WWW.PRIMECLINICAL.COM

 

OnSTAFF 2000

 

When Paper Billing Fails

Prime Clinical Systems, Inc.

 

Client I.D.____________  Reference Number:_______________  Contact:___________________

 

1)         Account No.                                                                                                                                                                                          _______________________________

3)         \Ledger

                        a)         Rendering Provider Code                                                                                                             _______________________________

                        b)         Date of Service                                                                                                                                                  _______________________________

                        c)         Date of Entry                                                                                                                                                                 _______________________________

                        d)         Code Column                                                                                                                                                     _______________________________

                        e)         Who                                                                                                                                                                                         _______________________________

4)         Enter the patient's category code at \Utility\Category                                            _______________________________

                        a)         Billing Method (C/D/N)                                                                                                                            _______________________________

5)         Enter the patient's Primary Insurance Code at the \Utility\Insurance.____________________________

                        a)         VS/CPT/E/M (R/C/E/U)                                                                                                                          _______________________________

                        b)         Insurance Type                                                                                                                                                  _______________________________

                        c)         Selection (1/2/3)                                                                                                                                                            _______________________________

                        d)         Form Type                                                                                                                                                                     _______________________________

6)         Enter the patient's Secondary Insurance Code                                                                  _______________________________

                        a)         RVS/CPT/E/M (R/C/E/U)                                                                                                                        _______________________________

                        b)         Insurance Type                                                                                                                                                  _______________________________

                        c)         Selection (1/2/3)                                                                                                                                                            _______________________________

                        d)         Form Type                                                                                                                                                                     _______________________________

7)         Utility\Set Up\ Systems

            a)         Entry/Service date (E/S)                                                                                                                         _______________________________

            b)         Billing                                                                                                                                                                                                   _______________________________

8)         \Utility\Provider

                        a)         Provider 1                                                                                                                                                                      _______________________________

                        b)         Provider 2                                                                                                                                                                      _______________________________

                        c)         Provider 3                                                                                                                                                                      _______________________________

                        d)         Group 1                                                                                                                                                                         _______________________________

                        e)         Group 2                                                                                                                                                                         _______________________________

                        f)          Group 3                                                                                                                                                                         _______________________________

                        g)         Group (Y/N)                                                                                                                                                                   _______________________________

                        h)         Doctor/Cost Center (D/C)                                                                                                                        _______________________________

                        a)         Panel Code                                                                                                                                                                   _______________________________

                        b)         Billing (A/N/C/E/P/S)                                                                                                                              _______________________________

                        c)         Provider                                                                                                                                                                         _______________________________

                        d)         Form                                                                                                                                                                                         _______________________________

                        e)         RVS Code                                                                                                                                                                     _______________________________

                        f)          CPT Code                                                                                                                                                                     _______________________________

                        g)         E/M Code                                                                                                                                                                      _______________________________

10)        \Billing\Insurance

                        a)         From Date                                                                                                                                                                     _______________________________

                        b)         To Date                                                                                                                                                                         _______________________________

                        c)         Patient No.(s) (group or batch)                                                                                        _______________________________

                        d)         Primary/Sec/All/(P/S/A)                                                                                                                          _______________________________

                        e)         All/Unbilled/Rebill (A/U/R)                                                                                                                       _______________________________

                        f)          Category                                                                                                                                                                                   _______________________________

                        g)         Form Type                                                                                                                                                                     _______________________________

                        h)         Insurance Code                                                                                                                                                  _______________________________

                        I)          Billing Code                                                                                                                                                                   _______________________________

 

The above information may be obtained by going to the System Status Screen (Control X).  With your cursor next to the Failed Printing Claim report Press 'I'.  The Billing Insurance screen (by Group or Batch) will be displayed as you had originally entered the above requested information.