If you would like the appointment screen to always come up as the main screen when the program opens, check the appropriate box in the "Preferences" screen.

The patient may be chosen in the patient screen by either clicking on the actual name of the patient, choosing the first letter of the last name from the letter list, typing in the first letters of the last name in the last name box, or typing the patient’s PIN in the PIN box.

The program is equipped with several "Hot Keys". You may press these keys from anywhere in the program to access different data and perform certain functions.

F2 will close the currently open screen, including closing the program if the Main Screen is the only window open.

F3 brings up the patient list and then goes directly into patient information and insurance screen.

F4 will always bring up the patient list, and you may enter a new patient and access other patient information from the patient list screen.

F5 brings up the patient list, then diagnosis screen.

F6 brings up the patient list, then charge screen.

F7 brings up the post/apply payment screen.

F8 brings up the Quickpay Screen.

F9 brings up the Appointment book Screen.

F10 Toggles hides an input screen, and displays the Appt. Book, then toggles back to that input screen.

F11 brings up the Statement Screen.

F12 brings up the calculator.

Quick Start...

Make sure computer settings are correct for display and dates!

Set up User(s) (Master Files - User)

Set up Preferences; appt. book settings default city, state, zip, clinic hours, visit length.

Add Clinic information (Master Files - Clinic)

Add Provider(s) information (Master Files - Provider)

Set up Procedures: (Master Files-Procedures); edit the fees for existing procedures, or add new procedures.

Add first patient (Patient - Pick patient - Add patient)

Add Insurance Company - from patient screen, or from main screen, Master Files, Insurance Cos.

Add Insurance Information for patient.

You are now ready to add appointments, diagnoses, charges, payments, process claims, print claims, print reports etc.

Instructions for Using Passwords and Logging In (DO THIS SECOND)

The first time you enter the program, it will bring you to a screen allowing you to input some information it will need for the future. Please create a User ID, input your name, and a password.

Your User ID can be up to 10 characters in length, but it is suggested that you keep it short, such as your initials, or the number 1. Each User must have a unique ID.

Your Name is, well, your name. It does not have to be unique, but probably will be.

You password should be short (20 characters or less) easy to remember, but not easy for someone else to guess. It is suggested that everyone keep their password a secret, because the program will assign your user ID to certain procedures carried out in the program, such as deleting charges, or changing payment dates (See Auditing below). you will be asked to enter it twice, and test it... because the actual letters are hidden... to protect your privacy.

The program will ask (actually, it requires) you to Log in each time you enter the program. You will be asked to enter your User ID and password at that time.

The currently logged on user's name is displayed above the appointment book on the main screen of the program.

Add New USERS by going to Master Files| Users. The input screen has instructions for adding new users' accounts. Anyone who may need to access the program should personally go to that screen, and add themselves, so that they may enter the program.

Each user, by default, is set to a Level 5. This means they may access all areas of the program AND change the levels of other users. You may want everyone except the for the program administrator (the office manager, clinic owner, or IT department head) set to a level 6 or higher. Level 6 has full access, but can not change others’ level number. The levels screen has a full description of what each level can or can not do.

You may change the user logged on by going to File, on the Main Screen, and choosing "Log On different User". This will effectively "Log Off" the current user, once a new User successfully logs on. The only way to guarantee you have been logged off, if not watching someone else log on, is to leave the program.

Setting Preferences and Initializing the Appointment Book (DO THIS THIRD)

From the Main Menu, Choose Preferences, set program preferences.

Program Preferences

At the top of the screen, you will see several buttons to choose the type of Preference you want to set. Appointments (see next section), Patients; Statements, Claims, Receipts; and Misc. are the categorical preference choices on this screen. Click on Patients at the top of the screen.

If you choose to use defaults for the patient file, type these in here. These are not required, but can save time when entering patient information, and can always be edited. Don’t add all five digits of the zip code, but just the first three. Then you only have to enter the last two digits when entering new patient information. Use the city, state, first three numbers of the zip code and the area code MOST of your new patients will have.

Choose other preferences by clicking on the box to the left of the sentence. These preferences deal with a variety of issues throughout the program, and will be referenced specifically in those sections. Some of the are designed to meet the specific requirements of users in various states, and may not apply to your operation.

If you use a numbering system for your patient ID’s (PIN), you can set the NEXT one here. Every time you start the process of creating a new patient, this number automatically advances. So if you cancel the creation, the next number has already advanced, so you may want to come back here to reset the number. Most users of the program do not bother doing that, because numbers are free. But you may do so if desired.

There are additional Preferences for controlling other aspects of program execution relating to claims, statements, receipts etc.

Appointment Book Setup in the Preferences screen

Click on APPOINTMENTS at the top of the Preference screen. If you would like the appointment book to show every time you open the program, check that box. The basic appointment types are shown, with the amount of time those appointments should take (of the doctor’s time). You may change the allotted times by using the up/down arrow keys next to the number box. You may also pick the color you wish these appointments to appear in on the appointment book.

If you need additional visit types to schedule, use the Add’l Visit types button. Name your visit type (6 characters or less for the colors to work) Pick your colors, then save.

Set How many columns you want visible on the screen (2,3 or 4). Additionally, you can set the option to show an ADDITIONAL 4 columns on a second screen page of the appointment book.

Set the Names you want displayed on the visible columns.

Set how many appointment slots you want in each 15 minute block of the appointment book. You may choose 1, 3, or 5 (or 1 slot every ten minutes).

Set the daily office times for EACH day of the week. If the office sees no patients on a given day part (shift), uncheck that box. When you are finished with the entire week, hit the Save Button, and exit the screen.

Change the calendar to tomorrow, then click back on today. You will then see a blank appt. Book with the settings you have chosen.

NOTE: AFTER A DAY HAS BEEN CREATED IN THE APPOINTMENT BOOK, IT WILL NOT BE RE-CREATED, UNLESS YOU EMPTY IT FIRST. IF YOU CHANGE OFFICE HOURS IN PREFERENCES, THE NEW HOURS WILL NOT BE REFLECTED ON DAYS ALREADY CREATED. SUGGESTION: PRINT THE DAY, EMPTY IT, THEN RE-ENTER THE APPOINTMENTS.

Master Files

Master files are files that contain data used over and over again by the program in general. These include the clinic information, the provider data, all insurance companies, taff information, all procedures, etc.

CLINIC

From the main screen choose Master Files.

Choose Clinic.

Type in all clinic information, using tab to move from field to field.

Press the Save button.

This is the information that will show in Boxes 25, 32 and 33 of the HCFA 1500 form. This will be the name and address that you want your bills submitted under for payment. Separate doctor and multiple clinic addresses (address where service is actually rendered) should be entered in the doctor file.

PROVIDER

From the main screen choose Master Files. Choose Provider

Pick the clinic from the box marked “Office (Clinic)”

Type in the provider (doctor) information, using tab to move from field to field.

NOTE: If you press the “Use Clinic Data” button on this screen, the address field will be copied from the clinic file. When those two addresses are identical (to the last dot) Box 32 WILL NOT BE PRINTED on the HCFA form.

The Additional Claim ID fields are for entering other physician identification numbers (other than the social security number). This may be a BC/BS provider number or other provider number. You can link these numbers to specific claims and insurance companies in the Map Claim form screen and the Insurance Company screen. The default for the PIN number which appears in Box 33 of the HCFA form is the social security number. Choose the appropriate type of ID from the yellow dropdown box above the box you put the ID in.

The information on this screen will show in Box 32 of the HCFA 1500 form IF the provider address is different from the clinic address This will be the actual physical address of the clinic where the services were rendered. For multiple clinics, this address may be different from the address located in the Clinic Data screen. For clinics with multiple doctors or providers, EACH one should be entered into this screen.

Press the Save button.

Insurance Companies

From the Main Screen choose Master Files. Choose Insurance Companies

Press the New button

Enter the insurance ID number. This may be numbers, letters or a combination of both. For example, the first Aetna could be AET1, the second Aetna entry could be AET2, etc.

Enter the remaining insurance company information. Choose the correct claim to use when printing HCFA 1500’s for this company.

If desired you can PROHIBIT certain procedures from being billed to an insurance company. You would use this, for example, if a certain carrier typically does not pay for an Office Visit. Press the “Add” caption, then choose the procedure you want to prohibit. Suggestion: Wait until you have finished adding and editing your master procedures before you use this feature.

If you would like this insurance co have it’s HCFA forms printed with an alternate CPT code when billing certain procedures, assign the company to a CPT Group other than one (1), and type the alternate CPT codes in Master Procedures in THAT group. NOTE: This Insurance Company will ALWAYS use that group for ALL of it’s procedures.

Press Save, then continue adding companies or press finished.

You can find insurance companies either by code, or name, by clicking on the “Order By” box, then typing the first few character of the code or name.

You can PRINT a list of insurance companies by pressing Print List of All on the menu bar at the top of the screen.

Master Diagnoses

Entering a new Master diagnosis:

From the Main Screen choose Master Files.

Choose Diagnosis

Press the New button

Enter the ICD-9 code and the Diagnosis description

Press the Save button.

Editing an existing diagnosis:

Choose the diagnosis you wish to edit from the list. Click on it once so it is highlighted.

Press the Edit button. This will place the code and description in the top box.

Make the changes. Press the Save button.

You may search the diagnosis list by either pressing on the first letter of the diagnosis, or the first numbers of the ICD-9 code. It will bring up the closest match. Use the scroll bar or up/down arrow keys on the keyboard to move up or down the list.

