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OnSTAFF 2000

 

 

Utility/Procedure/MODIFIER

 

This option is used to add to and maintain modifiers used in billing.  When applicable, a modifier will affect a procedure’s global, professional, and/or technical /Utility/Procedure charge amount as well as it’s /Utility/Procedure/Fee Schedule  Alternate Charge and Approved amounts.  For example, an assistant surgeon modifier may be set to reduce the surgeon’s fee by 80%.  Thus, when entered at the time of posting the charge, this modifier would calculate a charge amount that is 80% less than the /Utility/Procedure charge amount.  In the case of a fee schedule, this modifier would calculate a charge amount that is 80% less than the fee schedule’s Alternate Charge as well as calculate and display an approved amount that is 80% less than the fee schedule’s Approved in the open item payment screen approved column.

 

MODIFIER MENU

Add        Modify        Delete       View         Print       Exit

 

 

Menu Options:

Add                 Add a new Modifier.

Modify            Modify and existing Modifier.

Delete             Delete and existing Modifier.

View                View and existing Modifier.

Print                Print a listing of the Modifiers in this file.

Exit                 Returns you to the Procedure Menu.

 

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

 

Modifier Code:          Enter the modifier as the modifier code, e.g. 80.

 

Modifier:                    Enter the modifier for this record.

 

Description:                Enter the description for this modifier.

 

Multiplier:                  Enter the percentage of change for the procedure (20.00 for 20%).  This field is used only when the modifier should affect the charge of the procedure.

 

INC/DEC (I/D/N):     Indicate whether the charge should be modified on the basis of the modifier.  Press the [F2] search key to display the following valid choices:

 

I        Increase fee based on Multiplier.

D      Decrease fee based on Multiplier.

N      No change in fee.

 

Base Unit:                  For Anesthesiology posting.  Enter a unit value.  This field entry is the Modifier Units and is used to calculate the Total Units.

 

Charge (G/P/T/R):     This field is used to determine which charge to post.  Press the [F2] search key to display the following valid choices:

 

G      Global Charge

         Post the global charge:

a)   entered in the /Utility/Procedure <Charge Global> field.

b)   entered in the /Utility/Procedure/Fee Schedule <Alternate> column when a fee schedule applies.

P       Professional Component Charge

         Post the professional charge:

a)   entered in the /Utility/Procedure <Professional> field.

b)   entered in the /Utility/Procedure/Fee Schedule <Prof.> field when a fee schedule applies.

T       Technical Component Charge

         Post the technical charge:

a)   which is the difference between the /Utility/Procedure <Charge Global> field entry and the <Professional> field entry.

b)     which is the difference between the /Utility/Procedure/Fee Schedule <Alternate> column entry and the <Prof.> column entry when a fee schedule applies.

R      Retired/Obsolete Procedure

(blank)         If this field is left blank, the default value will be G.

 

When posting a retired/obsolete procedure, the following warning will appear:

 

 

WARNING

 

 

This Modifier Code Has Been Flagged:

* * * NOT TO BE USED * * * *

Press Any Key To Continue.

 

 

 

 

 

 

For additional information regarding other areas relating to Charge (G/P/T/R):

 

Related screens and fields:

/Utility/Insurance/Pay Plan/Pay Plan fields:

<Conversion 0 (1, 2, 3, 4)>, and their <Percent> fields,

<Scale Code> and it’s related <Unit Value Pointer> field,

<Insurance Code> and, if sharing a fee schedule <Provider Code>, <Allowable (R/F/N)>, and it’s related <Multiplier> field.

 

/Utility/Procedure fields:

<Charge Global>, <Professional> and their associated <Unit Value> fields.

 

/Utility/Procedure/Unit Value screen.

 

See Session III Global, Professional and Technical Charge Posting.

 

After pressing [Enter] in the last field, the cursor will return to the Modifier field, allowing review of the entry for accuracy.  If the data entered is accurate, press [] to return to Modifier Code.  At this point, you may either add an additional modifier or press [] to return to the Modifier Menu.