, and all patients. This information can be filtered and used to open encounters, open notes, book appointments, book multiple repeat appointments, edit appointments, edit patient registration, and collect payments.

Patient Name: This button displays key patient demographic information for a selected patient.

Tasks: Displays assigned tasks, notes, and messages. Tasks or messages can be created and sent or assigned to employees.

Help: This button opens a multimedia help center.

Logout: Exits the application.

Superbill

Superbill displays all the charges for a patient encounter. A patient encounter must be selected to view the Superbill. Click the Find Patient button, click Encounters, search for the patient encounter you need to open, and click Open Superbill. This Superbill screen will open. If a diagnosis needs to be added, click the Add Diagnosis. To edit a diagnosis, click the Edit link next to the existing diagnosis. The Diagnosis screen will open – see the Provider Guide for information on using this screen.

Add a CPT, E&M, and Medication to the Superbill, click those buttons and this dialog appears:

Click the All Services Button to search through all the E&M codes. Click the Select link next to code you want to add. If there is a payer charge for the code or if there is a master price, it will appear below. If not, the price can be entered. Click Add to List and the code charge appears below. Click the Close Button to exit or the New Button to enter a new code. To Add a CPT or Medication Code, click on either of those links at the top of the screen or from the Superbill menu.

Typical Work Flow

Front Desk workflow is centered on three areas: Patient Registration, Appointments, Find Patient information, Payments, Contacts and Tasks. Typically, the work flow starts with a new patient booking an appointment and then completing their patient registration information. The Provider Dashboard shows all three in a concise view and is the beginning point for physicians. Should a physician need to access any other patient record, simply click Find Patient and a window opens with options to search for that patient by appointments, encounters, notes, and a list of patients. At any time a provider can type into the note and electronically sign when it is complete.

Booking patient appointments work flow:

  1. To book an appointment for a new patient, click appointments. If it is an existing patient, type the patient name, home number (type hyphen in numbers), or date of birth.
  2. Either select the day on the calendar and click a time on the calendar for a provider or click Find Appointments to location a future day for the appointment.
  3. When the new appointment dialog opens, type in the patient first and last name, date of birth, and mobile or main telephone number. Then select a type of appointment and the reason for the appointment. Saving the appointment create a new patient registration.
  4. When the patient arrives for their appointment, collect all the key patient registration information, which includes scanning a copy of their insurance card and attaching it into their registration using Attachments.
  5. Gather the referring physician name (may need to add it to Contacts), guarantor, and insurance or payment type of information.
  6. Click Appointments and edit the patient appointment, select the insurance case and referring physician (and a room), then select check in. An encounter is now created for the patient and they are ready for the nurse or provider.
  7. Click payment to collect co-pay and collect for any outstanding payments. 8. Collect the payment and print a receipt.

Provider Work Flow

Typical Work Flow Provider workflow is centered on three areas: Appointments, Notes, and Tasks. The Provider Dashboard shows all three in a concise view and is the beginning point for physicians. Should a physician need to access any other patient record, simply click Find Patient and a window opens with options to search for that patient by appointments, encounters, notes, and a list of patients. At any time a provider can type into the note and electronically sign when it is complete.

The typical work flow as a provider is as follows, but none of these steps are required to be performed:

  1. Clicking on patient names will open the dashboard or note for the associated encounter.
  2. The patient dashboard or clinical note opens.
  3. A form is loaded based on the type of visit, facility, and provider assigned as a default.
  4. The menu templates are assigned to the form.
  5. Typically, a nurse will fill in the vitals, patient history, current medications, and chief complaint section. A provider usually verifies this information and uses it as part of the assessment.
  6. The chief complaint is usually the first area of focus. This input dynamically builds a patient description of their complaints.
  7. A review of systems is usually performed.
  8. An exam is then conducted and details are completed in the template.
  9. A diagnosis is then made or a preliminary diagnosis is made and requires further tests to make a final diagnosis.
  10. Prescriptions may be ordered.
  11. Labs or imaging or other services/procedures may be ordered or performed.
  12. The note is then reviewed, edited, and signed. This step can be performed at any point.
  13. The Superbill is then reviewed. An E&M code is selected. The codes are then released for billing by clicking finalize.

