Charges

ACCIDENTONCASE

- ENFORCE ACCIDENT IS ALWAYS ON A CASE

• Mandatory: Always require an Accident on new Cases, for ALL Case Types.
• Not Mandatory (and ---): Cases will not require an Accident on the Case.

  Note that it rarely makes sense to set this to Mandatory.

ALLOWDUPLICATEMODIFIERS 

- ALLOW DUPLICATE MODIFIERS ON A PROCEDURE LINE

• Yes: Allow the same modifier to be added more than once when entering a procedure line.
• No (and ---): Do not allow duplicate modifiers on a procedure line.

AUTOUPDATECHARGES

- PREVENT VALIDATION WARNING WHEN UPDATING THE INSURANCE PROFILE ON A CHARGE

• Yes: Automatically change the fee when updating the Insurance Profile.
• No (and ---): Display a validation warning when updating the Insurance Profile will result in a fee change.

Background: Changing the Insurance Profile on an Encounter can result in a change to the fees being charged.

• This setting determines if the fee should update automatically, or if the user will first be alerted to the change in fees.
  Note: Changing of the Insurance Profile is only available in an Open Period.

CLAIMSPAYERSTATUSTIMEFRAME

- NUMBERS OF DAYS A CLAIM STATUS PAYER CHECK IS CONSIDERED VALID

• Enter the number of days a Real Time Claim Status Check with a Payer should be considered valid.
• If left blank, the default number of days will be three.

CODINGREVIEW

- ENABLES INCOMPLETE CHARGE REVIEW SCREEN

• Yes and (---): Enable the Incomplete Charge Review screen Incomplete Review Screen
• No: Do not use this screen. I prefer to review Encounters individually, one at a time.
• Background

• The Incomplete Charge Review screen allows users to review ALL Incomplete Charges on one screen rather than reviewing one at a time. Filters allow you to review groups of similar Charges and/or errors together. This single screen view makes it easy to review and approve multiple Encounters at once.
• The Incomplete Charge Review screen is accessed when selecting the Incomplete Encounters from the Encounters by Status list.

COPYCLAIMFIELDS

1. Yes (and ---): Default; The Facility, POS, Billing, and Rendering fields will be copied from the previous Charge.
   
2. No: Do not copy the Facility, POS, Billing, and Rendering from the previous Charge.
   
1. Use Case: If this setting is No, the Facility and POS can be set up on the Reference Batch, and the Rendering Provider can be added manually when entering the Charge (this will also populate the Billing field).

COPYPATPROV 

- COPY PATIENT ASSIGNED PROVIDER TO CHARGE

• Yes (and ---): The Assigned Provider from the Patient's demographics will default as the Rendering Provider in Charge entry
• No: Do not default the Assigned Provider as the Rendering Provider

DETACHINC 

- DO NOT ATTACH INCOMPLETE CHARGES TO A REFERENCE BATCH

• This setting controls whether Encounters saved as Incomplete Encounters are attached to the Reference Batch of the User saving the Encounter. The Yes/All options account for the situation where an Encounter that was already complete (and attached to a Reference Batch) and is then saved as Incomplete.

• No (Default): Charges saved as Incomplete are attached to the user's Reference Batch. 
• Yes: New Incomplete Charges are NOT saved to the user's Reference Batch. A Reference Batch will be assigned when the Charge is completed. Existing Encounters that are in a Reference Batch, that are subsequently saved as Incomplete, will retain the original Reference Batch.
• All: New Incomplete Charges are NOT saved to the user's Reference Batch. Existing Charges that are already attached to a Reference Batch and are subsequently saved as Incomplete, will have the Reference Batch removed. A new Reference Batch will be assigned when the Charge is again saved as a completed Encounter.
  

DIAGERROR

• This setting controls whether the System will display a Validation Warning or Error when an invalid diagnosis is entered on a Charge.
• No and (---): Display a Validation Warning and allow Charge to be saved when an invalid diagnosis is entered.
• Yes: Display a Validation Error and only allow the Charge to be saved as incomplete.
  

HCFA2PAID 

- SECONDARY HCFA CLAIM - BLOCK 29 AMOUNT PAID

• Choose what goes in Box 29 (Amount Paid) on a secondary HCFA

• Paid (Default): The amount Paid by the primary insurance 
• Payments+Adjustments: The primary payment plus all CO and OA adjustments from the primary

IGNUPDCASE 

- IGNORE THE DIAGNOSIS CHANGE ON THE CHARGE COMPARED TO THE CASE

• No (and ---): If a Charge being saved contains Dx codes that are different than the Dx codes on the Case attached to the Charge, the system will warn the user. The user is also given the option to have the system automatically update the Case Dx with the Dx information on the Charge. 
• Yes: The system will ignore discrepancies between the Dx on the Charge and the Dx on the Case. No warning will be provided.

INCOMPLETECHARGEREVIEWCLAIMSTATUS (Legacy Setting)

Enable the Claim Status dropdown on Incomplete Charge Review.

• No and ---: Do not enable the dropdown
• Yes: Place the dropdown on Incomplete Charge Review
  

LIMITSAVES 

- DO NOT ALLOW SAVING OF PROCEDURE LINES WITH ZERO DOLLAR TOTALS

• No (and ---): Procedure lines with $0 can be saved
• Yes: Do not allow the saving of $0 procedure lines

LINEORDER

- LINE ORDER(L)

• This setting controls the ability to reorder the procedure lines in charge entry based upon RVU value.

• RVU Order: Arrange the Charge lines in RVU order, from highest (line 1) to lowest.
• E&M Line 1, then RVU Order: Place the E&M code as Line 1, then the RVU lines in descending order.

