Enter a New Charge (Encounter) Manually

Enter a New Charge (Encounter) Manually


Before entering Charges, attach to a Reference Batch. Close the Reference Batch when finished reviewing the Charges. If the Reference Batch is left open, the Charges will not batch.


Accessing the Post (Add/Modify) Charge Screen

Use one of the ways below to access the Post Charge screen.

  1. Select Charges on the Left Side Menu and click the Post Charge button.

  1. Enter nc in the Navigation box and click Go or press enter, or

  1. Select Post Charge on the Patient Dashboard; or

  1. Select Enter Charge on the Patient Appointment Screen.

           


Post a New Charge

Enter information in the fields and press the Tab key to move to the next field.

  1. Create a new Reference Batch or attach to an existing Reference Batch.

  1. On the Patient Dashboard, select the Post Charge link. (Or use one of the other methods above.)

  1. Attached Tags History will display at the top of the Post Charge screen.
  2. Post Date: The Post Date defaults from the Reference Batch and cannot be changed here.
  • If there is no date, you are not attached to a Reference Batch and will not be able to save this screen. Attach to a Reference Batch and continue.
  1. Claim Type: Automatically defaults from Setup, but can be changed here if necessary. You will not have this option if you do not send both Professional and Institutional claims.
  • Professional
  • Institutional

Patient Panel

  1. Patient: If you are adding the charge from the Patient Dashboard or Appointment screen, the patient will default automatically. If you are using any other method, search for the Patient using the Lookup icon.
  2. Modify: This link takes you to the Patient Dashboard to view or make changes. When finished, close the new tab that was opened when you clicked on Modify. This will take you back to the Post Charge screen.
  3. Last Service: You can choose to Copy the full charge or partial charge information into the new charge. Click on the button and the options for copying are on the far right.
  • An Established Patient will be listed as a New Patient if their most recent DOS is greater than 3 years from the DOS associated with the charge.
  1. Appointments: If the Patient was checked-in on the Calendar, the System will automatically link the appointment to the charge.
  • If there is more than one appointment on the same day, you will manually link the appointment with the charge by clicking on the Appointments None button.
  • Linking the Appointments to the encounter drives the output on the Missing Encounters report.
  1. Case: Often used for Worker's Compensation, pregnancy, physical therapy, etc.
  1. Authorization: If there is a case, the Authorization would be entered on the Case. If there is no case, click Add Manually from the dropdown menu.
  2. Guarantor: Responsible party for the Encounter. This is the person that will receive the Statements for Patient Balances.
  3. Insurance: This will Default from the Profile Default in Insurance Management. If it is a different Profile, such as Workers Comp, you can manually select it.


Claim Panel

  1. Facility: Facility where the service was performed.
  2. Place of Service (POS): Where the service took place.
  • This is the Claim level POS and will default from the Facility Setup.
  • The Claim Level POS can be changed manually here, and as the line items are entered on a new Charge, the POS will reflect the change.
  • However, if a POS was set up on the Procedure (CPT) Code, the line item CPT will default from the Procedure Code Library.
  • If all line items have the same POS, the Claim level POS will be overridden by the POS on the line items.
  1. Rendering: Provider who performed the service.
  • The Rendering is not transmitted on an Electronic Claim, but is often used for reporting purposes.
  • The Rendering's NPI does print on the HCFA in Box 24j.
  1. BillingThis is the Provider that you want the Claim billed under, which auto-populates from your entry in the Rendering field.
  • If the Billing Provider is different than the Rendering Provider, you will need to change it manually.
  • The Billing Provider is sent on the electronic claim in loop 2310B as the Rendering Provider.
  • This field can be used when the Rendering Provider needs to send claims under a Supervising or Attending Provider.
  1. Referring: Use the Lookup icon to choose the Referring physician. Some insurances require a Referring provider.
  2. Supervising: This is the Provider who is supervising another Provider. This is used in Incident To billing.
  • Populates ANSI Loop 2310D (2310E on the ANSI Preview in the System).
  • The Provider Name and NPI with the qualifier "DQ" will populate in HCFA Box 17.
  1. Attending: This is used primarily for Institutional Claims for In-Patient and Out-Patient settings.
  • The Attending Physician is required on Institutional Claims.
  1. Statement: The Statement Profile defaults to the Profile chosen on the Patient Demographics screen but can be changed here.
  • Example: Choose Hold Statement if you do not want to send a Statement for this Encounter.
  • This overrides the choice in Patient Demographics. All other Encounters will be sent on the Statement.

