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BC Medical Billing - Computerized Flashcards

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4243415832How long must a new BC resident wait to be eligible for coverage with MSP?3 months (Month of arrival plus 2 months)0
4243418745What province does not have a reciprocal arrangement with BCQuebec1
4243422975Patient information required to bill to MSPFull name, DOB, PHN, and sex2
4243428067When confirming eligibility for coverage, MSP matches the PHN with:First intial of first name and first two initials of last name3
4243429728What is the ICD9 code?The diagnostic code4
4243434948In the GP office, fee/item codes fall into three groups:Office visits, minor procedures, clinical tests5
4243441317How often can a physicians (with hospital visiting privileges) visit a patient who is under the care of a specialist?One visit each day hospitalized for the first ten days, then one visit for every seven days hospitalized6
4243458413Major tray fee item code000907
4243476522Subcutaneous Injection fee code000348
4243481530Routine long term care visit fee code001149
4243487575Supportive care hospital visit fee code0012810
4243491721Pregnancy test fee code1512011
4243497706Minor laceration requiring anesthesia fee code1361112
4243498684Urinalysis by dipstick fee code1513013
4243508645Visit - in office age 50-59 fee ocde1530014
4243510336Individual counseling age 60-69 fee code1612015
4243511979Complete physical examination age 0-11210116
4243519774If MSP does not confirm a patient has been referred to a specialist by a GP:The specialist is paid at the GP rate17
4243522586When a patient is seen by a physician following a MVA:ICBC ELEC is billed through MSP18
4243526379The completion of the Medical Record (CL19) giving written info about a patient's condition following a MVA:Is billed to ICBC PAPER19
4243530662A completed form 8 or form 11 must be recieved by Worksafe BC:Within 5 days20
4243533851Fee code for Worksafe BC Form 8 recieved within 3 business days via MSP:1993721
4243541185If worksafe bc refuses to pay for an injured workers claim:the claim can be resubmitted to MSP if patient has coverage22
4243657943To enter a physicians name into Osler:1) Click "Help" and then on the "contents" menu 2) Access "Managing Providers" 3) Expand the menu under "providers within your practice" 4) Click on "entering physician information" (you'd need to contact Osler) 5) Read instructions on entering physicians; Osler adds them, not us.23
4243672948To activate physicians in Osler:1) Click on the "Physicians" tab 2) Click on "Active/Inactive Physicians" 3) Click on the Physician name in the left column and then the right arrow to move physician to active24
4243736795To maintain your list of insurance carriers:1) Open INSURERS screen (main menu, select SYSTEM, INSURERS to display screen OR on the REGISTRATION screen in the patient chart, select Insurers. 2) Select "ADD INSURER" from toolstrip 3) Enter the name of insurer 4) In ST.1, enter the street address. If required, complete field ST.2 5) Enter CITY, PROVINCE, POSTAL CODE, and COUNTRY (enter postal code as A1A 1A1 format) 6) Enter the phone and fax number; to enter an extension, type it at the end (ie 250 889 9000ext112) 7) Enter an email address 8) Enter a WEB URL 9) Enter any free-format comments in the comment field 10) In the CODE field, enter the unique 1-3 character code 11) From the ALTERNATE INSURER CODE dropdown list, select the alternate code 12) The OUTPUT MODE designates whether or not the claim will be sent electronically; select how you want it to be billed 13) Some insurance carriers have specific information requirements for billing; select boxes that apply; this will ensure on the BILLING screen the cursor will stop at those fields so you can input the required information; cursor skips fields unselected 14) On BILLING screen, if the MANDATORY INPUT checkbox is ticked, the cursor will stop at the fields you have selected in step 13 and not allow you to continue until those fields have been completed; Useful is an insurer requires certain fields to be filled in at time of billing; if unchecked, you will not be forced to enter a value 15) In the ANESTHEtIC UNIT AMOUNT field, enter the amount 16) In the GROUP CODE field, enter a 3 digit Group Code if you wish to "join" insurance carriers together on certain reports25
4244002190How to add a new service code:1) Select SYSTEM, SERVICE CODES to display the service codes screen 2) Select "New" from the tool strip 3) Select the insurer to which the new code belongs 4) Enter a 5-digit service code 5) If your site is NOT a PCO site, leave the PCO value blank for all service codes. If it IS a PCO site, all BC service codes for PCO insurers must be qualified with either Core or Extended in the PCO drop down. Choose CORE for medical billing by physicians, choose EXTENDED for billing by non-physicians (naturopaths, nurse practitioners, nutritionists, physiotherapists, etc) 6) If it applies to both sexes, leave the SEX field blank. If it is specialized, select the appropriate sex from the list. 7) In the DESCRIPTION, enter a description of the service 8) In the ALTERNATE DESCRIPTION, it will auto-fill with the original description; you can customize it so the search for service codes is more intuitive to you 9) In the FEE AMOUNT, enter the fee required to cover the costs o the services and overhead 10) In the PROF. COMPONENT, enter the portion of the Fee Amount payable to the doctor; appears on the right hand of the billing report and totals appear on your Accounting Summary Report; this is not sent to MSP for billing 11) In the DEFAULT # OF SERVICES, enter the most common number of services rendered per claim; almost always set to 1 however some are more (ie Service Code 9234 - stool occult blood test has default 3) 12) If applicable, enter the anaesthetic Intensity Level 13) Select Minimum age, if applicable 14) Select Maximum age, if applicable 15) Select default location26
4244163260How to search for a diagnostic code:From the diagnostic code screen: 1) To search by code, in the Diagnostic Code field, enter a code or partial code and hit enter. It will return a list of all codes containing your text. 2) To search by description, type in the description field and hit enter. If the letter entered are in a description, the system will return it.27
4244329962Before a physician can bill to MSP, they need to complete:A Teleplan Application Form28
4244333687Visits billed to an insurer are those that are only covered by MSP (true/false/NA)False29