PROCEDURE CODES

From the Main Screen choose Master Files.

Choose Procedures

Press the New Procedure button

Enter a code for the procedure (this is not the CPT code, as you may have MORE than one procedure using this cpt code but rather an internal code, i.e. IT - intersegmental traction, M - manipulation, etc.) This code may be up to 5 characters long and may be numbers, letters, or a combination of both. IT MUST BE UNIQUE for each entry. NOTE: When you input charges for a given day, the order in which those charges appear on the HCFA form will NOT be the order you enter them, but the alphanumeric order of this code, so use codes that will for instance, adding a zero in front of all office visit procedures, will assure they are the first item in the charges for that visit. (Numbers come before letters.)

Enter the CPT and description for the procedure.

If you want a particular service or supply to default to be billed to either the third party payer or to the patient, indicate that here by either typing I, indicating to always bill this service/supply to the 3rd party payer or P, indicating to always bill this service/supply to the patient regardless of insurance status. (NOTE: this may be changed when actually entering the transaction in the patient's file).

Enter the fee for one unit for the procedure or supply.

The program will allow you to change/update fees without having to reenter the code again. By designating a start and end date on a fee, the program can keep up with what prices were in effect on what date. When you change the fees, click on to the circle next to "Change charges for this code, but maintain prior services integrity". This will insure that all prior data is protected. The program will then prompt you through the steps of changing your fees. If you are setting the program up initially, JUST CHANGE THE UNIT RATE. Prior services integrity is irrelevant.

Inventory items should be checked, so that the program can manage how many items you have on hand, and remind you when to order again. When “Inventory” is checked, you will have access to an Inventory button that brings up an Inventory Detail screen. Fill in the items on this screen, and update it after you re-order an item to give the program the information it will need for inventory management. Note the HIDE button to the bottom right. It will remove the screen from view, if it is blocking other parts of the screen.

Set the category of this procedure. Statistics are based on the category you choose here.

In the case of two insurance companies requiring DIFFERENT CPT CODES for the same procedure, the program will allow you establish an ALTERNATE CPT. Assign the alternate group number to the Insurance Company in the Insurance Master Files.

Press Save. Continue entering new procedures or press exit to return to Main Menu.

Please NOTE: After a procedure has been charged to any patient one time, you may no longer delete the procedure from the system. This is because the charge file does not store the specific information about the procedure, only the procedure ID code itself. The description and cpt are accessed through this file. To determine if you are allowed to delete a procedure, you may press the “Enable Deletion if possible” button at the top of the screen. If there are NO charges using this procedure, the Delete button will become presssable.

The program keeps stats (specifically, visits) based on procedures charged on a given day. If a patient has at least one procedure charged (even one with a zero fee) it counts that as a Visit on the Daily Activity Report, as well as the monthly, weekly and yearly stat reports. EXCEPT for all procedures that are listed in the category of Supplies, and/or have box checked that is labeled ‘Do not count as a visit”. A visit will be counted on that day if ANOTHER charge for that patient that day does not meet that criterion.

Once a procedure has been used on charge, it cannot be deleted from the system. It can however, be made inactive, and will no longer appear in pick lists for charges, default charges, or procedure sets. Previously created default charges and procedure sets will STILL have these procedures in them.

PROCEDURE SETS

Procedure sets are pre-grouped sets of visits that are most typically performed in your clinic. For example, if one of the typical visits in your clinic is a Manipulation, Ultrasound, and Intersegmental Traction, you may want to create a procedure set named MUSI. In this case, you may enter three procedures by just clicking on one set.

From the Main Menu, choose Master Files.

Choose Procedure Sets

Press Create New Set

Find the procedure to include in the set from the list on the left, and click on it so it is highlighted. If the procedure is not listed in the list, click on the button marked "Procedures". This will take you to the procedure input screen, and you may add the new procedure here.

Press the include button. This will place the procedure in the right hand box.

Continue choosing procedures for the set in the same manner.

If you wish the software to "auto assign" the name of the set, make sure the circle labeled "Use procedure Short Cut titles to name set" is filled in. The program will use the short cut titles of the procedures to come up with the set name.

If you wish to name the sets yourself, type in the name of the set, up to ten digits long (numbers, letters, or combination of both), and make sure the circle is not marked.

Press SAVE. You may then continue to enter new sets or press exit to return to main screen.

PROSPECTS

Prospects are those people whose names you've acquired as possible new patients. Perhaps you got their name from a mall screening or a patient referral, or from the Welcome Wagon. This list can be maintained in order to send newsletters or other promotional or educational activity ... using the Letters and Mailing Labels features of the program.

From the Main Screen, choose Master Files, then Prospects.

To add a new prospect, hit the New Button.

A unique PIN will be generated for the prospect. You may change that number if you desire.

Fill out the rest of the information, tabbing from field to field.

At the bottom of the page, choose the mailing list(s) you want this person to be on. You may assign up to 5 lists for each Prospect.

If you want to create a new mailing list, choose Master Mail Lists from the Menu Bar.

ADD or EDIT MAILING LISTS

The program will send letters and create mailing labels for Patients and Prospects who have been assigned a mailing list. Go to the Patient Data Screen to access the Mailing List choices for patients (you may only assign lists to patients AFTER they have become a permanent patient, which occurs after a diagnosis has been entered, or after charges have been entered.) Prospects are assigned Mailing Lists in the Prospects screen. Each Patient and each Prospect may be assigned up to 5 lists.

From the Main Screen, choose Master Files, then Mailing Lists.

To add a new List, hit the New Button.

Type a descriptive name for the list.

Press Save.

EDI Receivers

Each entity you are going to directly send claims to electronically using the ANSI X12 HIPAA EDI format must be set up as an EDI Receiver. Most of the information needed on this screen will be provided by the Insurance company or clearinghouse to which you will be sending claims. This information must be filled in before you can Map the Claim Form for EDI only.

Pick patient

Most activity in the program is patient-centric. When you want to do something for a specific patient, the program will need to know for whom. Hitting F4 from the main screen will bring up the Pick Patient screen, allowing you to pick the patient, and the screen you wish to go to. You can search for a patient by: PIN, Last Name, First Name, a combination of first and last name, or SSN by clicking in to the appropriate search box, and typing. The box that has the cursor blinking in it will accept input from the keyboard buttons at the top of the screen.

By default, the program will only display active patients. The default can be changed in the preferences screen. To see all patients, check the box marked Show Inactive Patients Also.

PATIENT DATA ENTRY

General Information

Date boxes have a calendar symbol beside them. Pressing that will bring up a standard popup calendar. Navigating with the arrows and clicking on the date can be a fast way to input dates.

When typing in the Patient Data screen, the first letter of each new word is automatically capitalized.

Entering a new patient:

Press the F4 key to bring up the patient list

Choose New Patient

Enter in the patient's information. Use the tab button to change from field to field in this screen. (Patient's Case Number (PIN) may be changed at any time before charges or diagnosis are added)… HOWEVER if you already have an appointment on the appointment book for that patient, using the original PIN you should delete the appointment BEFORE changing the PIN, then re-enter it after you entered the changed PIN.

If the patient’s case type is not self pay, the program will prompt you to add the insurance information, after you press Save. You may either add it now or later. (Note: The program will not produce a claim without insurance information and required fields entered. See next page for list of required fields.)

Make Patient Inactive

To make a patient Inactive, click on the “Inactive button in the left hand corner of the screen. When a patient is inactive, you cannot add charges to their account. They display differently in the patient choice grid. Several reports give the option of including or excluding inactive patients.

Entering the Patient's Insurance Information

After saving the patient, click on the purple button labeled Insurance/Policy at the top of the screen.

Choose the patient's insurance company from the list. If the insurance company is not in the list, go to the Insurance Companies choice on the menu, and ADD the new insurance company.

Enter the patient's insurance information. (Note: Some fields will have default information, i.e. choosing Self as relation to insured will automatically fill in the fields following it.)

If the policy expects the patient to pay a percentage of each charge, enter that amount, and make sure the Use Percent box is marked. If the patient is expected to pay a set copay amount per visit, unclick use percent, and type the amount due in $ per visit box. If the policy requires BOTH, input data in both fields, check the Use Both box. If the policy requires copays in addition to deductibles (before the deductible is met) check the box to have them both charged simultaneously.

The deductible box should contain the annual deductible amount, the deductible balance is the amount LEFT on the patient’s deductible at this time. If the deductible re-starts on January 1, click the Calendar Year Deductible Box. (You can reset all patient’s deductible balances either once a year, or for patient’s whose reset month is different than January, once a month in the “Tools” menu of the program.) If their ReSet month is June, for example, choose “6” from the dropdown list on that box.

Each new policy defaults to Primary. If you are a adding a secondary, remember to set that policy as Secondary, by checking the secondary box.

If you want to limit the amount of money that a particular claim can include (for example, if you want no claims for this patient to exceed $500) then type that amount in the Max $ per Claim box.

The Misc. 1 and Misc. 2 boxes can include specific information that may need to be printed in a special box on the HCFA form. Please the Map Claim Form section for details.

Additional boxes dedicated to Adjuster information appear at the bottom of the form. Use these for informational purposes, or to address a statement to that adjuster if required.

Press Save Policy

Required Fields (to produce a Paper claim)

Hold-Ups

To check to see if you have entered data for all required fields, choose Hold-Ups from the menu of the Patient screen You may also print the list from this screen.

