Mastering Medisoft was created specifically to help students learn the art of medical billing through the use of Medisoft.  Since Medisoft is used in more clinics than any other software, it is the most likely software a student will encounter when entering the work field. Therefore, it is imperative that the student have a solid understanding of the functions of this powerful program.

This text is designed to allow the reader to first master the “must know” tasks such as patient, charge, and payment entry, and then  move on  to the less frequently-used, but “good to know” features such as setting up a new practice.

The goal of this text is to create sought-after, dependable students with a working knowledge of Medisoft who health care providers want to hire. This text provides the foundation students need to feel confident that they can enter the work environment able to perform the essential tasks of their job with little or no additional training.

PEDAGOGICAL FEATURES IN THIS TEXTBOOK

The following special features appear throughout this textbook:

• Learning Objectives — Specific learning objectives appear at the beginning of each chapter, stating what will be achieved upon successful completion of the chapter.
• Key Terminology and Abbreviations — Terms and their definitions appear at the beginning of each chapter as well as in the narrative and the comprehensive glossary. Abbreviations that are used in the text are listed at the beginning of each chapter.
• Billing Insights - These insight boxes appear throughout the chapters. They provide additional information on key topics relevant to billing.
• Medisoft Quick Tips -These tip boxes provide additional tips/shortcuts that pertain to the use of Medisoft software
• Test Your Knowledge — In-chapter questions that require students to pause and apply the concepts presented appear in each chapter.
• Practice Exercises — These exercises appear within the body of the chapters, and provide step-by-step instruction for the student.
• Figures —Numerous Medisoft screen captures and relevant forms appear throughout the book to support the textual material presented and to reinforce key concepts.
• Chapter Review Questions — End-of-chapter questions are provided in multiple-choice, true/false, and short answer format,  and  help to reinforce learning.  The review questions measure the student’s understanding of the material presented in the chapter. These tools are available for use by the student or by the instructor as an outcome assessment.
• Resources — This listing provides organization contact information, websites, and additional resources related to the chapter content and available for student research.
• Mock Clinic — A mock clinic simulation appears in Appendix A of the text.  This simulation is designed to allow students to create a new data set for a fictional clinic, Sunny Life Clinic.  The exercises in this appendix test the knowledge students have gained by reading the text and applying the practice exercises contained within each chapter. The exercises simulate the process of setting up Medisoft in a new clinic and performing tasks from entering the practice information to performing the Medisoft Daily Basics, to developing follow-up and backup procedures. Unlike the practice exercises within each chapter, the exercises in this appendix provide minimal guidance; therefore the reader must rely on his or her knowledge of Medisoft and critical thinking skills to create the new data set. This Appendix can serve as a comprehensive review of material learned, or instructors may choose to use it for examination purposes.

Flom/Mastering Medisoft

Table of Contents

Chapter 1: Medisoft Daily Tasks, Patient Charts and Appointments

Introduction

Overview of the Daily Medisoft Tasks and Office Procedures

    Scheduling Appointments and Developing Superbills

Practice Exercise 1-1: Scheduling Patients

Practice Exercise 1-2: Print a Schedule for Each Doctor

    Entering Patient Charges and Payments   

    Processing Mail Denials and Payments

    Proofing Daily Work

    Submitting Insurance Claims

    Backing-up Medisoft

Practice Exercise 1-3: Backing up Medisoft

Other Tasks Within a Medical Office

            Verify Eligibility of Insurance Coverage

            Review Proper Coding and Billing Procedures

            Review of Contract Payments

Medisoft Patient Charges and Appointment Entry

Practice Exercise 1-4: Entering Appointments and Patient Charts

Medisoft Short Cuts and Hot Keys

Medisoft Support

            Help within Medisoft

Practice Exercise 1-5: Accessing Help Within Medisoft

Linking the Patient Information to the CMS-1500 Form

Scheduling Breaks

Practice Exercise 1-6: Entering Breaks

Moving, Editing, and Deleting

Practice Exercise 1-7: Moving, Editing, and Deleting

Printing Schedules and Superbills

Practice Exercise 1-8: Printing the Schedule

Practice Exercise 1-9: Printing the Superbills

Chapter Review

Resources

 

