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Intellect™

CHARGES MENU OPTIONS

Encounter Intellect's various Encounter screens provide fields to add necesary claim specific information to complete CMS 1500 and UB04 or their electronic equivalents

UB Encounter

UB04 Review (Training Documentation)

and

BILLING MENU OPTIONS

Insurance

Paper Claim Resources

UB04 Review (Training Documentation)

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Overview

This review notes, per box, where the printed information may be found in Intellect, as well as any electronic submission loops and segments. 

1. Encounter Intellect's various Encounter screens provide fields to add necesary claim specific information to complete CMS 1500 and UB04 or their electronic equivalents screen

This review mentions the encounter Intellect's various Encounter screens provide fields to add necesary claim specific information to complete CMS 1500 and UB04 or their electronic equivalents screen. To determine if and what encounter has been attached to a charge, go to Charges --►Modify and pull up the patient and date of service in question. The encounter number is displayed under the EN# heading. To relate or change an encounter, move the cursor next to the charge. From the C (command) column press M to modify that line. Press [Enter] until the cursor is under the EN# heading and enter the appropriate encounter number. To exit the line, press [Enter] until the cursor is under the C (command) column.

2. Billing Methods

2.1 This review mentions billing methods. The billing method is determined by:

2.2.1 Billing method C (clinic):

Utility --►Set Up --► Parameter <Billing Method> = C. If this field is left blank, then
Utility --►Category <Billing Method> = C.

2.2.2 Billing method D (doctor):

Utility --►Set Up --► Parameter <Billing Method> = D. If this field is left blank, then
Utility --►Category <Billing Method)> = D

3. Insurance

3.1 This review mentions primary, secondary, and tertiary (third) insurance. Insurance is defined as such by:

3.1.1 Primary insurance:

Registration --► Regular --► Patient Insurance screen <Primary/Secondary> = P1, P2, P3, etc.

3.1.2 Secondary insurance:

Registration --► Regular --► Patient Insurance screen <Primary/Secondary> = S1, S2, S3, etc.

3.1.3 Tertiary (third) insurance:

Registration --► Regular --► Patient Insurance screen <Primary/Secondary> = T1, T2, T3, etc.

4. Referring Doctor

4.1 This review also mentions Referring doctor. To determine the origin of the referring source, go to Utility --► Set Up --► Parameter <Referring>:

4.1.1 P - Referring source originates from Registration --► Regular --► Patient <Referral>. When this is not a doctor (i.e., Internet, friend, etc., Utility --► Referring <Doctor/Other (D/O)> = O), the treating physician’s information is used.

4.1.2 C - Referring source originates from that which was entered at the time of posting the charge (Charges --► Charge <Ref Prv>). When no referring source was entered at the time of posting, the treating physician’s information is used.

4.1.3 F - Referring source first originates from the charge screen (Charges --► Charge <Ref Prv>). When none is entered, Intellect uses Registration --► Regular --► Patient <Referral>. When this is not a doctor (i.e., Internet, friend, etc., Utility --► Referring <Doctor/Other (D/O)> = O), the treating physician’s information is used.

4.2 Adding or modifying a referring source after the charge(s) have been posted (when Utility --► Set Up --► Parameter <Referring> is C or F), may be done through:

4.2.1 Ledger --►Accounting <Ref> by moving the cursor next to the charge, from the C (command) column press M (modify), press [Enter] until the cursor is under the Ref heading, enter the Utility --► Referring <Referring Code> (pressing the [F2] search key displays the Searching Referring screen to search for the referring code), press [Enter] until the cursor returns to the C (command) column.

4.2.2 Ledger --►Open Item <Rdr> by moving the cursor next to the charge, from the C (command) column press M (modify), press [Enter] until the cursor is under the Rdr heading, enter the Utility --► Referring <Referring Code> (pressing the [F2] search key displays the Searching Referring screen to search for the referring code), press [Enter] until the cursor returns to the C (command) column.

4.2.3 Charges --►Modify <Rdr> by moving the cursor next to the charge, from the C (command) column press M (modify), press [Enter] until the cursor is under the Rdr heading, enter the Utility --► Referring <Referring Code>, (pressing the [F2] search key displays the Searching Referring screen to search for the referring code), press [Enter]until the cursor returns to the C (command) column.

UB04 Box Definitions

Note: Effective version 9.12.29 (March 2012), changes were made to Boxes 8a, 51, 59, 62, 80, and 81 for UB04 Worker patients. See individual boxes below for specific information. The changes to UB04 forms are not automatically added with the update. To have these changes added, call Prime Clinical Systems and request the form be updated.

Billing Method C: Utility --► Set Up --► Clinic <Name>, <Address>, <Zip Code>, <City>, and <State>.

Billing Method D: Utility --► Provider --► Provider <Organization Name> (<Last Name><First Name> when <Organization Name> is blank), <Address>, <Zip Code>, <City>, and <State>.

837 Institutional Loop 2010 AA NM103, NM3, N4

and Phone number Loop 2010 AA PER04

Not used.

Registration --►Regular --►Patient <Patient Account No>.

837 Institutional Loop 2300 CLM01

Registration --►Regular --►Patient <Patient Account No>.

837 Institutional Loop 2300 REF02

Charges --► Encounter --► UB-Encounter <Bill Type>. If charges do not have an encounter then enter the Utility --► Set Up --► Clinic <Facility Identification Number>.

The type of bill code includes the two-digit facility type code and one-character claim frequency code. This is a required field when billing Medi-Cal

837 Institutional Loop 2300 CLM05

More About Bill Type Electronic Determination

Billing Method C: Utility --► Set Up --►Clinic <I.R.S. Number>.

Billing Method D: Utility --►Provider  --►Provider <I.R.S. Id.>.

Not required by Medi-Cal

837 Institutional Loop 2010AA REF02

Charges --► Charge <From Date> and <To> (date).

837 Institutional Loop 2300 DTP03

Not Used.

Not Used.

Effective version  9.12.29, this change was made to the UB04 for Worker patients:
Prints the patient's social security number as shown in the <Social Security No> field on the Registration --►Worker --►Worker screen. To have the SSN print, call PCS and ask support to add it to the form; it is not automatically inserted.

Registration --►Regular --►Patient <Last Name>, <First Name>, <Middle Initial>

837 Institutional Loop 2010BA NM103, NM104, NM105

Registration --►Regular --►Patient <Address>

837 Institutional Loop 2010BA N301

Registration --►Regular --►Patient <City>

837 Institutional Loop 2010BA N401

Registration --► Regular --► Patient  <State>

837 Institutional Loop 2010BA N402

Registration --► Regular --► Patient  <Zip Code>

837 Institutional Loop 2010BA N403

Registration --► Regular --► Patient  <DOB>

837 Institutional Loop 2010BA DMG02

Registration --► Regular --► Patient  <Gender>