This will alert you of the fields which are missing information which would “hold-up” a claim. Please Note: The system only checks for the presence of Diagnoses on this screen, not whether those diagnoses are valid as far as charge dates.

Other Dates and Information

From the Patient Screen, click on the Other Data Button. Some additional data fields, which may not be necessary for patient billing, but could be helpful in patient management are available on this screen. You can assign the patient to mailing lists, track certain tests, etc. You may also add a photo of the patient on this screen, using the jpeg format. The photo will also be displayed on the “Pick Patient” screen.

Patient’s Account

The Blue “Account” Button on the top of the Patient screen takes you the Account screen. On this screen, you have options relating to whether to send statements or not, how you want to those statements based (full charges, or just the patient portion) whether to suggest patient payments due each visit, and whether or not to charge interest.

If you leave the “Send Statement” box checked, statements will be prepared when you prepare them for all patients, and the account meets the other criteria you have set on the statement screen.

If you want the statements to reflect only the patient portion amount, check the box labeled “Include only Patient Portion Amount…”. If you click on the box “Suggest Quickpay Amount, the program will have amount of the amount already filled in, based on what you put in “Calculate Suggestion by” boxes. If you want the patient to pay 20% of that day’s charges, enter 20, and click on “Per Cent”. If the patient has a $10 per visit co-pay, click on “Dollar Amount” and type 10 in the box beside it.

Personalized Messages on Statements

Each patient’s statement can include a message tailored to them (or you can use a generic message for all patients. If you want a specific message for a specific patient, from the Patient Data Screen, click on the Line labeled “Statement Message (Click Here)” In the screen that opens next, you can create a new message by clicking on “New Message”, Give the message a title, Write the message in the large text box, complete with formatting as you wish for it to appear, then press “Save Message”. Then press the “Use” button to return to the Patient Screen. You will then see the title of the message for that patient displayed on the screen.

Referral Source

The program allows you to track the referral source for each patient. Referrers can be other patients, employees, an attorney, signage, or even a specific newspaper ad.

From the patient screen, click on the line marked “Referred By:

This will open the Master Referral Screen. If this is a new Referrer, press the button labeled “New Referrer”. Then choose the type. If the referrer is a patient, choose patient. You can then choose them from the patient grid that will appear. Other types, such as radio, or screening should be named in such manner as to easily identify it for you when you produce reports, such as “Health Fair 2002”. Once the Referrer exists, and is highlighted, press the “Save” button to assign that referrer to this patient.

This Patient

Many of the input screens in Autumn8 are Patient concentric… that is, before you can enter the data, whether it be their diagnoses, their charges, default charges, .an alert, first you must PICK the patient. These tasks can be performed from the Main screen (the appointment book), but many of those tasks can also be accomplished from the patient data screen, without having to pick a patient (because you already have.)

Patient's Diagnosis

Choose This Patient, Diagnosis from the patient menu bar, or hit F5.

If entering a new patient, choose New Diagnosis, if editing an existing diagnosis, choose Edit Existing.

To quickly navigate the grid, you can search for the diagnosis by clicking on the letters (below) to search for the Dx description, or the numbers (above the grid) to search for the ICD9 code. Choose the appropriate diagnosis by double clicking on it in the grid. The program will ask you if you wish to save the diagnosis. Press Yes. If you wish to edit some of the options regarding the diagnosis such as Visits allowed for a particular diagnosis, or #of visits pre-certified for that diagnosis, choose NO when asked if you want to save, edit any fields you wish to change, and press SAVE.

Diagnoses are ordered by their priority, the lower the number, the higher the priority. You can manually change the priority, and thus change the order in which the Dx’s appear on the HCFA forms and in reports.

The program will assign a start date and an expiration date to each diagnosis. The start date will be the same as the First Visit Date in the patient data screen… unless the date you are entering this diagnosis is thirty days or more AFTER the first visit date… in which case it will use today’s date. You can manually edit the date when entering the diagnosis. The program will assign a date far in to the future for it’s expiration. When it’s time to add a new diagnosis, manually edit the old diagnosis expiration date to the day before the start of the new diagnoses. DO NOT DELETE OLD DIAGS, just expire them, in case you need to produce SOAP notes or Narratives, or enter a charge for a period in the past.

PLEASE NOTE: Claims cannot be produced unless the very first charge you enter for a patient has at least one valid diagnosis associated with it. To be valid, the date of the diagnosis MUST be equal to or before the date of the charge. Enter the patient’s diagnosis first, if possible, before entering charges. If not possible, after entering the diagnosis, press the button in the middle of the screen to update the charges’ diags.

Using the Appointment Book

What the controls do

Calendar – Right top of the screen, controls which day you are looking at. When the date is NOT today, there is a button directly below the calendar that will return to today’s date. Change the month currently viewed by clicking on the Month at the top of the calendar. This will pop up a list of recent and future months to scroll to. NOTE: Each time you click on a day that has NEVER been clicked on before, the program creates a new BLANK appointment schedule for that day, so there is a slight delay in display while the program creates the records.

Time Line – Directly above the appointment book. Goes the closest time on the appointment book for that day. “First” goes to the first appointment already scheduled. “Last” goes to the last appointment already scheduled. All others go to the time clicked on, regardless of whether or not there is an appointment scheduled.

Schedule New Patient Button. Brings up the basic information screen for creating a new patient. After filling out that form, hit OK, then set the appointment as described in Setting a New Appointment.

One Patient’s Appointments Button. Shows you the appointment information for the patient you choose AFTER pressing this button. On this screen you can cancel an appointment, reschedule an appointment, print an appointment list (only future appointments print) or delete all PAST and FUTURE appointments.

Generate Multiple Appointments Button. Takes you to a screen for a chosen patient to set multiple appointments.

Memo Box. Located at the top left side of the screen. Allows typing and automatically saves a general message you would like to see on the day the calendar is on. Additionally, this box contains the Patient Remarks you may have entered in the Patient data screen (when you have clicked on a specific patient’s appointment.

Some Patient Specifics, including next visit, last visit date, last x-ray date (blinks if older than 17 months) preferred phone number, in time and out time (after checked in and out). This information is located to the left of the calendar, and to the right of the Generate Multiple Appointments Button.

The Appointment Book. In and Out boxes to indicate when a patient comes in and is ready to be checked out. The Name Column, shows the name and the visit type, and a notes column… double clicking brings up a memo box to type additional information about patients on that line of the book. At the top of each column is a recap of appointments for THAT column.

Setting a New Appointment (or Dropping In)

1) Find the day you want to set the new appointment by clicking on the calendar if not already on the right day.

2) Find the time you want to set the new appointment by clicking on the time line.

3) Double Click on a BLANK Space in the column you want to set the appointment for.

4) Choose the patient.

5) Click on the Visit Type (OV, or ReXray etc).

6) If a drop-in, click on Drop In, otherwise press OK

7) If the allotted time as set in preferences EXCEEDS the block of time for that appointment (i.e. if the visit length in preferences is set for 15 minutes, and each block represents 5 minutes) the following block(s) will be filled with *’s , so that you cannot overbook a period of time.

Checking a Patient In/Out

Checking a patient IN:

Bring up the appointment book for the current date.

SINGLE click on the blank box labeled "IN" next to the patient's name.

Checking a patient OUT:

SINGLE click on the blank box labeled "OUT" next to the patient's name.

Charges

If you have default charges set for the patient, the program will now ask if you'd like these entered as the charges for this visit. Choosing YES will automatically enter these default charges. Choosing NO will allow you to enter charges OTHER than the default charges.

If you have no default charges set for the patient, or answer no to the previous question, the computer will ask if you'd like to enter the charges for this visit now.

Choosing YES will take you to the charge input screen, choosing NO will keep you at the appointment screen, and the program will continue through the check out routine. Charges may be entered at any time by pressing F6 and choosing ADD CHARGES. (See CHARGES for more information)

Quick Payment

After the charges option the program will ask you if you like to enter a Quick Payment. If you have set the Account screen to suggest an amount, the amount of the payment will already be typed in.

If the provider to get credit for this payment is different than the highlighted one, click on the appropriate provider. If the payment type is not “patient check”, click on the payment type that fits this transaction. Enter the check number, and press save. You may print a simple receipt, or a detailed receipt at this point. A detailed receipt will contain the data necessary for the patient to be reimbursed if they are going to file their insurance themselves.

Next Appointment

After finishing with Quick Payment, the program will tell you when the next appointment for that patient is IF they have one scheduled.

Changing a Patient’s Appointment

If a patient has not yet been checked in, double click on their name. This accomplishes the same thing as pressing the One Patient’s Appointments Button, except that you do not have to choose the patient from the Patient Grid.

Make sure the correct appointment is highlighted in the appointment grid to the left.

To cancel the appointment, press the Cancel button. This will NOT prompt for rescheduling.

To reschedule, click that button, then press OK to the message that pops up. Change the calendar and time if necessary, and double click on an empty space. The program will confirm that you are re-scheduling the appointment you were working on.

PLEASE NOTE , if you cancel or reschedule an appointment that went over in time, and is followed by blocks with *’s, you will have to manually delete the *’s, by double clicking on the *’s.

If you would like to return to the appointment book, press the Hide Button.

Multiple Appointments

From the appointment book, choose Appointments from the Main Menu, then , or hit the

Generate Multiple Appointments Button.