• As Entered and (---): Keep the line order based on the order that charges are entered into the system

NDCPOPUP 

- DURING CHARGE ENTRY, PRESENT THE POPUP TO CONFIRM NDC INFORMATION

• NDC information pulls from the CPT® Library.

• No (and ---): The NDC information will pull from the CPT® Library and will not show during Charge entry 
• Yes: The NDC information will show in a popup when applicable procedure codes are entered so the user can verify the information

NONPARTOPAT 

- TRANSFERS THE BALANCE FROM INSURANCE TO PATIENT WHILE SIMULTANEOUSLY BILLING THE INSURANCE IN THE CASE OF A NON-PARTICIPATING PAYER

• This setting determines how balances are handled when Encounters are created with Non-Par Insurances

• NO (Default): The Encounter balance will remain an Insurance balance 
• Yes: Submit a courtesy claim to the Non-Par Insurance, but move the balance to Patient responsibility as soon as the Encounter is saved. 

  This courtesy claim / auto-transfer function will only apply to newly created or newly completed (previously Incomplete) Encounters.

PROCDESC 

- ORDER PROCEDURE LINES WITH MOST RECENT ON TOP

• Controls the order of Charge lines during Charge Entry.

• NO (Default) - add new lines to the bottom (first line entered remains on top)
• YES - add new lines on top (first line entered remains on the bottom)

REFPROVIDER

- DEFAULT REFERRING PROVIDER

• Yes: Pull the Referring Provider from the Patient Demographics onto all new Charges.

This will NOT override the Referring Provider value on the Charges created from the Clinical Documentation.

• No & (---): Do not pull the Referring Provider from the Demographics to new Charges.

REORDERDIAGNOSISOVERRIDE 

- ALLOW DIAGNOIS POINTERS TO BE RE-ORDERED WHEN THE DIAGNOSIS LINKS ON THE PROCEDURE LINES ARE DIFFERENT

• This setting controls the availability of the diagnosis Reorder/Delete feature when there are multiple procedure lines and the diagnosis links on the procedure lines are not all the same.

• No and (---): Only show the Reorder/Delete link if the pointers on all procedure lines are the same
• Yes: Always display the Reorder/Delete link

• Background: When Charges are created automatically from clinical documentation, the ICD codes often need to be updated for billing. The drag and drop Dx Reorder feature makes it very easy to update the Dx code order on the Claim, however, when the pointers are different on each line, rearranging the order can affect lines differently, which is why this feature is not active by default unless the pointers are the same on all lines.

SPANDATES

- ALLOW USE OF SPAN DATES (DOS FROM/TO) DURING CHARGE ENTRY/MODIFICATION

• Determines if Charge entry lines contain a single DOS field or a DOS From and DOS To field. 

• Yes: Charge entry will require a "To" date (as in "From" and "To"), typically used for hospital stays and DME billing to represent the dates of equipment use.
• No: There will be a single DOS for new Charges entered. Span dates will still be available when editing a Charge line.

SPLIT

- TURNS ON THE OPTION TO SPLIT ENCOUNTERS MANUALLY ON THE POST/MODIFY CHARGE SCREEN AND ACTION BUTTON ON ENCOUNTER DASHBOARD.

• Splitting allows you to take one Encounter and separate the Charge lines onto two separate Encounters. This feature is available when entering/modifying a Charge and from the Encounter Dashboard.

• No and (---): Do not allow the splitting of Encounters
• Yes: Allow Encounter splitting

STICKYDATE 

- USE SAME DATE IN BATCHES

• No (and ---): Users need to enter a date of service (DOS) for every service line during Charge entry
• Yes: the DOS entered for a service line defaults as the DOS for the next service line

SUBMITFIELD 

- ON LEAVE OF THE SELECTED FIELD IS WHEN THE PROCEDURE LINE IS SAVED

• This is simply a keystroke saver if you don't usually enter Line Notes. If this is the case, choose 'Unit' for this Setting and when you leave the Unit field, you will be ready to enter the next line (this is the default behavior). 
• To enter a Line Note, you would need to click the line after entry and enter the note.
• If you regularly enter Line Notes, you will want to choose "Note" as the selection.

TAXABLECHGLN

- ENABLES THE ABILITY TO APPEND SALES TAX ON A CHARGE LINE

• Add the Tax Procedure Code: Libraries > Procedure Codes > Add

• Yes: Adds the Yes/No Tax field on the Charge Entry screen.
• No and ---: the Tax field is not available on the Charge Entry screen. (Default)

TEMPLATELOOKUP

- USE LOOKUP FOR TEMPLATE FIELD IN NEW CHARGE

• This setting controls how Charge Templates are accessed during Charge Entry (drop-down or Lookup).

• Use Dropdown (also the default --- value): Uses a drop-down box to choose the appropriate Charge Template
• Use Lookup: Uses the Lookup tool to choose the appropriate Charge Template

UB04_USED

- USE UB04 CHARGES

• Yes: Provides the ability in Charge entry to designate the Charge as Professional or Institutional
• No & ---: Default; All Charges are entered as Professional Charges

USECASEFROMAPPT 

- USE CASE FROM APPOINTMENT

• This setting determines if a Case on an appointment should be automatically added to the Charge when the appointment and Charge are linked in Charge entry.

• Yes and (---): Add the Case from the appointment to the Charge.
• No: Do not use the Case on the appointment when an appointment is linked to the Charge.

 With this selected, the system will populate the Charge with the current default Case on the Patient Dashboard. If there is no default Case, then no Case will be automatically added to the Charge.