  1. Admitted: Mostly used for In Patient and Out Patient Encounters.
  • This can be left blank if not applicable.
  1. Discharged: Most commonly used for In Patient and Out Patient Encounters.
  2. ANSI Field: Provide additional information in reference to a specific service and certain specialties.
  • For a Note to be submitted on a Claim, use the ANSI Field.
  • In the ANSI Field, enter CLMNOTE or select it using the Lookup icon.
  • Tab out of the field.
  • Enter the Note in the popup.
  • Select Save [F2].
  1. Accident: Enter accident details (important for Worker's Compensation). This will default from the Case if information is entered in the Case. Learn MoreRelated Causes

  1. Template: Charge Templates can be built in the Charge Template Library.
  • Choosing a Template will complete the information automatically that is set up on the Charge Template.
  1. Claim Note: Enter a Claim Note.
  • This note is internal only and is not submitted on the claim.
  1. Anesthesia Type: Used for Anesthesia billing.
  2. Physical Status: Used for Anesthesia billing.


Diagnosis Panel

On the Procedure Lines, the Diagnosis Codes are represented with a number or letter.

  • Dx 1 - Dx 9 represent Diagnosis Codes 1-9.
  • Dx 10,11,12 are represented by A,B,C.
  • The decimal is required if the code has one. For Example: E07.9 not E079.
  • Select the Lookup icon to search for the Diagnosis Codes or enter the Diagnosis Codes in the Dx fields. GEMS (ICD9) equivalency lookup.


Procedure Panel

Tab twice after the last Diagnosis Code has been entered to take you to the DOS field in the Procedure Panel.

  1. DOS: If the Date of Service box is blank or incorrect, enter the DOS. If it is already populated with the correct date, use your tab key to move to the next field.
  • Span Dates are typically used for hospital stays and for DME billing to represent the dates of equipment use.
  1. Facility: Auto-populates based on the Facility chosen in the Claim panel.
  2. POS: Auto-populates based on the Facility chosen above which defaults from the setup of the Facility.
  • However, If a POS is present on the CPT code in the Procedure Code Library, it will change automatically on the line item when the CPT is entered.
  1. CPT®: Enter or select the Procedure Code.
  2. M1-4: Up to 4 Modifiers can be added per line item.
  3. DX Link: These are the Diagnoses that belong with this Procedure Code.
  • The diagnosis pointers can be reordered if necessary.
  • Example:
  • The System automatically connected dx 1, 2, & 3 (123), but you need them in a different order or need to remove one from this Procedure Line.
  • Click in the box and enter the diagnoses in the correct order (213).
  • In this case, Diagnosis 2 is first, diagnosis 1 is second, and diagnosis 3 is third.
  • There are no spaces or commas between the numbers or letters.
  1. Billable : You can have more than one billable type on an Encounter. The system will know what to do with each line item depending on the options chosen for Billable.
  • Y - Bill all parties on the insurance profile in the order specified on the Insurance Profile.
  • N - Do not bill anyone. No money can be posted on a Do not Bill charge. It is for informational purposes only.
  • P - Bill the Guarantor of the Patient, but not the insurance. The Patient Charge will not print/be sent on the Claim.
  1. Tax: This field only displays if you have a tax setup on the Procedure Code.
  2. Fee: Auto-populates based on fee associated with the CPT. The fee can be manually changed here.
  3. Unit: Defaults to Units setup for the Procedure code in the Procedure Code Library. The units can be changed.
  4. Total: Calculated based on the values in the Fee and Unit fields. This field cannot be modified.
  5. Line Note: Free Text a billing note, if applicable.