Multiple appointment sets allow for quick scheduling of several appointments for a patient. If used properly, it can be a great tool for patient retention, making sure the patient always has a next appointment scheduled. You may pre-set your own sets, and use a different time when scheduling individual patients. For example, instead of scheduling ten separate appointments for the patient's first two weeks of care, choose set 5 times/week for 2 weeks. With one click you will have scheduled 10 visits for the patient. The times can always be edited, but your patient knows they are expected on those days.

Choose the correct patient for whom you are scheduling appointments.

There are several pre-loaded multiple appointment sets. These may be edited using the same procedure below except Choose Change set instead of Create new set.

Choose create new set

Hit the button marked “Create New Set” Type the description of the set (example: 3 times/week for 4 weeks)

Under visit frequency, click on the down arrow and choose the appropriate number for the VISIT FREQUENCY.

Click whether that frequency is per week, once/month or twice/month

Enter the total number of visits contained in this set (example above would be twelve)

Next click on the days for this particular set (example: Monday, Wednesday, Friday).

Choose SAVE SET.

The program will default to the type of visit will default to OV, with the time units previously indicated in your "Preferences" file. You may pick a different office visit type at this time.

Choose the desired Appointment Set from the list on the left of the screen Note: Appointment sets may be edited or created right from this screen by choosing Change Set to edit or Create New Set to build a brand new one. You CANNOT change the days that are in the set when you are generating multiple appointments. You must edit the set first if you do not like the days that are currently in that set.

Type in or choose the start date for your appointment set (this will be the date on which you want the first appointment of the set to be scheduled) or use the calendar by double clicking on the date you wish to start the appointment set.

Type in the correct appointment time, or use the up/down arrow keys to adjust to the correct time for EACH day in the set already checked. This can be an approximate time and the time can always be edited if the patient needs a different time on any given day.

Choose the column you want the appointment to be set in.

Note that the "Visit Frequency" and "Days" information cannot be edited or changed from this screen. You may edit the set to change this information.

Hit the button marked "Generate". The text will appear at the bottom of this screen showing you that the appointments were successfully generated.

ONE PATIENT'S APPOINTMENTS

To bring up the appointment book, choose Appointments from the Main Menu.

Choose the button "One Patient's Appointments"

Choose the correct patient from the grid.

The list of the patients appointments now show in the left grid. From this screen you have several options.

Printing Appointments for One Patient

Choose print schedule.

Press OK when the printer prompt comes on screen.

Press OK on the print screen when it appears. The appointments will then print to your default printer. The list will include all future appointments, including the day on which you are printing it.

Canceling a patient's appointment

This feature is used to COMPLETELY CANCEL or DELETE a single visit for a patient. If you choose the cancel a visit without rescheduling, it will show up on the Daily Activity Report.

Choose Cancel Appointment Without Rescheduling

The computer will then confirm this is what you wish to do. If it is, press YES. This will completely delete the appointment.

Reschedule Appointment

The program tracks canceled and rescheduled appointments as two different types of statistics. Therefore, if the patient is rescheduling, rather than just canceling, it is best to reschedule rather than just cancel, and set a new appointment. Choose Reschedule Highlighted Appointment (make sure the appointment you want to reschedule is the one highlighted.) Hit the “Hide” button, and go to the day and time you want to move this appointment to. Double click the space, and the program will ask you if you want to reschedule the appointment there. If you say yes, the process is complete.

Cancel Appointment, leave on book

The purpose of the Mark Appointment OFF without rescheduling button is to mark through the appointment when canceling it, but to leave it on the appointment book so that you can see it, in case you are asked where they are.

Change Appointment Type

When a scheduled appointment needs to be changed from one type of visit to another, press the button labeled “Change Visit Type”, then click on the new type when prompted, and hit OK.

Show All Appointments for Patient

By default, the only appointments that show on this screen are today’s and all future dates. If you would like to see all past appointments as well, press the button labeled: “Show Past Appointments if Available”.

Delete All Appointments for this Patient

If, for some reason, all past and future appointments for this need to be purged from the system, press the button marked: “Delete ALL Appointments”.

Printing/Clearing/Compacting Appointments

To print the appointments for a given day, click on the calendar to choose the date you want to print. Go to Appointments on the menu bar, and choose Print.

If you want to clear ALL appointments on a given day (or Un-BLOCK) go to appointments on the menu bar, then choose Empty Today. ALL APPOINTMENTS will be deleted for the day the calendar is set to.

Every so often (daily, weekly, etc.) you can conserve disk space and make the size of your back-up smaller by choosing to compact previous days’ appointments. This will delete all blank lines on the appointment book on days previous to today. Go to tools, then choose Compact Previous Appointment Dates. This can take a few minutes if you haven’t done it in a while.

NOTE: AFTER A DAY HAS BEEN CREATED IN THE APPOINTMENT BOOK, IT WILL NOT BE RE-CREATED, UNLESS YOU EMPTY IT FIRST. IF YOU CHANGE OFFICE HOURS IN PREFERENCES, THE NEW HOURS WILL NOT BE REFLECTED ON DAYS ALREADY CREATED. SUGGESTION: PRINT THE DAY, EMPTY IT, CREATE IT AGAIN BY CLICKING OFF THAT DATE, THEN BACK ON IT, THEN RE-ENTER THE APPOINTMENTS.

CHARGES

The Charge Screen can be accessed by hitting F6 from the Main Screen, or by choosing Patient, then Charges from the Main Menu, then picking the patient you wish to enter or edit charges for.

On this screen, you have access to a summary of the patients account. The blue numbers are total account (Insurance AND patient portion) The green numbers are the patient portion only.

There is an Update Diags button, use this if you have added diags AFTER you have entered charges.

From this screen you can navigate to the screen to enter charges, or to the screen to enter Quick Payments.

You can view the policy information (co-payment and deductible balance) by selecting Insurance Information from the menu bar.

Choose the button "Add Charges on (date)". You may change the date by pressing the calendar and choosing the correct date, or typing it in the box.

The program will then display the ENTER CHARGE SCREEN.

Entering Charges

There are three basic ways to enter charges for a patient.

The fastest way to add charges for a patient is to set DEFAULT CHARGES (see Default Charges) for the patient. For example, if the usual visit for the patient is Manipulation, Cryotherapy and Ultrasound, setting these three procedures as the default charges in the patient's file will allow you to enter them with one click. This button is available if you have already set default charges for that patient.

Also, you may enter unlimited PROCEDURE SETS (Procedure Sets) which are the most commonly performed visits in your office. This will allow you to enter a visit by choosing a set (one click) as opposed to line by line procedures (multiple clicks).

The third way to enter charges for a patient is line by line (one at a time).

The charges will either default to "Enter One Charge at a Time" or "Enter Procedure Sets", depending on what you have set up in your preference file. You may always select the other choice by simply clicking on it. Depending on which choice is clicked, you will either see the list of Individual Charges or Procedure Sets.

Entering Procedure Sets

Make sure that "Enter a SET of Procedures is highlighted in the upper left box.

The list of Procedure Sets that you have entered in your master file will show in the grid on the right.

You may either type in the name of the procedure set and hit return, or double click it on the grid to place it in the bottom box. Once it is in the bottom box IT IS SAVED.

The program will tell you the number of procedures entered and the total charge for the visit.

Press FINISHED.

Entering Charges One at a Time

If you'd like the computer to automatically save each procedure and automatically add another, click the box marked "Save and Add Another Without Asking". Otherwise you will need to hit the ANOTHER button between each procedure.

Make sure that "Enter One Procedure at a Time" is highlighted in the upper left box.

The list of Procedures that are entered in your master file will show in the grid on the right.

You may either type in the name of the procedure and hit return to place it in the bottom grid or double click on the procedure from the list on the right. Once it is in the bottom grid, IT IS SAVED.

The program will tell you the number of procedures entered and the total charge for the visit.

Press FINISHED.

A FEW THINGS TO KNOW ABOUT THE CHARGE SCREEN

If you want to change the information for a given visit, (doctor, charge, diagnosis, bill to) you may do so when entering the transaction. You must enter the charges one by one and change the information prior to saving the transaction. Therefore, type the name of the procedure in the edit box, which will bring up the unit price and charge for the procedure. You may then edit the charge, doctor, diagnosis or bill to prior to pressing the enter key.

EDIT CHARGES

Hit the F6 button the access the charges screen. Choose the correct patient.

The edit charge screen will appear with "All Procedures" checked (at the top of the screen) and a list of the patient's procedures in the bottom grid. You may edit the transaction by clicking right into the grid and changing the information. Once you have the correct information in the field, choose SAVE EDITS.

The two exceptions to this are "DIAGNOSIS" and "BILL TO". To change information in these two fields, click onto date and line you wish to change. A diagnosis box and bill to box will appear right above the grid. Make any changes here and press SAVE EDITS.

CHOOSING "CHOOSE VISIT DATE" will bring up a list of individual dates of service for that patient. You may then view the visits one at a time by date. Make your edits in the same manner as above, choosing SAVE EDITS when finished.

DELETE A CHARGE

The edit charge screen will appear with "All Procedures" checked and a list of the patient's procedures in the bottom grid. You may DELETE the transaction by clicking onto the date of the transaction (make sure it is highlighted) and pressing the DELETE button located at the left of the grid.

The program will confirm your deletion. Choose YES or NO.

CHOOSING "CHOOSE VISIT DATE" will bring up a list of individual dates of service for that patient. You may then view the visits one at a time by date. Make your deletions in the same manner as above. When set to a specific date, a button appears allowing you to make that day’s charges the Default Charges for that patient.

