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Updating Cases

Updating Cases

Oct 24, 2024

 

 

Complete this task to modify cases. 

The case creation includes information collected on the following tabs:

Step-By-Step Guide

Step

Instructions

Additional Information

Step

Instructions

Additional Information

1

From the Charge Batch: [ID] / Charge Batch Information tab, select the case to be updated.  

 

 

2

Click Update (or press [Alt] + U). The Case: [ID] page opens with the Patient, Guarantor & Insurance tab displayed to enter or update the patient, guarantor, and insurance information on the case.

Update the relevant information via the applicable steps below...

If the case has already been submitted, a number of the fields are read-only and can only be changed through a Rebill. Information that can be updated on a submitted case includes:

  • Case Reporting Type

  • Outcomes

All information on an unsubmitted case can still be updated.

3

Patient, Guarantor & Insurance Tab

In the Image Set and Coding section, select the image set to attach to the case, if applicable.

 

If the case has been coded for charge entry, all previously coded data is imported into the new case. If using dual monitors, the Image Viewer window appears with the first image of the image set shown in the preview pane. If you are not sure of which image set to attach, click View to preview the images in the image set.

4

If the case has been coded, the existing patient and insurance information is imported into the Patient and Insurance information sections.

 OR

If the patient is not found, the Search Person window displays. Enter the patient demographics and click Search.

  • If multiple matches on the patient name is found, the Select a Person window opens where you can select the appropriate person as the patient.

  • If the patient is not found, the Create Person window opens to create a new patient.

 

5

In the Guarantor section, the Type defaults to Patient and thus the Guarantor defaults to the selected Patient.

(Optional) To change the Guarantor to Some Other Person:

  1. Open the Type drop down list and select Some Other Person.

  2. Enter the patient information and click Search.

(Optional) To change the Guarantor to Organization:

  1. Open the Type drop down list and select Organization.

  2. Open the Guarantor drop down list and select the organization.

 

6

(Optional) To add a payer and designate the plan to which claims will be submitted for the patient, click Create (or press [Alt] + C). in the Insurance section.

The Create Insurance window opens for you to add insurance for the patient.

If the selected patient's insurance has already been established in the system, it will auto-populate in the Insurance section. It can be updated by selecting it and clicking Update (or press [Alt] + U). 

To edit the current insurance associated with the patient, select the insurance from the list and click Update (or press [Alt] + U). The Update Insurance window opens. Make the necessary changes and click Save (or press [Alt] + S). 

If the ordering and prioritization of the needs to be adjusted, select the insurance to move and click the Up or Down Arrow to move the insurance to the correct place in the list.

7

(Optional) Select the Force Self Print checkbox to indicate the claim for this case will be printed manually.

 

8

(Optional) To record there is paperwork on file and attach documentation to a case:

  1. Click Create (or press [Alt] + C) in the Paperwork Attachments section. The Paperwork Attachment window opens.

  2. Open the Attachment Type drop down list and select the type of documentation being sent to the payer.

  3. Open the Transmission Method drop down list and select the method the documentation is being sent to the payer.

  4. Enter the Attachment Control # for the receiving payer office to use to link the documentation to the claim.

  5. Do one of the following:

    1. To attach the documentation at the procedure level, click on the applicable service fee line in the Procedures section.

    2. To attach the documentation at the case level, skip this step.

  6. Click Save (or press [Alt] + S) or Save & Add Next (or press [Alt] + V) to add another attachment).

To make updates to an already attached file, select the document and click Update (or press [Alt] + U). The Paperwork Attachment window opens. Make the necessary changes and click Save.

To delete a document, select it from the list and click Delete (or press [Alt] + D). The Delete Attachment window opens. Click Yes to the confirmation message.

9

(Optional) To designate a person related to the patient, click the Person drop down arrow and enter the Person information, and then click Search.

 

10

(Optional) Enter a Description, such as the relation, for the Related Person.

 

11

Click Apply to save the information.

 

12

General Case Information Tab

Click the General Case Information tab (or press [Alt] + 2) to enter or modify the general information on a case.

 

13

Enter the Date of Service that services were rendered.

 

14

Enter the Accounting Date to use as the accounting date for the case.

If your practice is configured for accounting dates, the Accounting Date option is required.

If the required information was set in the charge batch, you can override this date, if needed.

If your practice is not configured for accounting dates, the Accounting Date option is not available.

The Accounting Date can be up to 14 days in the future. 

15

Enter the Charge Received Date to designate when the charge was received.

 

16

Open the Facility drop down list and select the facility where the patient was treated.

This step is only necessary if the facility is different from the default facility.

17

(Optional) Enter the facility identification number assigned to the case in the Facility Case ID field.

 

18

(Optional) Open the Room drop down list and select the room at the facility where services were rendered.

 

19

(Optional) Enter the external identification number assigned to the case in the External Case ID field.

 

20

(Optional) Select the Participation checkbox to treat non-participating providers as participating providers.

 

21

(Optional) Click the Custom Fields View button. The Custom Fields window opens with the custom fields created for your practice.

 

22

(Optional) Enter the custom fields information and click Save.

 

23

Open the Patient Assigns Benefits drop down list and select the option to indicate whether the patient has given permission for the provider to be paid directly from the payer or plan.

