Jane Dotson
Medisoft is a medical billing software that allows users to prepare, review, and transmit claims, as well as identify and bill secondary or tertiary insurance. It also helps with payment posting and insurance payments. There are two ways to enter insurance payments in Medisoft: on a case-by-case basis or in bulk via Deposit Entry. Case-by-case is ideal for single patients, while bulk entry is more efficient for multiple patients. Medisoft also offers custom reports that provide daily deposit information, including deposit dates, amounts, and categories. These reports can be tailored to include specific data, such as insurance payments, charges, adjustments, and net profits.
| Characteristics | Values |
|---|---|
| Number of ways to enter Insurance Payments | 2 |
| First method | Case-by-case basis |
| Second method | In bulk via "Deposit Entry" |
| First method preferable when | Entering Insurance Payments for one patient, case, or date of service |
| Second method preferable when | Entering Insurance Payments for multiple patients (from one insurance/check) |
| Steps to enter Insurance Payments on a case-by-case basis | Go to Activities, then Enter Transactions. Select the desired patient Chart, then the Case. Click New in the lower half of the Window, under the “Payments, Adjustments, and Comments” section. A new payment line will appear. Enter the payment Date, then select a Pay/Adj Code. Select Who Paid, and optionally enter a Description (such as a Reference number, or any note you would like to). The Provider should default, but you can change it if needed. |
| Medisoft used for | Preparing, reviewing, and transmitting claims; identifying and billing secondary or tertiary insurance; checking each insurance payment for accuracy and compliance with contract discounts |
| Medisoft used to | Submit claims to insurance carriers |
| Medisoft used to create | Custom reports |
| Custom reports include | Daily deposit information, custom Appointment List, custom Patient open balance report |
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What You'll Learn
Entering insurance payments on a case-by-case basis
There are two different ways to enter insurance payments in Medisoft: on a case-by-case basis or in bulk via "Deposit Entry". The first method is preferable when entering insurance payments for one patient, case, or date of service.
To enter insurance payments on a case-by-case basis, go to Activities, then Enter Transactions. Select the desired patient chart and then the case. Click New in the lower half of the window, under the "Payments, Adjustments, and Comments" section. A new payment line will appear. Enter the payment date, then select a Pay/Adj Code. Select who paid and optionally enter a description, such as a reference number or any other note. The provider should default, but you can change it if needed.
Once you have finished entering the patient's information, click Save Payments/Adjustments. You will be prompted to print a statement or click Cancel if you do not wish to do so at this time. Continue selecting patients and entering payments/adjustments until you are finished.
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Deposit Entry for bulk payments
To post insurance payments in Medisoft, there are two methods: entering payments on a case-by-case basis or in bulk via "Deposit Entry". The latter is more suitable when dealing with multiple patients from one insurance/check.
- Go to "Activities", then select "Enter Deposits/Payments".
- Click "New".
- The Deposit Date will default to the current date, but you can change this if needed.
- The Payor Type will default to "Insurance", and the Payment Method will default to "Check". You can change these if they are different.
- Enter the Check Number and a Description/Bank Number.
- Input the Payment Amount and choose the Insurance.
- If the codes do not default within the selected insurance, choose a code for each field.
- Once you have entered all the necessary information, click "Save Transactions" to complete the process.
It is important to note that payments entered into "Transaction Entry" will automatically appear in the "Deposit List". However, they will not affect accounts receivable totals until they have been applied to specific charges.
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Compliance checks and payments
Medisoft's billing software also enables the identification and billing of secondary or tertiary insurance, with each payment checked for accuracy and compliance with contract discounts. The software flags errors and incompleteness, ensuring that claims are correct and complete before being uploaded in the insurer-prescribed format. This process is designed to integrate with the billing system, reducing the time spent on integration issues.
Medisoft also offers custom reports, providing daily deposit information, including deposit dates, the number of deposits, and the total deposit amount. These reports can be filtered by assigned providers and broken down into categories of checks, cash, credit card, and electronic payments.
