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PostPosted: Thu Apr 20, 2017 7:01 pm 
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Joined: Thu Jul 03, 2014 1:21 pm
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When entering payments in the Enter Deposits and Apply payments area, I am not finding a way to easily put in insurance incentive payments. Currently, all fields, including the Payment, Deductible, Withhold, Allowed, and Adjustment areas, are being utilized to enter payments. While the Take Back column is typically free of use, it will not populate any adjustment other than the Take Back. Is it possible to add an insurance Incentive payment tab/field so that I can avoid the extra work of having to hand calculate the added payment?


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PostPosted: Fri Apr 21, 2017 11:15 am 
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Joined: Wed Apr 04, 2007 10:11 pm
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Location: Springfield, MO
There is not really a good way to enter that in Medisoft. You could setup a fake patient for this insurance in Medisoft and probably use a separate payment code so you can track these payments on the Practice Analysis report.

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PostPosted: Tue May 02, 2017 3:46 pm 
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Joined: Thu Jul 03, 2014 1:21 pm
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Thank you for responding. I am not as concerned about tracking the payments, as I am looking for an easier way to have the program add and subtract the various payments and adjustments for each line item. When entering payments, by putting in the amounts in each column, the program automatically calculates and makes the adjustments leaving the correct balance owed by the patient or second insurance, if any. Currently, because there is not a column for the extra incentive payment, we are having to hand calculate the adjustment, making the process more time consuming than desired. I think you have already answered my question when you stated that there is no easy way to do it, but is there a setting in Medisoft that might allow me to add an additional column with a positive adjustment? If not, could you give me an example of how it would look if I set up a fake patient and, for the purposes I am speaking of, would it make sense?


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PostPosted: Thu May 04, 2017 8:33 am 
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Location: Springfield, MO
So let me see if I understand. You are receiving money from a particular insurance for a particular patient that does not reduce the balance due from the patient? So if the fee was $100 and the allowed amount was $80 and the insurance pays $65, but $5 of that is a bonus, you are saying the patient owes $20 instead of $15.


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PostPosted: Tue May 08, 2018 8:13 am 
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Joined: Tue Sep 15, 2015 12:46 pm
Posts: 26
Quote:
So let me see if I understand. You are receiving money from a particular insurance for a particular patient that does not reduce the balance due from the patient? So if the fee was $100 and the allowed amount was $80 and the insurance pays $65, but $5 of that is a bonus, you are saying the patient owes $20 instead of $15.


Hi Gavin, yes that is correct. I'm here with a similar question. ASHN pays incentive payments for submitting claims electronically. I only recently discovered that they now offer 835 downloads. I've been inputting their EoB info manually for years. It's terribly slow.... I've already got a "fake patient" set up to receive all of the incentive payments, but I just used to enter them as payments manually. Now I need to create a Procedure code in Medisoft so that the 835 can download the info to the fake patient. I'm trying to figure out if Posting Codes "PI161: Provider Performance Bonus" & "PI144: Incentive Adjustment e.g. Preferred Product/Service" should be created as a Comment, Insurance Payment, or Cash Payment in the Medisoft Procedure Code list? Thank you!


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PostPosted: Wed May 09, 2018 8:26 am 
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Joined: Wed May 02, 2018 8:35 am
Posts: 4
Hello,

I have a fake patient named Incentive and made a CPT code INCENTIVE. Then I use different cases for each insurance. However, you will still have to create the charge in the 'fake' patient in order to have somewhere to apply the incentive payment. If you want to use the PI161 or PI144 as the posting code, then set it up as an insurance payment.


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PostPosted: Wed May 09, 2018 11:23 am 
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Joined: Tue Sep 15, 2015 12:46 pm
Posts: 26
Hi Rachelb,

Thank you, I appreciate your advice! I will set the posting codes up as insurance payments. Thanks again!

I'm glad we have a place where we can all help each other.

Edit:
So I created Procedure (CPT) Codes PI144 & PI161 as Insurance Payments, but when I did they would not show up in my Revenue Management>Configure>Preferences>Assign Posting Codes list so I went back to the Procedure Code List & reclassified them as Insurance Adjustments. (which seems to work) I can't seem to get my 835 to post the incentive payments automatically, so I post everything except those payments using Revenue Management Reports & then manually assign the leftover incentive payments that weren't posted, using Enter Deposits & Apply Payments (the money bag icon) in Medisoft. It's leaps & bounds easier than entering every single patient payment manually so I think I can live with it. If anyone comes up with work-arounds for the issues I mentioned, I'd love to hear them. Thanks! -Julia


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PostPosted: Wed May 09, 2018 4:05 pm 
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Joined: Tue Sep 15, 2015 12:46 pm
Posts: 26
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Then I use different cases for each insurance.


BTW, Rachelb, Thank you for including the above info. I could not figure out why I couldn't apply payments from 3 different ins companies. :?


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