 

24

Open the Emergency drop down list and select the option to indicate if the patient was treated under emergency conditions.

 

25

(Optional) Open the Case Reporting Type drop down list and select the category to associate to this case.

The Case Reporting Type can be updated anytime, regardless if the case has been submitted or saved. You do not have to perform a rebill to update the Case Reporting Type.

26

(Optional) Enter the date the patient was admitted to the hospital in the Admission field.

 

27

(Optional) Enter the date the patient was discharged from the hospital in the Discharge field.

 

28

(Optional) Enter the date the patient became disabled in the Begin Date field.

 

29

(Optional) Enter the date the disability ended in the End Date field.

 

30

(Optional) If the case involves a work comp related accident, select the Related to Employment checkbox.

 

31

(Optional) If the case involves an accident, select the Case Involves Accident checkbox.

 

32

(Optional) If the Case Involves Accident checkbox is selected, the following information should also be updated:

  • Enter the Accident Date & Time.

  • Select the Automobile Accident checkbox to indicate an automobile is the cause of the accident.

  • If the Automobile Accident checkbox is selected, the following information should also be updated:

    • Open the State Where Auto Accident Occurred drop down and specify which state the accident occurred.

    • If another party was responsible for the accident, select the Another Party Responsible checkbox.

 

33

(Optional) Enter the information to include in Box 10d on the paper claim form in the Box 10d field.

 

34

(Optional) Enter the information to include in Box 19 on the paper claim form in the Box 19 field.

 

35

(Optional) Open the Insurance Type drop down list and select the insurance type to use for the Medicare payer.

By default, this option is set according to the claim type specified in the plan configuration.

36

(Optional) Open the Referring Physician drop down list and select the referring physician on the case.

If the physician is not listed, use the icons to perform the appropriate actions:

  • - search for physician

  • - create new physician

  • - modify physician

  • - remove current selected physician

37

(Optional) Select the Referring physician is patient's primary care physician checkbox if appropriate.

 

38

(Optional) Enter the patient's weight (in pounds) in the Weight field.

If the patient is younger than 30 days old, you can enter up to 2 decimal places for the weight.

39

(Optional) If the patient is pregnant, open the Pregnant drop down list and select the relevant option.

 

40

(Optional) If the patient is pregnant, enter the last menstrual period of the patient in the Last Menstrual Period field.

 

41

Click Apply to save the information.

 

42

Procedures & Provider Time Tab

Click the Procedures & Provider Time tab (or press [Alt] + 3) to collect the detailed information of the procedure and provider time related to anesthesia procedures.

 

43

To record a procedure on the case, click Add (or press [Alt] + D). The Add Procedure window opens.

To change the Procedure, select the relevant line item and click Update (or press [Alt] + U). The Update Procedure window opens. Update any of the relevant information and click Save.

To delete a Procedure line item, select it from the list and click Remove (or press [Alt] + R). The Delete Procedure window opens. Click OK to the confirmation message.

To apply a base unit or fee override to a procedure, select the Procedure line item and click Override (or press [Alt] + O). The Override Units & Fee window opens.

  • To override the base unit value, select the Override base units option and enter the Override value. This value will be added to the standard base unit, and fees will be recalculated based on the override amount. Override amounts appear in red in the Override column of the Base Units in the Procedure Details section.

  • To override the calculated fee amount for the procedure, select the Override fee option and enter the Override value. This value will be added to the standard fee, and the fees will be recalculated based on the override amount. Override amounts appears in red in the Override column of the Procedure Details section.

  • To override the billed time units, enter the Override Billed Time Units value. The fee will be recalculated based on the override amount. Overrides to the billed time units appear in the Override column of the Billed Time Units in the Case Fee Summary section.

  • To override the expected time units, enter the Override Expected Time Units value. The expected fee is recalculated based on the override amount. Overrides to the expected time units appear in the Override column of the Expected Time Units in the Case Fee Summary section.

  • To override the description, enter the Override Procedure Description value. The procedure description will be changed to the text you enter as the override value. Note: The field will now allow use of special characters.

 

44

Open the Code drop down list and select the appropriate procedure code from the list of procedures.

When selecting a procedure code that is a non-anesthesia code, the provider must be the same provider as the rendering anesthesia directing provider. This validation is done at the time of saving the case. If the provider for the procedure is different from the provider entered in the Anesthesia Case Provider Time section, a validation message appears. Click OK to close the message, and then click the applicable providers for both the procedure and anesthesia directing provider.

45

Open the Type of Service drop down list and select the type of service provided.

The Type of Service will default to a value based on the Code selected above.

You can manually enter the Type of Service and use the alphanumeric shortcut keys to quickly select the Type:

46

For an anesthesia procedure, open the ASA Code field, and select a code for the specified procedure.

 

47

(Optional) Enter the two-character code used to describe services associated with the procedure in the Modifiers field.

You can enter up to four modifiers. Each modifier must be two characters and be separated by a comma, for example: QK, QA.

To assign different modifiers to the Directed provider than the Directing provider, select the Override Directed checkbox and enter the applicable modifier in the field. This allows for billing both providers out on the same claim with different modifiers.

The following modifiers are invalid for anesthesia procedures:

  • TC

  • 26

  • 53