  1. Tab through all of the fields until the Charge Line appears in the window below.
  2. Copay/Applied: Most of the time a Copay has already been entered by the Front Desk user(s), and you will be presented with a popup to Apply the Copay.
  • If you choose to apply the copay from the popup or if the copay has already been posted, the button will read Applied.
  • The Payment is posted to the Encounter if the Modify Charge screen is Saved.

If you leave the Modify Charge screen without saving, the Copay will not be applied.

  • If the Front Desk User does not enter the Copay, it can be entered here.
  • If there is an existing Copay with the same Receipt Date as the Date of Service, the Existing Copay button will display.
  • Select the Existing Copay button to apply the Payment.
  • The Receipt Tab can also be used to see any existing Receipts.

If the Copay is already there, do not select the Copay button because that will create a .duplicate Receipt

  1. Add other Procedure Codes to the Charge screen:
  • Enter the Procedure Code
  • Some information will automatically populate from the first line entered.
  • Tab through the fields for the Line item to appear in the window.
    • Procedure Lines can be modified by selecting the Line item number.
      • A field can be changed if it is not grayed out.
      • If a change is made, Save the screen before exiting.
      • Learn More: Modify a Charge

  1. Reorder the Procedure lines: If the Procedure Lines are not in the correct order, they can be reordered.
  • Re-order the Line Items using the up and down arrows.

  • If the Front Desk user(s) do not enter the Copay, it can be entered here.
  • If there is an existing Copay with the same Receipt Date as the Date of Service, the Existing Copay button will display.
  • Select the Existing Copay button to apply the Payment.
  • The Receipt Tab can also be used to see any existing Receipts. If the Copay is already there, do not click the Copay button because that will create a duplicate Receipt.
  • Credit Cards can also be processed using the Copay button.


                  


Bottom Panel

  1. Force Primary Claim to Paper
  • Forces the Primary Electronic Claim to paper for this Encounter. Secondary and Tertiary claims for this charge will be billed according to their setup in the Insurance Libraries.
  1. Charge Type
  • Defaults to Production which makes the claim to ready to submit.
  • If this claim is not ready to be submitted, the Charge Type should be changed to Incomplete, and when the screen is saved, you will be asked to add a reason for saving as Incomplete.
  • Test: Can be used to test your Claims at the Clearinghouse level. When the Test Claims are submitted they are flagged so that the Claims will not be submitted to the Payer.
  1. Override Assignment 
  • Defaults to Default which is driven by the settings in the Insurance Library. Yes or No can be chosen, but this is not often used here.
  1. Encounter Claim Status
  • This defaults to System Default and will be saved as Ready for Submission.
  • Additional Claim Status options can be added to this dropdown list by flagging a Claim Status as Available in Charge Entry.
  • Example: you can add a new Claim Status to hold Claims.
  1. Next Action
  • Choose which location you want to go after saving the screen.
  1. Send to Worklist
  • Encounter can be sent to an Encounter Worklist from this screen. This is most often used when the Encounter is saved as Incomplete or the Encounter is put in a status other than Ready for Submission/Resubmission.
  1. Select Save [F2].


Hierarchy of Auto-Population of the Rendering Provider on the Charge

  1. The Appointment will drive the Rendering Provider:

 AND

  1. If not coming from the Appointment, the Assigned Provider on the Patient Demographic screen will drive the Rendering Provider.
  • If you do not want the Rendering pulled from the Assigned Provider on the Patient Demographics , set the System SettingsChargesCopypatprov to No.
  1. If none of the above is set up, the Rendering Provider needs to be entered manually.


Hierarchy of Auto-Population of the Facility on the Charge

  1. The Facility on the attached Reference Batch drives the population of the Facility.
  2. If the Facility is not used in the Reference Batch, the Facility on the Appointment drives the population of the Facility.
  3. If neither of the above, the User needs to enter the Facility manually.

Note: The Facility on Demographic screen does not pull into charge entry.



Learn More

Manually Batch and Upload Claims

Modify a Charge

Incomplete Charge Review

Charges Dashboard

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