EHR Lab #5
The purpose of this assignment is to see how billing is done using OpenEMR.
- Go toOpenEMR Billing Instructions(Links to an external site.)
- Review Fee Sheet Preparation. This explains how the billing is set up using the billing codes. This is just for your understanding of how the billing codes are presented to the user.
- Closely review how an encounter is created (located halfway down the page) and note the information needed for this step.
- Then review the tutorial for preparing a fee sheet for submitting a claim for submittal.
- Then view this video:video(Links to an external site.)Loading media...Minimize embedded content
- Next review thistutorial on creating a fee sheet(Links to an external site.)
- For this assignment, list the required tasks as a step-by-step process for creating a fee sheet as described in #6 using clear and complete sentences to describe each step in the process.
Preparing for Billing and using the Fee Sheet - OpenEMR Project Wiki Features Demo Download Blog Docs Forum Chat Support Costs and Support Options Community Support Free Basic Chat Support Professional Support How-to Guides Views Page Discussion View source History Personal tools Log in Preparing for Billing and using the Fee Sheet From OpenEMR Project Wiki Jump to: navigation, search Contents 1 Fee Sheet Preparation 2 Creating an Encounter 3 Making a Fee Sheet for an Encounter 4 You are now ready to bill using the Billing module. == Preparing for Billing and using the Fee Sheet in OpenEMR 3.1.0 == and is almost the same for later versions(V1.2 till 20130719) Please note: This was prepared based on version 3.0.1, so comments have been added to reflect the 3.1.0 version and later versions, which has a “tree” view by default instead of the “Radio Button” view default of 3.0.1. Either can actually be set using globals.php. The primary advantages in 3.1.0 are the ease of adding choices which were hard coded in 3.0.1, and the support for multiple language usage. Also note that some of the specific labels have been changed from the distribution version because they are more intuitive. You can do that also. Before you can bill for services, you must enter the ICD (ICD9 or ICD10), CPT (CPT4) and HCPCS codes (or any other billing code you might use in your own setting in a different Country) you will use these codes via the “Superbill” (Administration – Services in Tree View/or Administration - Codes in V1.3 and later). All are entered and then saved using the fields at the top of the main frame shown here. We find it generally is best for the CPT and HCPCS codes to have the code repeated in the leading text in the “Description:” field. That will help in building the Fee Sheet and Issues listings to be shown later, and their usage in claims. The screenshot on the next page simply shows more of the listing, but shows some special codes with their suffix (“F” in this case), since only a single price and description can be associated for an individual code. And please notice the prices are defined here, which will save a lot of effort when you prepare the bills in the Fee Sheet. Note that these “special” codes are NOT CMS compliant and so would likely reject, but they work fine where the payer has a different fee schedule or other payment process and which accepts them as for “Fayetteville” in the example here. Check with your specific payer before using them. The full ICD code set is not distributed because of data download size. Most practices will readily populate and maintain their own listing on an “as-needed” basis. However, the Sourceforge.net forums for OpenEMR contain instructions for free downloads of such code sets. The screenshot below is from version 3.1.0 which has an added column called “Act”, which means Active, as well as a checkbox to set the code either way. However, I could not find any way in which that changes the usability of that code at the Fee Sheet, so I do not really know what the Active / Inactive status does. It may only be a required capability for a future release. If you have an entry, you can select it for “Edit” at right, and then can change any of the settings for that entry, and select the “Update” below that. Note also that the “Search” box will allow all code matches even a part of text or code of the descriptive text, so entry of 296 for example will result in a listing of all from 296 to 296.99, and will include any “special” codes you enter which contain that series of digits (like A296B). That can be useful in finding if you have already entered a value, or wish to edit one. That capability is the same in 3.0.1 as well as 3.1.0 and later versions. Fee Sheet Preparation The Fee Sheet must be setup in Administration – Lists – Fee Sheet. The distribution contains two groups as shown, but you can add others depending on your practice which best meet your business needs. Again, entering the first digit with the description will define the group placement in the dropdowns, and the use of the code in the description text called “Option” will make it easiest to select the appropriate code in practice. Once the fields are populated, you select the codes to be listed therein from the Superbill (“Services” in Tree View) listing (and Codes in Version V.4.3). To add new groups or new items to a group, you use the “Add” lines at bottom. The field under GROUP is the first line to show in Fee Sheet and can also be used as a descriptive name, Every time you save, a new set of three blanks will appear, and the entire list will be reordered according to the first count digits shown. Then, you will select the codes at right from the search function, which will copy the “Superbill” (“Services” in Tree View) selections here. Note that you can have more than one use for a single Superbill item, but not more than a single Superbill item for any single list item. And remember to save. To correct things, simply overwrite and save again. Since the Fee sheet is divides in two columns, the first group shows in the left column and the second group shows in the right column. 1->left. 2->right 3->left etc. You are strongly advised to include the code itself in the “Option” field and in the description field as well, as these will make it far easier to select once users are accustomed to the process, saving a lot of data entry time. Note a “fluke” of the software causes the text to the right of the “chart” to always display as lowercase, no matter how you entered it in Superbill, except the leftmost character. They will also show that way in the Fee Sheet listing at bottom. However, when the bills are prepared, all text will be uppercase. Another powerful usage for the Superbill (Service) Codes data is to export them using Admin – Database – and the Export as CSV function once you have your codes defined. By using Excel (or similar which has the capabilities), you can sort that data by code_type and secondarily by code, which will result in the screenshot below. Using the “Concatenate Function” as shown and using the “Paste Special – Values” command to copy them to a list, you can create the entire series of ICD codes as a “medical_problems” listing which can be placed directly in ../custom/clickoptions.txt for use in the “Add Issues” area. You can do the same for “Dental”, “Surgery”, “Medications” and the like. You can find the syntax required in clickoptions.txt. When you do so, and select from that list, you can then selectably choose the appropriate codes by “ctrl click” of only those appropriate for that specific encounter, with the actual encounter shown in the lower frame, while you use it to show you the ICD codes you will want to choose in preparing the Fee Sheet in the upper frame, which greatly eliminates errors and omissions. The syntax for the “concatenate” function, developed by Idea Man, is as shown, and it is a very powerful time saver. If you frequently add ICD codes, for example, you should run this process and swap for the existing code set in clickoptions.txt based on how soon the lack thereof slows process time. Copy the concatenate formula to all cells for the code type 2, then select all those cells, copy, then Paste Special in another location using the Values button, which will make the text usable in clickoptions.txt Then grab all those and paste into clickoptions.txt using a decent text editor. Note that you may wish to add zeros and decimals to the listing for readability before or after you actually post them to the clickoptions.txt file. The ../custom/clickoptions.txt file is used by the program to populate the dropdown list(s) in the “Add Issues” window, and can save a lot of typing, since the distribution search has limits. When you click on the “Diagnosis” line to bring up the Code Search function, it will ONLY carry over the CODE, and not the description. Few people memorize those descriptions, so if only the code is used, remembering what it means in the Issues list box later is difficult. But by using the clickoptions.txt process developed by Idea Man, including both code and description, that will populate the top