Chapter 2: Patient Information

Introduction

Overview of the Case Information

Creating a Case

Practice Exercise 2.1: Creating a New Case

Practice Exercise 2.2: Determining the Version of Medisoft on Your Computer

Practice Exercise 2.3: Creating a Case for Jane N. Jordan

Practice Exercise 2.4: Chapter Application: Creating a New Case for William Jon Johnson

Copy Case Feature

Practice Exercise 2.5: Copying a Case

Creating Custom Patient and Case Data

Practice Exercise 2-6: Creating Custom Patient Data

Three Forms of Help in Medisoft

            Medisoft Manual

            Help within Medisoft

            Knowledge Base

Practice Exercise 2-7: Using the Knowledge Base

Signatures and Assignments

Chapter Review

Resources

 

Chapter 3: Transaction Entry

Introduction

Overview of Transaction Entry

            The Components of a Charge

Practice Exercise 3-1: Adding a Charge

            The Components of a Payment

Practice Exercise 3-2: Posting a Payment

            The Components of an Adjustment

Practice Exercise 3-3: Posting an Adjustment

            The Components of a Comment

Practice Exercise 3-4: Adding Notes and Comments

Modifying the Grid Columns

Practice Exercise 3-5: Modifying Grid Columns

Defining Coding Systems

            CPT and HCPCS Codes

            Modifiers

            Diagnosis Linkage

            Place of Service (POS) Codes

            Multilink Codes

Practice Exercise 3-6: Using Medisoft Help to Research Key Terms

Practice Exercise 3-7: Entering Charges, Payments, Adjustments, and Comments

Practice Exercise 3-8: Checks and Balances: Patient Day Sheet

Chapter Review

Resources

 

Chapter 4: Claim Management

Introduction

Overview of Claim Management

            Creating Claims

Practice Exercise 4-1: Creating Claims

            Printing and/or Transmitting Claims

                        Paper Claims

Practice Exercise 4-2: Printing Claims

                        Electronic Claims

            Primary, Secondary, and Tertiary Claims

                        Determining Primary Coverage

Managing Claims in Claim Management

            Defining Claim Status

Practice Exercise 4-3: The “List Only” Feature of Claims Management

            Automatic versus Manual Claim Status

            Managing Claims by the Claims Grid, Search and Sort, and List Only

                        The Claims Grid

Practice Exercise 4-4: Finding Claims

                        Search and Sort

                        List Only

            Viewing Claim Detail

            Rebilling Claims

Practice Exercise 4-5: Rebilling Claims, One At A Time]

Practice Exercise 4-6: Rebilling Claims by Selection

Practice Exercise 4-7: Rebilling Claims in a Group

Aligning the Claim Form

Practice Exercise 4-8: A Final Review of Creating, Filtering, and Printing Claims

Chapter Review

Resources

 

Chapter 5: Posting Mail Payments and Balancing the Day

Introduction

Overview of Posting Mail Payments

            Accessing Enter/Deposit Payments

            Opening and Preparing to Process the Mail

            Creating a New Deposit

                        Creating Deposits for Patient Payments

                        Applying Deposits for Patient Payments

Practice Exercise 5-2: Creating a Patient Payment Deposit

                        Creating Deposits for Insurance Payments

                        Applying Deposits for Insurance Payments

Practice Exercise 5-3: Creating an Insurance Deposit

                        Creating Deposits for Capitation Payments

            Applying Payments/Adjustments to Charges

Practice Exercise 5-4: Creating a Capitation Deposit

                        Applying Deposits for Patient Payments

                        Applying Deposits for Insurance Payments

            Printing the Deposit Report

            Printing the Day Sheet and Balancing the Day

Practice Exercise 5-5: Entering New Deposits: Additional Practice

Practice Exercise 5-6: Applying Deposits: Additional Practice

Practice Exercise 5-7: Balancing the Day: Additional Practice

Chapter Review

Resources

 

Chapter 6: Statement Management

Introduction

Overview of Statement Management

            Accessing Statement Management

            Creating Statements

            Printing Statements

Practice Exercise 6-1: Creating and Printing Statements

            Tracking Statements

Practice Exercise 6-2: Tracking Statements

            Sorting Statements

            Modifying the Statement Management Grid

Practice Exercise 6-3: Creating Clinic Policies

            Statement Manager Toolbar Options

                        The Top Toolbar

                        The Bottom Toolbar

            Cycle Billing Statement

Practice Exercise 6-4: Implementing Cycle Billing

Practice Exercise 6-5: Sorting Statements and Adding Comments

Chapter Review

Resources

 

