Medical Practice Management Software
McKesson's PracticePoint Manager
Medical Billing and Claims
McKesson's PracticePoint Manager Medical Billing Software offers much flexibility in the way it bills patients and carriers for services rendered. Monthly statements for responsible parties can be generated by last name, zip code, format, minimum balance, or billing cycle. You can also produce ones statement at a time on request. Medical claims are generated by patient, payer or provider in either paper or electronic format. Other Billing options allow you to rebill claims and generate finance charges.
Bill Responsible Party or Payor for Services
- Generate a statement for a single responsible party, regardless of billing cycle.
- Generate statements for a group of responsible parties
- Generate insurance claims on paper or in an electronic format
- Reset claim billing flags so the entire claim is rebilled
- Submit electronic claims
- Reset claim generated flags so individual charges with no response are rebilled
- Calculate finance charges for accounts.
Billing and Electronic Claims Features
- Monthly Statements
- Paper Claims
- Electronic Claims
- Rebilling Claims
- Transmitting Claims
- Resetting Claim Generated Indicator
- Transfer Insurance Charges
- Finance Charges
Monthly Statements
PracticePoint Manager Medical Software allows you to produce monthly statements in two ways—for an individual, or for a group of responsible parties. Responsible party groups are by last name or zip code range. For example, if you choose to generate statements by responsible party last name, you can use the last name range to specify those you wish to produce during that statement cycle. Besides generating statements through Billing, you can also produce demand statements and demand superbills through Transaction Entry.
Paper Claims
The Insurance Claims—Paper option prints paper insurance claims for each episode in Transaction Entry. Claims can be produced by patient, payer, or provider. Furthermore, you can generate a separate claim for each provider within an episode. Due to Medicare requirements, PracticePoint Manager Medical Billing Software automatically splits transactions into assigned and non-assigned claims. When insurance is processed, claims are produced for all carriers whose format matches that on the Insurance Claims—Paper window. If the carrier range is left blank, charges for all carriers who are eligible for this run (as specified by the Bill Carriers field) are processed. A separate format can also be specified for pre-billing.
Electronic Claims
The Insurance Claims—Electronic option is identical to Insurance Claims—Paper except that claims are put into a transmit file rather than printed to paper. This file may be submitted using McKesson's Electronic Claims Submission Clearinghouse for processing. Insurance Claims—Electronic generates a file of claims for each episode in Transaction Entry. Unlike other medical software programs, claims can be produced by patient, payer, or provider through McKesson's premier medical office software. Furthermore, you can generate a separate claim for each provider within an episode. Due to Medicare requirements, PracticePoint Manager Medical Software automatically splits transactions into assigned and non-assigned claims.
Rebilling Claims
Occasionally, you may wish to regenerate or rebill an entire claim for a specific patient or payer. The Claims—Rebill module does this by resetting the billing flag so the claim is included in the next insurance run. You can reset billing flags for an individual patient, range of patients, or all patients billed on a particular date. Nothing prints when this option is used; it merely resets the billing flags to tell the PracticePoint Manager Medical Software that this claim has not been billed.
Transmitting Claims
The McKesson Transaction Solutions Hub toolbar button begins a transmission program which sends electronic insurance claims and statement files to the Transaction Solutions Hub. A billing run must be completed prior to the transmission. This same toolbar button is used to dial into the Transaction Solutions Hub to download carrier and transmission reports.
Resetting Claim Generated Indicator
There may be times when you wish to resubmit a charge to a payer because no response (payment) has been received within a reasonable period of time. This is done by resetting the claim generated indicator. When charges are submitted on a claim, a claim generated flag on each charge is set to Yes. This is necessary so that charges are not submitted more than once to the same carrer. By resetting the claim generated flag to No, the charges are resubmitted to the payer the next time insurance is run.
Transfer Insurance Charges
Under the Billing Menu, the option Transfer Insurance Charges allows you to move insurance responsible charges to the next responsible entity once the currently billed carrier’s courtesy billing period has expired. Insurance responsible charges are moved to the next responsible entity by posting a 0.00 payment to each respective charge. (We simply simulate a 0.00 payment posted with a status of Response). This feature uses information on the Carrier and Procedure maintenance windows to give your practice the flexibility to determine which carriers and procedures are allowed to be automatically transferred.
Finance Charges
The Finance Charge option calculates finance charges on all accounts that you have indicated should receive them. To provide your practice with total control over these assessments, finance charges are only applied when this Billing option is used. Finance charges are controlled on the System Defaults window in PracticePoint Manager Utilities. Here, you can turn finance charges on or off for all accounts. The system default can be overridden for each account type. By account type, you can specify whether to calculate finance charges, the annual percentage rate, starting period, minimum balance and minimum charge. The percentage of finance charge and other conditions can be set differently for each account type. Every time the Yes button is selected, finance charges are calculated. Therefore, it is imperative that you establish a schedule for generating finance charges (last billing cycle of the month, for example) so that duplicate finance charges are not calculated.