QUICK PAYMENT

A quick payment is defined as a payment on the patient's account that you do not wish to apply to a specific claim or charge but to the account as a whole. (You may later apply) The preferred method for applying insurance payments is in the APPLY PAYMENTS screen, as opposed to the quick payment screen, so the payment may be applied to a specific charge or claim for collection purposes.

To enter a quick payment:

From the Main Screen Menu Bar, Choose Patient, then Quick Payment (F8). You may also access the quick payment screen from the Charges (F6) screen.

Choose the correct patient.

Choose the correct date for the payment by hitting the calendar button and clicking on the correct date or typing it in the box.

If the provider to get credit for this payment is different than the highlighted one, click on the appropriate provider. If the payment type is not “patient check”, click on the payment type that fits this transaction. Enter the check number. Optionally, you may enter the date of service this payment is paying for. Press save. You may print a simple receipt, or a detailed receipt at this point. A detailed receipt will contain the data necessary for the patient to be reimbursed if they are going to file their insurance themselves. The receipt also includes next scheduled appointment information for the patient, if applicable.

You may view the payments in the payment grid by using the up/down arrow keys.

Default Charges

You may access the default charges screen from the Main Menu by Patients from the top menu bar, then clicking on Default Charges. You may also access it from the Patient data file by clicking on “This Patient”, then “Default Charges” on the top menu bar.

This feature is used to set up a "typical" visit for the patient to make inputting charges easier. It may always be edited or changed.

If you'd like the computer to automatically save each procedure and prompt you to add another, click the box marked "Save and Add Another Without Asking". Otherwise you will need to hit the save button between each procedure. Hit “Another” after saving if you wish to add an additional default charge.

You may either type in the name of the procedure or set and hit return to place it in the bottom grid or double click on the procedure or set from the list on the right. Once it is in the bottom grid, IT IS SAVED.

The program will tell you the number of procedures entered and the total charge for the default visit.

Press EXIT.

Applying Insurance Payments

This is the screen used to enter in checks that are received from insurance companies. The figure below shows what the screen will look like upon first entering it.

Entering a payment

The top grid (with the tan background) lists each claim that has been processed for the current patient. Select the claim that you would like to make an insurance payment for by clicking on it. The claim will turn blue as shown in the figure above.

Click on the button labeled Payment for Claim XXXXX. This will open up a second grid near the middle of the screen. This grid is shown below.

Note: If the patient has both a primary insurance and a secondary insurance, then a window will appear asking if the payer is the primary insurance company. If so, select ‘Yes.’ If you choose ‘No,’ then the secondary insurance company will be listed as the payer.

Type in the amount you would like to apply to this claim under the ‘Amount’ column. Note that this amount may be different from the total amount of the check. That is, if the total check is for $200, but you only want to apply $100 to this claim, you should enter $100.

Hit Tab, then type in the check number under the column ‘Check #.’

Hit Tab again to select and change the date, if necessary.

Next, select either ‘Apply Only to Claim’ or ‘Apply to Items.’

‘Apply Only to Claim’ will apply the payment to the claim in general.

‘Apply to Items’ will allow you to break the payment down into individual charges within the claim. One benefit to breaking the payment down to individual charges is that we have more control over the book-keeping, since we can see exactly how the payment gets split up and applied.

Once the above information has been entered, click the Save button. The following two sections detail how to complete the payment based upon whether you chose ‘Apply Only to Claim’ or ‘Apply to Items.’

Apply Only to Claim

Below is the window in which we enter the patient responsibility and the write off amount. If the patient

has a co-pay amount with his/her insurance company, it is automatically calculated and displayed in green (see figure to left). If this is the amount you wish to assign to the patient, then type that into the white box under ‘Patient.’ Likewise, enter the amount that you would like to write off into the white box under ‘Write Off.’

Notice that the remaining amount on the claim is shown in blue. It is updated after making entries into the ‘Patient’ and ‘Write Off’ boxes. Your goal is to make that amount $0, through patient assignments and/or write offs. The ‘All’ buttons will assign the total remaining amount on the claim to either the patient or write off, whichever you click.

If you have entered anything other than the patient’s co-pay amount in the ‘Patient’ box, be sure to click the button. This will update the Charges screen to reflect any new patient amount assignments you have made.

Apply to Items

Next, proceed to the bottom grid on the screen, shown below.

To apply the payment/s, simply double-click in the ‘Payment’ column next to the charge you would like to apply payment to. Then type in the amount and hit Enter. Notice that this amount has been subtracted from the ‘Unapplied’ section and added to the ‘Applied’ section. This helps you keep track of how much of the check you have applied to the claim.

The ‘Deduct/CoPay’ column contains the co-pay amount for the patient which has been automatically calculated from the patient’s insurance policy information. If this is the only amount you would like to assign to the patient, then click on the button labeled ‘CoPay.’ Otherwise, enter whatever amount you would like.

If you have entered anything other than the patient’s co-pay amount in the ‘Patient’ box, then you should click the ‘Update Patient Portion Amount in Charge Screen’ button.

The ‘Write Off’ column is where you enter the amount for each charge that you would like to write off. This would typically be equal to any remaining amount on the charge after applying the insurance payment and patient assignment.

As a shortcut, you may choose to use the buttons just above the ‘Payment,’ ‘Assign Patient,’ and ‘Deduct/CoPay’ columns to enter amounts on each charge. Clicking ‘All’ will enter the entire remaining amount of the charge into the corresponding column, while clicking ‘80’ will enter 80% of the remaining amount of the charge, etc.

Once finished, click

If there are any discrepancies between the ‘Deduct/CoPay’ and ‘Assign Patient’ columns when you are finished, then be sure to click the button. This will update the Charges screen to reflect any new patient amount assignments you have made.

on-screen buttons

There are several buttons available on the Apply Insurance Screen. The functions of these buttons are explained below.

Mark this Claim to Sends the currently highlighted claim to the print queue. Upon next entrance of

Re-print (Resubmit) the Print Claims screen, this claim will show up as ready to print.

Print Secondary Sends only the secondary claim for the currently highlighted claim to the print

Only queue. Upon next entrance of the Print Claims screen, this claim will show up as ready to print.

Mark this Claim Toggles the status of the currently highlighted claim between Open and Closed.

CLOSED/OPEN Open claims will show up as ready to print in the Print Claims screen.

Claims should be marked Open until the remaining amount has reached $0.

Call Opens a new window in which the insurance company information, insured information, and claim data are displayed for the currently highlighted claim. This is one-click information that is useful for when you need to call an insurance company about a claim.

First Highlights the first claim in the grid (by date).

Last Highlights the last claim in the grid (by date).

Find Payment Brings up a list of all payments made thus far. Highlighting a payment and clicking ‘OK’ will bring that payment up in the middle grid for editing. Highlighting a payment and clicking ‘Assign this Payment to Highlighted Claim Above’ will remove the payment from the claim it is currently assigned to, and apply it to the claim highlighted in the top grid.

Delete Payment Deletes the currently selected payment (asks for confirmation first). Note that this only deletes the payment from the middle grid. Any payments that have been applied to the individual charges in the bottom grid will need to be removed as well.

menu options

There are also several menu options listed across the top of the Apply Insurance Payments screen. These options are explained below.

Find Claim by Date This will bring up a small calendar. Choose the day on which a particular charge was made (service rendered), and the system will find and highlight the claim containing that charge.

Change Patient Brings up the Pick Patient list, allowing you to change the patient whose claims are displayed.

Tracer Report Provides a quick link to the Insurance Tracer Report, which lists unpaid claims. (see p. XX for more information on this report)

Print Print Claim # XXXXX NOW! – Prints currently highlighted claim onto a HCFA form

Preview Claim # XXXXX NOW! – Previews claim in standard HCFA format

Print Claim Grid – Prints top grid of screen (patient claim history)

Print Screen – Prints a screenshot of the Apply Insurance Payments screen.

Decimal Restorer When printing claims, Autumn8 instructs Windows to turn the decimal point into a ‘space’ so that dollar and cent amounts print correctly on HCFA forms. Occasionally, the decimal point will remain disabled upon entering the Apply Insurance Payments screen. Clicking on the Decimal Restorer will instruct Windows to re-enable the decimal key if you find that it is not working. If the decimal key still does not work after using the Decimal Restorer, exit Autumn8 then re-enter the program.

Statement for this Provides a quick link to the Process and Print Statements screen.

Patient (see p. XX for more information on statements)

Bulk Check Opens the Bulk Check utility. This is a utility that helps you keep track of payments made from bulk checks. See below for a full explanation of the Bulk Check utility.

To enter a bulk check, click ‘New Check.’ Then, use the drop-down boxes to select the insurance

company and the date of the check. Next, fill in the check # and enter the total amount of the check under ‘Bulk Check Amount.’ Once finished, click ‘Save.’

To deduct a claim payment from the bulk check, simply click once on the payment in the middle grid (with the light-blue column headers), then click the ‘Count Current Claim Payment as Disbursement’ button. Notice how the amount of that payment has now been added to the ‘Disbursed’ box and subtracted from the ‘Remaining’ box. Be sure to click ‘Save’ when you are finished.

Map CLAIM Forms

This screen tells the program to produce claims with special formatting, and it tells the program whether you want to print the claims to paper, sending them electronically, or a combination of both.

It is often the case that most insurance companies want to see the same type of information on the HCFA 1500 form. Therefore, it makes sense to have one claim form that a majority of the insurance companies use (such as Default). However, you may find that a handful of insurance companies will want to see something different. This is why Autumn8 gives us the option to create variations on the standard claim form and assign these unique forms to certain insurance companies.