4305978697How to create a patient record in Osler (register a patient)As a stand alone: 1) Create a new chart by pressing CTRL+N *or* select PATIENTS, NEW PATIENT from main menu *or* if the chart is open, on the chart menu, select FILE, CREATE NEW PATIENT (if you're using a family charting method, you can choose FILE, CREATE A NEW FAMILY MEMBER) 2) If you use a card reader, follow separate instructions 3) If not, enter the legal last and first name 4) To ensure patient isnt already registered: Press enter from any name field or hit SEARCH (this search can be set up to work with phonetic matches ie. Shepard, Shephard, Shepherd, etc) 5) If no match is found you recieve a message indicating no patients found. Press enter to close dialog. Continue to fill in registration information. 6) If patients with matching names are found, the FIND PATIENTS screen opens. Review list to determine if the patient you're trying to add is the one registered. If they ARE in the list, click OK and it will open for you. If it's NOT in the list, click CANCEL and continue entering information. -ADDING FROM A PATIENT LOOK UP: If you need to work with a patient and you are not sure if the patient is already registered in your system, you will try to look up the patient. If the patient is not found the Find Patient screen will appear with an indication that the patient has not been found To register the new patient: 1) To register the patient press the button labeled Add this Patient (or use the keyboard shortcut Alt+A). 2) An empty registration form will appear and the information you typed in to search for the patient will be pre-filled for you 3) Enter any additional registration information you want to and click Save and Close (or use the keyboard shortcut Alt+S). 4) The Registration Form will close and the patient you just registered will be selected and ready for use. -ADDING A PATIENT WHILE FILING eRESULTS AND REFERRAL MESSAGES Follow previous instructions in regards to filing results and: Press Add this Patient The registration form will appear with the patient information from the result already filled in for you Enter any additional information you wish to on the registration form and press Save and Close or use the keyboard shortcut Alt+S to save. Once you have found or added the patient, confirmation screen will appear to finalize the filing Press OK to file the result to the patient's chart. The result will now show Yes in the Chart column in the inbox list.30
4305992982Registering a patient with a card readerTo register a new patient or look up an existing patient using a Combination Card, BC Services card, CareCard or Driver's license follow these steps: On the Registration screen: Press Ctrl+N or From the main menu select Patients, New Patient or If a chart is already open, on the chart menu, select File, Create New Patient. Before you swipe the card, ensure that the Activate Card Reader button has been pressed. (It should appear greyed out like this ). If you have started typing patient information, click the button. The card reader is now ready to read the Card. With your cursor In the last name field, swipe the Card. The following fields will be automatically populated: Combination Card: Last name, First name, Middle name, Date of Birth, PHN, Sex, Address Service Card: Last name, First name, Middle name, Date of Birth, PHN Care Card: Last name, First name, Middle name, Date of Birth, PHN Driver's License: Last name, First name, Middle name, Date of Birth, Sex, Address Some cards will be damaged and unreadable while others may provide limited information, depending on the damage. Swipe the card again. If the card is unreadable, you will need to manually enter the card information, or add any information the card reader was unable to obtain from the card. After you have swiped the card, press Enter or click the button to ensure that the patient is not already registered in your system. The search will be conducted on Last and First Name. This step is important. If you don't conduct a search, the system does not know if this patient is already registered. You may enter all the patient details, only to find when you attempt to save, that the patient is already in the database and you are unable to save the record. If no patients are found, you can continue to register the patient (see Entering and Updating Patient Information ) If the system finds a patient name match, the Find Patient screen will display. Choose the correct patient from the list, or, if none of the patients displayed are the correct patient, click Cancel to carry on registering the new patient.31
4306039780Entering information on a baby/newbornDependent type /66 is used for registering a newborn before the baby has received its PHN. Baby Is registered with mother's last name, and PHN with the dependent number /66 and the baby's Date of birth (fo rthe month the baby is born plus two months). Once the baby has received their CareCard, you can search for their record and update the information32
4306061441Adding Insurers and Other Identifiers to a Patient Chart1) on the REGISTRATION tab of a patient chart, select the ID'S sub-tab 2) In the NAME field, choose an insurer or organization from menu 3) Enter ID NUMBER if required 4) Enter VALID FROM and VALID UNTIL dates if required 5) In the NOTE field, enter free-format notes, if required33
4306186791Creating a patient list1) from main menu, select PATIENTS, LIST 2) Select PRACTITIONER radio button, select practitioner 3) Select BILLING GROUP CODE to show one group code 4) Select a registration type (R - regular, T - temporary, Z - marked for removal, P - Primary Care 5) Filter by status, you can use ? as a wildcard, if you want it starting with a certain letter use *X* 6) Specify Sex from dropdown list 7) Tick "LAST SERVICE DATE" to specify range of dates over which they were billed 8) Tick age if necessary 10) Tick name if necessary 11) Tick Chart # if you want to narrow by chart number start and end 12) Press search To print all patients in the list: Press the Print List button on the toolstrip at the top of the screen OR right-click on the list and choose Print List. A print dialog will appear. Choose your printer, number of copies etc. The Print Range should be set to All. (show me...) To print all results, the Print Range should be set to All. To print SOME of the patients in the list: Select the patients you want to print. Refer to Selecting Multiple Items in a List for information on how to do this. Once the desired patients are selected, press the Print List button on the toolstrip at the top of the screen OR right-click on the list and choose Print List. A print dialog will appear. Choose your printer, number of copies etc. Set the Print Range to Selected. (show me...) To print a selection of results, the Print Range should be set to Selection.34

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