This menu allows you to bill the financially responsible party by sending either an insurance form (paper or electronic) or a detailed statement.

 

 

 

 

 

 

There are ten different forms that may be printed from this option.  The amount of forms available to you will depend on the amount of memory available on your laser printer.  These forms cannot be generated on a dot matrix printer.  After selecting the Form option,  the system will display the following screen:

 

 

Menu Options:

 

                        Group Of Patients      Used to print forms for a consecutive account numbers

                                                            i.e., from account number 1000 to 2884.

 

                        Batch of Patients        Used to print form(s) for one account or random account

                                                            numbers i.e., for account number 3328 or for account

                                                            numbers 3328, 1332, 1004, 2883, etc.            

 

                        Exit                             Returns you to the Worker Compensation Menu.

 

After either Group or Batch of patients is selected, the system will display the following screen:

 

 

 

If you have selected Group of Patients, you will see:

 

Selection Criteria:      This field will default to an asterisk (*).  Accepting the asterisk by pressing [Enter] is selecting all accounts within the following selected account  number range for patient's whose last names start with A through Z.  Other options could be all accounts within the following selected account number range but only for patient's whose last name starts with A through A (entered on the field as A-A), or I through P (I-P), M through MO (M-MO)etc.  

 

Account

Number From:            Enter the first account number of the sequence.

 

Account

Number To:                Enter the last account number of the sequence.

 

If you selected Batch of Patients, you will see:

 

Patient No.:                 For only one account:

                                    Enter the account number and press [Enter] twice to proceed to the next field.

 

                                    For more than one account:

                                    Enter all of the account numbers pressing [Enter] after each entry.  When you have comp­leted your selec­tion, press [Enter] two more times to proceed to the next field.

 

Form Code (PRN):     QT       -  QME & AME Frame Extension Request

                                    DE       -  WCAB Data Entry Sheet

                                    QN      -  QME Appointment Notification Form

                                    NQ      -  Notice of QME Unavailability/Availability

                                    DR      -  WCAB Declaration of Readiness to Proceed

                                    QA      -  Qualified or Agreed Medical Evaluator's Findings Summary

                                    EP       -  Employee's Permanent Disability Questionaire

                                    RS       -  Request for Summary Rating Determination

                                    RW     -  Return to Work Certificate

                                    WIEF  -  Visit Encounter Form

 

Form File (forms):      Same as Form Code (.PRN) above.

 

Category Code:          Enter the code from Utility/Category of the specific category only if you want to limit your search parameters.  This is generally used when selecting the Group of Patients option.

 

Insurance Code:         Enter the code from Utility/Insurance of the specific insurance only if you want to limit your search parameters.  This is generally used when selecting the Group of Patients option.

 

Primary/Sec/All

(P/S/A/N):                   Indicate whether you want to send this form to the Primary, Secondary, All or None of the patient's insur­ance listings.

 

Provider Code:           The appropriate code from Utility/Provider.

 

After pressing [Enter] on the last field, the system will prompt with the following:

 

Enter your print out destination or Re­turn for default ? HP

 

Enter the  printer code  for  the  destination  desired or  press [Enter]  to accept  the displayed  default. On-Staff will then return to the Worker Compensation Menu.  The system should answer your request with a single beep.  If you hear two beeps, there is an error in your request. 

 

Criteria for Printing Forms

 

1.         The patient must exist in the system.

 

2.         The patient must have charges posted to the account (paid or unpaid).

 

3.         The patient must have a New Patient <Category> entry and this entry must be a worker's comp category 'type' (defined by the Utility/Category <Type (C/P/W/O/F/G)> entry of W or F).

 

4.         The Workers Comp third screen of the New Patient file must exist.

 

5.         The Employer information must be completed (see the first screen of the New Patient file).

 

6.         The New Patient second screen for Insurance information must exist.

 

7.         The attorney must be entered under the Referral field (see the first screen of the New Patient file) and in Utility/Referring.

 

If you have confirmed the accuracy of the above criteria and are still unable to generate the Green Lien form, press [CTRL] [X], with the cursor next to the line that says 'Failed' press [I] for inquire.  From the displayed screen, you may check the accuracy of the information you had entered. Press the [â] or [Page Down] key to further check the reason for the failure.