Additionally, Medisoft's insurance reports offer insights into billed procedures, analyzing units billed, charges, insurance payments, and pay percentages. These reports also detail average charges, expected and actual net profits, and the total number of procedures, charges, payments, adjustments, and accounts receivable.
Medisoft's compliance checks and payments features ensure accurate and efficient billing, streamlining the claims process and providing valuable insights through customizable reports.
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Preparing, reviewing, and transmitting claims
Preparing Claims
Preparing claims involves gathering and entering accurate and complete patient and billing information into the Medisoft software. This includes the patient's demographic data (full name, date of birth, address, contact details), insurance details (insurance company name, policy number, group number, co-pay details), and specific services rendered. Medisoft allows you to create claims for transactions you've saved by clicking the "CREATE CLAIMS" button. You can then filter and create claims based on various parameters, including transaction dates, chart numbers, primary insurance, billing codes, case indicators, and amounts.
Reviewing Claims
Once the information is entered, Medisoft helps review and validate the claims. The software checks for errors and incompleteness, and compliance with regulatory requirements. If any issues are flagged, they can be resolved before uploading the claim in the insurer-prescribed format. This step ensures that the claim meets industry standards for medical billing, reducing the chances of claim denials and delays in reimbursement.
Transmitting Claims
After preparing and reviewing the claim, Medisoft allows for secure electronic transmission to the designated recipient, such as a clearinghouse or insurance company. The software generates an electronic claim file using the appropriate billing codes and formats required by the chosen clearinghouse or payer. This electronic transmission streamlines the claim submission process, leading to quicker reimbursements and fewer issues. Medisoft's integration with clearinghouses, such as Microwize EDI Direct, further simplifies the process by formatting, tracking, and reporting claim information, ensuring compatibility with HIPAA standards.
Additionally, Medisoft offers the flexibility to print and submit paper claims if needed. After clicking the PRINT/SEND button, users can select the desired form and choose between printing to blank paper or pre-printed forms. This option is particularly useful when dealing with specific claim formats required by different institutions.
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Custom reports
Medisoft offers a range of custom reports to help users manage insurance payments and patient data. One such report is the Unapplied Deposit Report by Payor Name, which lists all deposits that have not been applied, including the deposit date, insurance code, payor name, payment amount, and unapplied payment amount. This report helps identify trends in adjustments and charges posted for the practice.
The Procedure Day Sheet (with Practice Totals) Insurance report is another useful tool, providing information on the total number of procedures, total charges, total payments, total adjustments, and accounts receivable. This report gives a comprehensive overview of daily activities and financial transactions.
The Productivity by Procedure Code report is valuable for understanding billing and payment trends. It lists procedure codes billed, including the code description, units, adjustments, and payments. This report helps identify the most frequently billed codes, the codes that generate the most payments, and those that are most often adjusted.
Additionally, the Production by Provider Summary report offers a concise summary of provider totals, including expected and actual insurance payments, adjustments, and guarantor payments. This report helps track provider productivity and financial performance.
Medisoft also allows users to customise certain reports to their specific needs. For example, the custom Appointment List report includes a column indicating whether an appointment has been approved and details the patient's remainder balance and copay amount. Similarly, the custom Patient Open Balance report can be exported to Excel and provides a detailed breakdown of each CPT code, insurance and patient payments, deductibles, adjustments, and reminder balances. These custom reports enhance data analysis and decision-making processes.
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Frequently asked questions
Go to Activities, then select Enter Transactions. Choose the patient Chart and then the Case. Click New in the lower half of the Window under the Payments, Adjustments, and Comments section. A new payment line will appear where you can enter the payment date and other details.
Use the "Deposit Entry" feature in Medisoft. This is preferable when entering insurance payments for multiple patients.
Medisoft can be used to prepare, review, and transmit claims, identify and bill secondary or tertiary insurance, and check each insurance payment for accuracy and compliance with contract discounts. It can also be used to create custom reports, including insurance reports, and to submit claims to insurance carriers.
Examples include the Procedure Day Sheet (with Practice Totals) Insurance report, the Productivity by Procedure Code report, and the custom Patient open balance report, which can be exported to Excel.