Chapter 7: Data Backup and Data Maintenance

Introduction

Overview of Backing Up Medisoft

Practice Exercise 7-1: Becoming Familiar with the Backup and Restore Facilities

            Creating a Backup

            Task Scheduler

Practice Exercise 7-2: Task Scheduler

Practice Exercise 7-3: Printing the Registration

            View Backup Disks

Practice Exercise 7-4: Creating a Backup

            Restoring a Backup

            Backup Root Data

            Backing Up Multiple Practices

            Restore Root Data

Practice Exercise 7-5: Finding Help

            File Maintenance for Multiple Practices and Backups

Practice Exercise 7-6: Running File Maintenance

Chapter Review

Resources

 

Chapter 8: Billing Charges, Security Setup and Other Little- Known Features

Introduction

Overview of the Little Known Features

            Billing Charges

            Small Balance Write-Off

            Security Setup

            Group Setup

            Permissions

Audit Records

Detailing the Features

            Billing Charges: A Closer Look

Practice Exercise 8-1`: Billing Charges

            Small Balance Write-offs: A Closer Look

Practice Exercise 8-2: Small Balance Write-Offs

            Security Setup: A Closer Look

Practice Exercise 8-3: Security Setup

            Group Settings: A Closer Look

Practice Exercise 8-4: Group Setup

            Permissions: A Closer Look

Practice Exercise 8-5: Changing Permissions

            Audit Records

Practice Exercise 8-6: Creating an Audit Report: Audit Generator

Chapter Review

Resources

 

Chapter 9: Reporting and Accounts Receivable Management

Introduction

An Overview of Managing Accounts Receivables

            Creating Accounts Receivables Clinic Policies

            Determining the Days in AR

Practice Exercise 9-1: Determining the Days in Accounts Receivables

Reports and Strategies for Collecting Accounts Receivables

            The Simple Patient Aging Report

Practice Exercise 9-2: Setting the Aging Column in Program Options

Practice Exercise 9-3: Printing the Patient Aging Report

            Printing the Insurance Aging Reports: Primary, Secondary, and Tertiary

Practice Exercise 9-4: Printing Insurance Aging Reports

            Insurance Follow-up through Claim Management and Collection List

                        Claim Management

                        Collection List

Practice Exercise 9-5: Adding Items to the Collection List

            Patient Follow-up through Statement Management and Collection List

                        Statement Management

                        Collection List

Practice Exercise 9-5: Resolving Collection List Items

Practice Exercise 9-6: Printing a Practice Analysis

Reports for the Doctor and/or Office Manager

            Practice Analysis

            Patient Day Sheet

            User Information Report

 

Chapter 10: Report Designer

Introduction

Overview of Design Custom Reports and Bills

            Accessing Design Custom Reports and Bills

Practice Exercise 10-1: Customizing the Toolbar

            An Overview of Design Custom Reports and Bills

Practice Exercise 10-2: Becoming Familiar with DCRB

            Opening an Existing Report and Making Minor Adjustments

Practice Exercise 10-3: Opening and Viewing a Report

            Opening an Existing Report and Making Major Adjustments

                        Adding a Field

                        Using Report Properties

Practice Exercise 10-4: Modifying the Insurance Form

            Most Common Labels

            Creating a New Report

            Logos, Warnings, and Other Options to Customize

Practice Exercise 10-5: Adding a Company Logo to Statements

            Copying a Report or Bill from one Practice Set to Another

Practice Exercise 10-6: Printing Labels for Fliers and Newsletters

Chapter Review

Resources

 

Chapter 11: Work Administrator, HIPAA, and Electronic Transactions

Introduction

Overview of Work Administrator

            Creating Users and Groups

            Accessing Work Administrator

            Viewing the Work Administrator Dashboard

Practice Exercise 11-1: Becoming Familiar with Work Administrator

            Adding Assignments Manually to Work Administrator

            Adding Assignments Automatically to Work Administrator

Practice Exercise 11-2: Creating a New Assignment

            Filtering Assignments

Practice Exercise 1103: Filtering Assignments

            Processing Assignments

Practice Exercise 11-4: Creating a Rule

Overview of HIPAA and EDI Transactions

            Health Insurance Reform

            Administrative Simplification

            Privacy and Security

            EDI Transactions

            EDI Transactions in Medisoft

            The EDI Enrollment Process

Chapter Review

Resources