CHAPTER 5

1. CHAPTER 5 PROCESSING TRANSACTIONS

2. What You Will LearnWhen you finish this chapter you will be able to: • Define the terms introduced in this chapter. • Explain the information contained on a patient’s encounter form and how it is used to record a transaction.

3. What You Will LearnWhen you finish this chapter you will be able to: • Enter procedure charge transactions. • Record and apply payments received from patients and insurance carriers. • Print a walkout receipt. • Enter an adjustment.

4. Processing Transactions • Handling Transactions • Recording and Entering Procedure Charges • Reviewing a Completed Encounter Form • Entering a Procedure Charge

5. Checkpoint 1. Which application menu option do you use to enter a procedure charge? Activities menu, Enter Transactions 2. What document is the primary source of information used to record a procedure charge transaction? Encounter form

6. Checkpoint 3.What two pieces of information must be entered before you can enter a procedure charge? Chart and Case numbers

7. Processing Transactions • Entering Payments • Patient payments • Printing a Walkout Receipt • Insurance payments • Adjustments

8. Checkpoint 4. Which application menu option do you use to enter a patient payment? Activities menu, Enter Transactions 5. Which option do you use to assign a patient payment to a particular procedure charge? Enter Transactions, New, Apply

9. Checkpoint 6. Which application menu option do you use to enter an insurance carrier payment? Activities menu, Enter Deposits/Payments

10. Terminology ReviewSupply the correct term for each definition • An amount, positive or negative, entered to correct a patient’s account balance. Adjustment • Amount (or cost) of a procedure performed by a provider. Charge • An entry automatically displayed in an input field (can be overwritten). Default

11. Terminology ReviewSupply the correct term for each definition • Reference to a patient admitted and discharged from a hospital with a length of stay of one or more days. Inpatient • Payments made to the practice from insurance carriers. Insurance payments

12. Terminology ReviewSupply the correct term for each definition • One- or two-digit codes that allow a more specific description to be entered for the services the physician performed. Modifiers • A code that incorporates a number of individual procedure codes that are related. MultiLink code

13. Terminology ReviewSupply the correct term for each definition • Reference to a patient who is treated at a hospital, but who does not stay overnight. Outpatient • Cash, checks, or charges from patients for services rendered. Patient payments

14. Terminology ReviewSupply the correct term for each definition • A document received from an insurance carrier that lists patients, dates of service, charges, and the amount paid or denied. Remittance advice (RA)

15. Critical Analysis Exercise • Why does the NDCMedisoft program organize transactions based on patient cases? (Objs. 5-3, 5-4) The NDCMedisoft program requires that you identify a patient and case for every transaction. Rather than just show a list of transactions for a patient, the program links each charge, payment, and adjustment to a particular case. A case-based accounting system allows for much more detailed reporting, which is often required when processing insurance claims.