Creating and modifying a new claim form

To create a new claim form variation, simply click , then fill in the ‘Claim ID’ and ‘Claim Name’ boxes. Give the claim form a descriptive ID and name so that it will be easier for you to remember what it is for (ex. A claim form to be used exclusively by Blue Cross might have an ID of ‘BC’ and a name of ‘Blue Cross.’

Along the left side of the screen, you see the different boxes on the HCFA that can be modified (Note: all boxes on the HCFA are modifiable, even the ones not listed on this screen. They are modified elsewhere).

Notice the and columns near the top of the screen. The ‘Table’ column determines what part of the program to pull the data from, while the ‘Field’ column determines the exact information to be pulled from that table. For example, if you wanted to have the patient’s SSN appear in Box 23 of the HCFA, you would select the

The following pages detail each box on the HCFA and where to enter the information that you want to see in that box.

PROCESS CLAIMS

Before printing claims (electronically or to paper), the claims must first be processed. This is accomplished through the Process Claims screen. It can be reached from the main menu: Claims, Process.

On the Process Claims screen, you will find several options. All of these checkboxes are limiting options. That is, clicking on Process Claims without having any boxes checked will attempt to process all charges in the system that have not yet been processed. Below is a description of what each limiting option does.

Hold Exclusive Items for 48 hours (Do not process)

Prevents any charge that is marked as an “exclusive item” on the Master Files: Procedures screen from processing until 48 hours have passed from the date of service.

Update Diagnoses

Updates the diagnoses entered for all unclaimed charges that are attempting to process. If a diagnosis has been entered/changed for a patient and has not been updated from the Diagnosis screen, this will update the diagnoses before processing.

Process Incomplete Claims Too

NOT RECOMMENDED UNDER NORMAL CIRCUMSTANCES.

This will generate claim numbers for all charges and prepare them to print, even if there is pertinent information missing which would normally result in a Holdup.

Process 1 Type

Process all unclaimed charges for a specific patient type (Major Med, Medicare, etc.).

Process 1 Company

Process all unclaimed charges for a specific insurance company.

Process 1 Patient

Process all unclaimed charges for one patient.

Alpha Range of Patients

Process all unclaimed charges for a group of patients, by last name.

For example, you can process claims for all patients whose last name begins with the letter ‘A,’ or for all patients whose last name begins with a letter between ‘B’ and ‘D.’

Limit by Date

Process all unclaimed charges by dates of service. For example, you can choose to process all charges that were rendered in the past week. If you place a check in the box labeled “One Day Only,” then claims will be processed for only the day listed.

Limit by Provider

Process all unclaimed charges rendered by a specific provider.

Process One Procedure Only

Process claims for only one procedure. For example you can choose to process claims for only a CMT1 procedure.

Warn Before Processing ALL Claims

Produces a warning box every time you attempt to process claims with NO limiting options selected.

Ignore State and Zips Missing

Processes all unclaimed charges even if the patient is missing the state and/or zip code from the Patient Data screen.

Show Each Patient with Patient Billing

This is a “Technical Support” feature that can help our Customer Care representatives in assisting you with certain errors that may pop up on this screen. As such, it is not necessary to use this checkbox.

It should be noted that all of the options on the Process Claims screen are cumulative. That is, you can select multiple limiting options and their effect will be combined. For example, you could choose to process claims for one patient, over a range of dates, for one provider.

There are also several menu items on the Process Claims screen. Below is a description of each of these options.

Exit (F2)

Exit the Process Claims screen. This can also be accomplished by pressing the F2 key.

Print Claims

Opens the Print Claims screen. See p. XX

Charge Screen F6

Opens the Charge Screen. See P. XX

Finish NY WC Claims

Opens the NY Workers Comp screen for finalizing NYWC claims. Simply fill-in the required data and click “Finish and Preview” to finalize.

UN-PROCESS Claims by Process Date

Allows you to un-process claims that have previously been processed. You can choose a range of dates for which the claims were processed, then un-claim them.

Note: Claims that have a Remaining amount that differs from the Charge amount will not be un-processed. This is because payment has already been applied to that claim.

Clean Claims

Opens the Clean Claims utility. See p. XX

PRINT CLAIMS

Claims being printed for the first time (not resubmits) need to be processed before printing. See the Process Claims section for information on processing.

The Print Claims screen can be opened by clicking on Claims, Print (HCFA 1500 – Paper and Print Image) from the main menu. It can also be opened by clicking on the Print Claims option on the Process Claims screen.

If there are any claims that are ready to print for the first time (or have been marked to re-print), then they will show up in the white grid at the top-right of the screen. The program will also tell you how many primary claims are ready to print directly above the Print Claims button.

Form alignment

Sometimes the printer alignment needs to be tweaked so that the claim information prints correctly on the HCFA 1500 form.

First, press the Test Print for Alignment button. Inspect the printout and determine how the information needs to be shifted. For example, if the information printed too low and too far to the left, then you would adjust the printing by clicking the scroll bars a few notches up and to the right. Again, press Test Print for Alignment and determine if further adjustments are needed.

If your Align Printing box does not look like this, then you are probably using Autumn8 on a computer that is running the Windows 98 or Windows ME operating system. On these systems, there is an alternate alignment method, shown below.

Press the Test Print for Alignment button and inspect the printout. Determine how the information needs to be shifted, and choose the box that best represents that shift.

Claim printing options

There are many options that you can choose from in order to print only the claims that you want to print. These options are discussed below.

Print to File (Print Image)

Allows claims to be created in a .txt file for electronic sending.

Extra line on Eclaim

Places an extra line at end of .txt file (may be required for some clearinghouses).

Extra Line EOF

Places an End of File line at end of .txt file (may be required for some clearinghouses).

Use Alternate Alignment Method

Switches to “Legacy Version” alignment method.

Print Secondary Only

Print only secondary claims.

Automatically Print Secondaries if indicated in Patient Screen

Print secondaries if “Bill 2^nd Insurance” is checked on Patient Data screen.

All Claims for 1 Patient

Print all claims that have been processed for a patient. Selecting this option will open up the Pick Patient screen for you to select which patient to print all claims for.

Range of Dates (Processed) for 1 Patient

Print all claims that have been processed for a patient within a range of process dates. For example, you can choose to print all claims for one patient that you processed 2 weeks ago.

All Claims – Range of Dates (Processed)

Print all claims that have been processed within a range of process dates. For example, you can choose to print all claims that you processed 2 weeks ago.

All Claims – Range of Dates (Charge Dates)

Print all claims that have been processed within a range of charge dates. For example, you can choose to print all claims pertaining to charges that were incurred during the last week.

Range of Dates (Charge Dates) for 1 Patient

Print all claims for 1 patient that have been processed within a range of charge dates. Exactly the same as the previous option, except limited to only one patient.

One Claim Number

Print one claim number.

Range of Claim #’s

Print a range of claim numbers. For example, you can choose to print all claims between 70000 and 70010.

All Unprinted Claims

Print all processed claims that have not yet been printed.

Unprinted by Type

Print all processed claims that have not yet been printed and are of a certain type (Major Med, Medicare, etc.).

Limit Re-Prints by Type

Print claims that have been previously printed and are of a certain type (Major Med, Medicare, etc.).

Limit by Provider

Print all processed claims, limited by the provider.

Limit by BOTH

Print all processed claims, limited by a certain type (Major Med, Medicare) and limited by provider.

Limit by Primary Insurance

Print all processed claims for a specific primary insurance company.

Make Balance Due: $0

Force BALANCE DUE (box 30) to print 0.

Make Amount Paid $0

Force AMOUNT PAID (box 29) to print 0.

Print in All Caps

Print all characters in CAPITAL LETTERS.

Print Max:

Limit how many pages that can be printed.

Preview

When checked, all claims that are to be printed will appear first on the screen after clicking Print Claims, allowing you to inspect them before sending them to the printer.

Print 2 Copies

Print 2 of each claim.

Skip if Remaining $ is Zero

Do not print claims that have 0 for BALANCE DUE (box 30).

Font

Select the font for the text on the HCFA form. Most commonly selected font: Arial

Start with Insco ID starting with:

Start printing with Insurance Company whose ID begins with a certain letter.

Start with Pat Last Name beginning:

Start printing with patient last name that begins with a certain letter.

RE-PRINTing CLAIMS

If you'd like to print your resubmitted separate from your regular billing, follow the procedure below, PRIOR to processing and printing regular billing.

You may also re-print all claims for a range of dates, all claims for one patient, or a range of dates for one patient. It is not necessary to re-process re-prints first.

Choose the print option from the process claims screen or from the Main Menu choose claims.

Choose Print Claims

The program will tell you how many resubmitted claims there are to print. To print re-submits choose the button "Print Claims"

Choose OK on the print screen.

NOTE: To test the alignment of the claim form, hit the TEST button. You can then use the Up/Down and Left/Right align bars to adjust the text on the claim form.

Other Options...

You may re-print claims that have not been marked for re-submission in the following manner:

All Claims for one Patient-

Choose patient you wish to reprint claims for and press Print Claims

Range of Dates for one Patient-

Choose patient then use calendar to choose range of dates and press Print Claims

All Claims - Range of Dates-

Choose range of dates to re-print and press Print Claims

Print Electronic Claims

Print Image Claims

Creating a print image file of your claims rather than printing to paper requires creating a new printer for your computer that prints to a file, instead of a printer. LEAVE THE PROGRAM, Go to Settings, Printers, then Add New Printer. Give the following answers to the questions the Windows Printer Wizard Asks:

Local or Network, choose local.

