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OnSTAFF 2000

 

 

 

This option is used to enter and maintain approved amounts and/or alternate fees (as may be required by an insurance company) for global, professional and technical charge amounts.

 

 

 

Menu Options:

 

Add                 Add new Fee Schedule.

Modify            Modify an existing Fee Schedule.

Delete             Delete all or portion of an existing Fee Schedule.

View                View an existing Fee Schedule.

Copy               Will copy a fee schedule from one provider to another.

Print                Print a listing of the Fee Schedules for your practice.

Exit                 Returns you to the Procedure Menu.

 

 

 

When the Add option is selected, On-Staff will display the following fields:

 

Provider Code:           Enter the user defined code for the provider.  The name of the provider will be displayed automatically.

 

Next, On-Staff will display the following headings:

 

 

CMD:                         Command Column.  To add a procedure to the Fee Schedule, press A.  Pressing the [F2] search key will display the following valid choices from the command column:

 

A      Add a new record.

M     Modify an existing record.

D      Delete a record.

X      Delete ENTIRE Fee Schedule for this provider

Q      Quit.

 

Insurance:                  Enter the user defined code for the insurance company you are setting up a fee schedule for.  Pressing the [F2] search key on this field when it is blank will search /Utility/Insurance.  On-Staff will display a blank Selection Screen for Insurance to allow entry of specific search criteria or pressing [F2] again will bring up all Insurances.

 

Panel Code

/CPT:                          Enter the user defined /Utility/Procedure <Panel Code> for the procedure you are entering into the fee schedule.  After pressing [Enter] this field will then display the /Utility/Procedure <Code C> field entry.  Pressing the [F2] search key on this field when it is blank will search /Utility/Procedure.  On-Staff will display a blank Selection Screen for Procedure to allow entry of specific search criteria or pressing [F2] again will bring up all Procedures.

 

Charge:                       The /Utility/Procedure <Charge Global> field entry will automatically display as the default.  Your cursor will not stop in this field but will advance to the next column.

 

Alternate:                   The /Utility/Procedure <Charge Global> field entry will automatically display as the default.  To override this default, enter the new alternate charge.  For example, your Medicare Fee Schedule Approved Amount.

 

 

Approved :                  Enter the approved amount for the global charge.  If you are not setting up approved amounts you may accept the default of 0.00.  

 

Prof.:                           The /Utility/Procedure <Professional> field entry will automatically display as the default.  To override this default, enter the new alternate professional component charge.

 

 

Approved:                   Enter the approved amount for the professional component.  If you are not setting up approved amounts, you may accept the default of 0.00.

 

After pressing [Enter] at the last field, the cursor will move to the C (command) column.  Press A to add the next procedure to you fee schedule.  After pressing [Enter] at the last field for this entry, the cursor will move down a line under the Insurance heading to allow entry of subsequent procedures, and so on until all members have been addressed.  When you have finished, press [“] to move to the C (command) column.  Here you may edit your choices further.  Pressing Q from the C (command) column will return the cursor to Provider Code.  At this point you may either enter additional fee schedule information of press [“] to return to the Fee Schedule Menu.

 

 

 

When using a professional component modifier, (/Utility/Procedure/Modifier <Charge(G/P/T)> field entry is P) On-Staff will:

 

a)   Post the /Utility/Procedure/Fee Schedule <Prof.> column entry as the charge amount. 

 

      Using FIG. 1:  EXAMPLE FEE SCHEDULE, $145.00.

 

b)   Display the /Utility/Procedure/Fee Schedule <Approved> column entry (the professional component approved amount which is the entry in the Approved column to the right of the Prof. column). 

 

Using FIG. 1:  EXAMPLE FEE SCHEDULE, $105.00.

 

c)   If the pay plan’s Percent field is 80 for FIG. 1: EXAMPLE FEE SCHEDULE:

·        Allow automatic calculation and posting of payment and adjustment by pressing A in the C (command) column of the /Payment/Open_Item screen. 

 

Using FIG. 1:  EXAMPLE FEE SCHEDULE, 

a payment of $84.00 (80% of $105.00, the professional approved amount (2^nd Approved column)) an adjustment of $40.00 ($145.00 Prof. charge less $105.00 professional approved amount).

 

·        Allow the patient’s responsibility to display (what the patient will owe after primary insurance payment has been received) in the /Charges/Charge <Patient> box, thus allowing this amount to be collected at the time of posting charges. 

 

Using FIG. 1:  EXAMPLE FEE SCHEDULE, $21.00 ($105.00 professional approved amount (2^nd Approved column) less $84.00 expected contracted primary insurance payment (80% of the professional approved amount)).

 

When using a technical component modifier, (/Utility/Procedure/Modifier <Charge (G/P/T)> field entry is T) On-Staff will:

 

a)   Post the Technical charge amount *.

 

Using FIG. 1:  EXAMPLE FEE SCHEDULE, $105.00

(Alternate $250.00 minus Prof. $145.00)

 

b)   Display the Technical approved amount** in the /Payment/Open_Item <Approved>          column.

 

Using FIG. 1:  EXAMPLE FEE SCHEDULE, $100.00

(global charge approved amount of $205.00 minus the professional component approved amount of $105.00).

 

c)   If the pay plan Percent field is 80, for FIG. 1: EXAMPLE FEE SCHEDULE:

 

·        Allow automatic calculation and posting of payment and adjustment by pressing A in the C (command) column of the /Payment/Open_Item screen. 

 

Using FIG. 1:  EXAMPLE FEE SCHEDULE, 

a payment of $80.00 (80% of $100.00, the Technical approved amount **.) an adjustment of $5.00 ($105.00 Technical charge amount* minus $100.00 Technical approved amount**)

 

·        Allow the patient’s responsibility to display (what the patient will owe after primary insurance payment has been received) in the /Charges/Charge <Patient> box, thus allowing this amount to be collected at the time of posting charges. 

 

Using FIG. 1:  EXAMPLE FEE SCHEDULE, $20.00 ($100.00 Technical approved amount** less $80.00 expected contracted primary insurance payment (80% of approved amount)).

 

*Technical charge amount:

The difference between the /Utility/Procedure/Fee Schedule <Alternate> and <Prof.> column entries.

 

**Technical approved amount:  The difference between the /Utility/Procedure/Fee Schedule global charge approved amount (the 1^st Approved column entry) minus the professional approved amount (the 2^nd Approved column entry).

 

FIG. 1:  EXAMPLE FEE SCHEDULE:

 

 

 

See Global, Professional and Technical Charge Posting