Enabledoc displays a check in the menu next to each template as information is entered and saved. A yellow check appears next to that template name to show that information has been entered. If a red check mark appears next to a template that template has been locked to indicate the information is finalized. This feature makes it easier to know what work has been completed and what work has not. A provider is not required to use this feature.

Find Patient, Appointments, & Encounters

To open an encounter, edit an appointment, add an appointment, book repeat appointments, edit the patient registration, open a patient dashboard, or enter a payment use the Find Patient feature. Click Find Patient button to display a list of appointments, encounters, notes, and patients.

Find Patient Appointments To find a patient appointment, type their name and/or select a provider, facility, status, or date and then click the Filter button. Click on the name of the patient and the appointment. The buttons at the bottom of this menu are not active and can open an encounter, edit the patient registration, edit the appointment, book a new appointment, book a repeat appointment, open the patient dashboard (chart summary) or collect a payment.

Find Patient Encounters To find a patient encounters, type their name and/or select a provider, facility, status, or date and then click the Filter button. Click on the name of the patient and the encounter. The buttons at the bottom of this menu are not active and can open an encounter, edit the patient registration, edit the appointment, book a new appointment, book a repeat appointment, open the patient dashboard (chart summary) or collect a payment.

Find Patient Notes To find a patient notes, type their name and/or select a provider, facility, status, or date and then click the Filter button. Click on the name of the patient and the encounter. The buttons at the bottom of this menu are not active and can open a note, edit the patient registration, edit the appointment, book a new appointment, book a repeat appointment, open the patient dashboard (chart summary) or collect a payment.

Find Patient List To find a patient with a registration, type their name and/or select a provider, facility, status, or date and then click the Filter button. Click on the name of the patient and the encounter. The buttons at the bottom of this menu are not active and can open a new encounter without an appointment, edit the patient registration, edit the appointment, book a new appointment, book a repeat appointment, open the patient dashboard (chart summary) or collect a payment.

Editing an Encounter Detail for a Checked in Patient To modify a patient’s encounter details, such as their insurance, provider assigned to the patient, or referring physician, after they have already checked in can do so through Find Patient. Click Patient List, select the patient, click open encounter, and the dialog box below opens. Click edit on the encounter that needs to be modified, make the changes, and then click the Update Encounter button.

Forms, Notes, & Letters

Forms, Notes, and Letters are selected by clicking Forms on the main menu. The form that is defaulted to open for an encounter is displayed under the Patient Notes section. Any of the forms can be selected and opened, by clicking Add to Notes and then clicking on the Form name under Patient Notes. If one or more letters are created from the Word Processor, the Letters will display here. Clicking on a letter name will open that letter.

Past Patient History

Past patient medical, social and family history is a custom template that can be modified to add custom sections with the following field types: texts, check box, pull downs, Boolean (yes/no), date, and word processors with selectable default text. Fields can also be set to appear based on patient gender and can display in a table. Section names, field names, and value text can be set to appear in the note. Default text can be created to appear in the note instead of the field values.

Provider Dashboard

A provider account is usually setup with the provider first seeing their dashboard of work. This dashboard displays provider tasks, open notes, and appointments. Tasks can be accessed by clicking the Tasks button. Notes are opened by clicking on the patient name in the notes list. Appointments can be filtered by date. To open patient dash board for patients with appointments, click on their name.

Screen Layout

Enabledoc is designed with the following buttons:

Menu: The menu can be tacked open or closed. If closed, the Menu button displays the menu. Each module in the system that the provider has access to is displayed in the menu.

Find Patient: This button displays appointments, encounters (patients that checked in), notes, and all patients. This information can be filtered and used to open encounters, open notes, book appointments, book multiple repeat appointments, edit appointments, edit patient registration, and collect payments.

Patient Name: This button displays key patient demographic information for a selected patient.

Tasks: Displays assigned tasks, notes, and messages. Tasks or messages can be created and sent or assigned to employees.

Help: This button opens a multimedia help center.

Logout: Exits the application.

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