Manufacturer: Generic

Printer: Plain Text

Port: FILE

Name: tgi (must be lower case)

Default Printer: NO

Test Page: No

After you have created the printer, return to Autumn8, go to claims, Print. One of the print alignment choices at the left top of the screen is Print to File, click that, press Save. When that choice is clicked, and there is a local File printer named tgi, the program will automatically print the claims to a file after the Print Claims button is pushed. When the print process is nearing completion, a box will appear asking what you would like to name the file. A name like CLM41503.TXT (claim file created April 15.2003) will help you identify WHEN you created the file. In order for internal view to recognize the file, you should make sure you end the file .txt (period, t-x-t.)

There is an option in the Map Claim form screen to Always Print to Paper… with that option marked true on a given Claim Form, any claims waiting to be printed would be skipped in the print process if you are printing to FILE. Therefore, if you are printing a mixture of E-Claims, and Paper claims, print the E-claims first. After you have named the file, the program will ask if you wish to mark those records as printed. Say Yes… then the remaining claims can be printed to paper.

ANSI X12 EDI Claims

NOTE: If you have been sending electronically through a clearinghouse, using the PRINT IMAGE format, you do not have to change what you have been doing. The new format does not replace the old format, it is an additional way to send claims, and requires establishing communication with EACH entity you will be sending claims to. Before using the EDI, you must already have been assigned a Submitter number, as well as been given THAT receiver's RECEIVER ID. This will be filled out in the Master Files, EDI Receivers screen. You will need an entry in THAT screen for EACH company you will be sending to.

Once the Receiver file is filled out, you can designate which claims go individual receivers in the Map Claim Form Screen (under Master Files or Tools). Choose the claim form, then in the Print To box at the bottom of the screen, choose EDI Only. You will then have an option to choose the Receiver of that Claim Forms' claims.

Process Claims as you normally do. There is no change in the procedure of processing claims, clearing holdups etc.

Once processed, EDI claims will be available ONLY in the EDI claims screen. Claims going to paper, OR Print Image electronic will be available in the Print Claims Screen. In the EDI screen, there is choice of sending either Test files, or Production Files. The default is Production. Change this to test if your receiver wants you to send test files. The program will default to the FIRST Receiver in the system. If you have multiple receivers, you will need to create a file to send to each one.

If you have set up a Default name for the file being sent, the program will name the file for you, with the date, followed by the first 4 letters of the Receiver's name, followed by .837. You may edit that name if you wish, before pressing the Make It button. Files created will be located in the C:\a8\edi folder on the machine on which the file was created.

When completed, the program will ask if you want to mark these claims as sent to the file. This DOES NOT MEAN they have been transmitted yet, just that the file has been made to send.

The file can be sent either by the HyperTerminal program (Programs,Accessories, communications, HyperTerminal), or any third party communication program that can send and receive files.

PRINT STATEMENTS

From the Main Screen, choose Statements on the Menu Bar.

The program dynamically produces statements, based on what you tell the program the starting and end dates of the period are. Previous balance is a calculation of what the balance was on the day prior to the start of the statement period. You may make the statement period any length of time you desire. You may print statements for one patient, or any range of ACTIVE patients, alphabetically by last name.

Accept or change the start and end dates of the statement period.

Accept or change the starting and ending last name.

Choose the range of statements you want to print.

Accept or change whether you want all charge details printed.

If producing a statement for one patient, you can choose an alternative addressee, such as an insurance company, or the adjuster.

Press Process and Print or Process and Preview.

NOTE: How the patient's account is set up (Patient Data Screen) will have a direct effect on the statement. If you have selected the option to only show Patient Portion amounts on the statement in the Patient’s Account screen, you will only see patient portion amounts, and patient payments on the statement. If you have indicated a minimum payment is due periodically, then only that payment will show as being due, despite whatever other charges have been billed to the patient.

Printing Reports

All reports my be accessed by either hitting the Reports button on the Main screen, or choosing Reports from the Menu Bar.

Daily Activity Report

From the list of reports choices choose Daily Activity Report.

Type in or choose a calendar date for the report.

If you have more than one provider in the system, choose all providers, or which one you want to build the report for.

Choose preview, or print.

If preview is chosen, you may print the report after viewing it by choosing File from the menu bar, then choosing Print.

Holdups

From the list of reports choices choose Holdups.

The program will generate a list of all patients who have charges, but have not had claims created because of missing information in either their patient file, their policy file, or there is no diagnosis either in the system or on a specific charge. NOTE: You may update a charge to include diagnoses that have been entered AFTER the charge was entered by hitting the UPDATE DIAGS button in the charges screen (F6).

You may print the report after viewing it by choosing File from the menu bar, then choosing Print.

Print Letters

You can create an unlimited number of Mail Merge letters in Autumn8. Start by creating a new letter, Add the letterhead, and any other fields and text you would like to have in your letter. The fields available are listed plainly on the screen, and are inserted in the letter where your cursor is at the time you press the button with field label on it. When your letter is complete, Save it… then go to Process Letters. Letters may be sent to either patients or prospects. There are a variety of filters available to choose to whom you are sending the letters, or making the labels for, including:

Print Mailing Labels

Labels may be generated for either patients or prospects. The program prints 30 labels per page @ 1" by 2 5/8" each. (Avery 5160) There are a variety of filters available to choose for whom you are printing labels, and are the same as the letters choices.

From the list of reports choices choose Mailing Labels

Choose the patient or prospect filter, or you can create labels to be sent to insurance companies according to the choices on the screen.

Press Print or Preview.

Print Patient Lists

From the list of reports choices choose Patient Lists

Choose the patient filter you want to print from the list on the screen (all patients, all active patients, all inactive patients, all patients by birth month.) Uncheck the fields you will not need on your report (too many fields make the list hard to read.)

Press Print on the Menu Bar.

Print Monthly, Weekly, or YEARLY Stats

From the list of reports choices choose Monthly ,Weekly or Yearly Stats

Make sure the date AND the year are correct for the period you are wanting to report. If you have more than one provider in your system, either choose the correct provider, or click the box marked “All Providers”.

Press GO.

Print Receivables Reports

Reports, Receivables Reports opens a screen where you can print either an Aged report, with 30,60,90 day ageing on activity, or a non-aged balance report. On the aged report, payments are applied to oldest charges in order to maintain a consistent convention.

HIPAA compliant edi

Filing electronically using the ANSI X12 format for ELECTRONIC DATA INTERCHANGE as mandated by HIPAA requires additional data in the system compared to printing the HCFA 1500 paper forms. The following will show you what is required on each of the affected screens to accomplish creation of the 827 electronic claim.

Master Files, Provider

In addition to name, address and assigned provider ID’s that paper claims need there are three additional points of input necessary for EDI.

The National Provider ID. Once assigned to a provider, it will be input beside the Provider Code.

The Provider Taxonomy code. Click in to that box, and common codes will be shown. Clicking on the appropriate specialty will fill the taxonomy field with the correct code. If the specialty you need is not listed, clicking on the yellow line above the taxonomy box will take you to the wpc-edi web site where additional numbers available. You must be online for this feature to work.

The Headings above each provider ID to the right of the screen must have an appropriate title chosen. Click on the down arrow on the heading above the ID for the choices.

Master Files, Insurance

On Print Image Claims, the Insurance Co. Payer ID generally goes in the Address 2 Box. For EDI, there is a special EDI Payer number box to the right of the ID for that company. This number will be supplied by your clearinghouse, or the insurance company itself. Additionally, there are two settings that must be chosen for each company. You must choose the type of insurance for each company, for those times when it is the Primary carrier, AND when it is the secondary carrier. The program will default to the “Commercial Insurance” setting.

Patient Data

For paper and Print image claims, the data on the patient screen is sufficient without additional case information. However, for the 827, additional information is necessary to report. This information can be entered by pressing the button marked “Add New Onset and/ EDI Case Info. This will bring up a new set of fields to be filled in. Even though you already have the Onset date filled above, you must enter it again in the new data area. Each time you have a new onset date for this patient, create a new set of case data. EDI claims will not process without this information. The fields that are bold are required if known. The entry for First Treatment relates to THIS onset date. If more than one set of case data exists, a grid will appear with the different onsets dates. Clicking on the appropriate date will display that onset’s set of case data.

NETWORKING tgi...PROGRAMS

FIRST: Install program on each machine, using the aforementioned installation instructions.

On the Server only… The entire local C drive must be set to share, with full write access.

On Each Client, Map the Server’s C drive to F (or any letter you wish, for purposes of these instructions, F will be assumed.)

On EACH machine (including the server):

Go to Start, Program, tgi, then tgi… Utilities. Choose Configure Database.

Go to the Configuration Tab, click on the Plus sign beside configuration, go to system, then INIT. Change Local Share to True, go to Object on the menu bar, choose Apply. This is the only change you need make on the “Server”

Follow the rest of the directions for EACH client machine.

Still in the configuration Tab, go to Drivers, then Native, Then Paradox. Change NetDir to F:\.

Click on the Database Tab, click once on Autumn8. If you only have the Notes program, change the path to: F:\tgi. If you have the Autumn8 program, and have been licensed for multi-user operation of Autumn8, change the path to F:\A8. Note: if the you cannot edit the path, right click Autumn8, choose close, then edit the path.

Click once on the tgi database, change the path to F:\tgi., click right above the path in to the Enable BCD. Then go to the menu bar, choose object, then press apply.

tgi… CASEnotes

SET-UP CLINIC INFO AND DEFAULTS

From the main menu, press the large button at the top of the screen labeled "Press Here to Enter Clinic Set up Data"… or go to Master Files, Clinic.

This is the screen in which clinic default information will be entered. To move between boxes, press TAB.

Enter the doctor's name.

Enter the clinic name. If you wish to have to clinic address show on your narrative reports, you may enter this information. The address is not mandatory.

OBJECTIVE FINDINGS - You may either choose the objective findings from the list provided by pressing the down arrow key, or you may type in your own. To use the ones already on the screen, TAB through each box. (Note: These are the six objective findings which will show in the Main Objective Screen in the VISITS Entry Screens.) Additionally you may change the verbs following each objective finding by picking from the list or typing your own. (Example: Edema NOTED in the cervical region or Muscle Spasm OBSERVED in the thoracic region).

DIAGNOSTICS USED IN CLINIC - Type in the diagnostic choices used in your clinic.

Next you will choose whether you will TYPICALLY use a 1-10 pain rating scale ,the AMA pain rating guidelines, or whether you will report on your patients. This will be used as a default setting but may be changed from patient to patient.

The Codes for Chiropractic Manipulative Treatment are only applicable if you are using our billing program, Autumn8. Otherwise disregard this section.

You may change how your adjustment reporting reads by changing the text next to Adjustment Sentence Builder

THERAPY USED IN CLINIC - Press the THERAPIES button located at the bottom of the screen. You may change these therapies by simply clicking into the box and typing the therapy you wish to appear there. You may also choose how the text reads when reporting each therapy. Next you will want to choose the region used when reporting the therapy. For example, if you wish to report Trigger Point Therapy at muscles, choose Muscles in this box. You may automatically accept the pre-loaded ones, by not making any changes. To save any changes you have made, press FINISHED, then SAVE and EXIT. (Note: These are the Therapies which will appear in the Treatment Screen in the VISIT portion of the program)

Segment Names – Pressing the Segment Names button will bring you to a screen in which you customize how you report adjustments in the ONE SCREEN VISITS screen. You can create a whole new set of segment names for cervical, thoracic, lumbar, sacrum, and extra spinal. You can also designate “how” the adjustment was performed.

The AMA pain rating guidelines may be edited by pressing the button marked "AMA Subjective Descriptions". Click into the box to the edited and type your change. When you are finished, press DONE.

Once you are finished entering in the information, press SAVE.

To add an additional doctor, choose the Add New Doctor box and follow steps 1-9 above.

GENERATING FORMS

The program generates several forms which if used, make inputting information much simpler. Print out a master of each form to see if any changes are necessary. Most all forms may be modified. The patient forms also print out in Spanish.

From the Main Screen, choose Forms. This will take you into the word processor to access the pre-loaded forms.

Choose All Other Forms, then choose which specific form you wish to preview/print.

Once the document is on the screen, choose File, then Print to print out a hardcopy of the form. Otherwise, you may view it on the screen.

If changes are necessary, please refer to the section "Editing Forms" section of the Manual.

NOTE: Once you have customized your software, you may want to also customize your forms so that inputting is easier.

Instructions for Printing and Customizing the Travel Card

The Travel Card can be printed using any one of the ten existing templates as they are, or those templates can be customized.

There are three broad categories of templates; 12 visit, 9 visit, and 6 visit. Choose the one that you are most comfortable with, deciding between more visits on each card, and space limitations for your writing. For each category, there are three choices of presenting the adjustments you perform. Segments across the page in each column, blank columns, with a single list of segments to the left, and regions in each column. Additionally, there is an Activator 12 visit card, with the isolation tests across the page.

The templates are set up to print basic patient information, their subjective complaints, the Objective Findings that are listed in the Master Clinic/Doctor Setup screen, and the first six Therapy modalities from that screen as well.

Printing a card for a specific patient… Go to Travel Card, One Patient. Choose the patient, then choose the template for the card, press OK. The card will then appear on the screen as it will be printed. You may edit this card before printing, but changes will appear only on this card at this time.

You may print a blank card instead of one with a patient’s data on it, by choosing Travel Card, blank. Again, typing will appear on this instance of the card only.

Customizing the Travel Card Masters

From the menu bar in the in Forms Screen, choose Travel Cards, Edit Masters, then choose the specific card you want to change. You will then have a basic word processing screen with that master card showing.

About Merge Fields… data, such as the patients name ,address, modalities etc is available on the card by dropping merge fields from the list that appears when you click on “Merge Fields” on the menu bar. First, make sure your cursor is where you want the data to appear, then go to Merge Fields, and pick the field.

About Adding Rows… If you need to add an additional row to the card, click in to the row that you want to be above the new one, go to Table on the menu bar, choose Insert Row. Deleting a row occurs from the same menu item.

About Just Typing… Anything you type on the master card will appear on the ones you print for specific patients. Adding Objective Findings to the card is one application for just typing.

Save it…after you have completed your changes, go to File, press save. Saving the master card will make your changes available to other computers in your network as well. If you mess up, and don’t want your changes saved, simply close the screen.

Print Lists of Pre-loaded selections

Most all of the lists (comments, subjective, objective, ortho tests, etc.) contained in the program may be modified. You may want to print out lists of all the pre-loaded lists in the program to review and edit.

From the Main Screen, top menu bar, click on Master Files. Click on Edit or Print Data Tables.

Choose the table type you'd like to edit/print.

Click on the specific table you wish to edit/print.

This will bring up a screen showing the list of choices already preloaded in the program, with a menu bar at the top.

The following lists may be accessed through this function:

Assessment Comments

Patient Assessment Comments

Work Related Comments

Home Related Comments

Medical Necessity Comments

Miscellaneous Comments

Library Comments

Objective Findings

Orthopedic Tests

Patients and Case Numbers

X-ray views

Treatment Plan (sections)

Muscle tables

ROM norms

Under OPTIONS, choose if you'd like to print the report to the printer or preview it on the screen.

Click the button labeled PRINT LISTS.

HOW DO I?....

ENTER A PATIENT

Click on PATIENT button from the main menu.

Click on the ADD NEW PATIENT button at the right of the screen.

To move between fields in this screen, press TAB.

The following fields are required fields in this screen:

Case Number - may be up to 10 digits long and may be any combination of number, letters or both. (NOTE: The case number may not be edited once it is entered. ALL patient information and visits must be deleted and re-entered if the case number is entered wrong).

Patient's First and Last Name

Patient's Case Type

Date of Birth

Initial Exam Date

Doctor - do not type the doctor information in this field, choose the appropriate doctor by clicking on the down arrow on the right side of the box and choose the correct doctor from the list.

Gender

Type of subjective rating desired (AMA or 1-10 rating method)

Subjective Complaints must have a rating higher than zero

Diagnosis

The following fields are optional:

Patient's Social Security Number

Reports reference #.

History Information- this information is taken from the intake form (report from this information available in CASEnotes only)

Consultation Information - this information is taken from the intake form (report from this information available in CASEnotes only)

Subjective Complaints

To enter a patient's subjective complaints, you may press the down arrow next to each box to bring up a pre-loaded list of complaints, or you may simply type in the complaint you wish to appear in the box. Then choose the appropriate initial rating for that subjective complaint.

If you wish to report subjective complaints “from scratch” each visit, choose Visit by Visit in the Subjective Rating Method box.

The pre-loaded list of subjective complaints may be modified by choosing Master Files from the main screen.

Once you are finished entering ALL complaints and ratings, PRESS SAVE

This will then activate the Diagnosis, History and Consultation buttons.

Diagnosis (required)

You may input diagnosis for a patient with a start and end date. It is very important you put the correct start and end date for a particular diagnosis, so that if you ever change the patient's diagnosis, the software will know which diagnosis goes with which report dates. When you input a diagnosis, the program will assign today's date as the start date for the diagnosis and give an end date of 12/12/99. These may be edited after the diagnosis is entered by choosing the diagnosis, and choosing EDIT EXISTING, then changing the start date.

To enter a diagnosis:

Press Add Diagnosis

Choose the correct diagnosis from the list by double clicking on it. You may either search by ICD-9 code or by description.

The program will then ask if you wish to save the diagnosis. If the diagnosis is correct press YES, if it is incorrect, press NO.

The program will then ask if you wish to enter another diagnosis. Pressing YES will allow you to enter an additional diagnosis. Pressing NO will complete the diagnosis process.

Once you have entered all diagnosis for a patient, press F2 to exit this screen.

NOTE: A diagnosis entered directly in the box will be saved FOR THIS PATIENT ONLY. In order to add a new dx in the master diagnosis file, choose Master Diagnosis File label from the top menu bar in the DX screen.

History (not required info, only reportable with tgi...CASEnotes)

This information is taken from the patient's intake form.

Click onto the button labeled "History List". Click onto any of the listed symptoms that the patient has reported they suffer or has suffered from. You may also manually type any unlisted condition in the "other" box. Once you have chosen all applicable choices, press the USE button. To hide the box without using the choices, press HIDE.

List any familial history by pressing the "Father", "Mother", or "Other", buttons to bring up the symptom list. Choose the applicable symptoms by clicking on the symptom.

Once all symptoms are chosen, press USE.

Once you are finished entering all data in this screen, PRESS THE COMPILE BUTTON.

Press S