Home Forums Discussions Problems problem c "PROBLEMS" on printed invoice

Hi AC community! I'm in trial period and just saw my first patient using AC. I have cash practice and need to print invoices and CMS-1500's for pt's to submit. My problem is that of the 7 problems I listed in the note, only 4 are listed on the printed invoice. Does anyone have any suggestions how I can have all problems listed on the printed invoice. Thanks!

Well, as far as I know, AC only uses 4 columns for the diagnosis. What I would do would be to click on the View menu option near the top of AC while it is at the scheduling (startup/main) screen and click on Codes. Then select the top left menu option (the only option) that says Edit Codes. Now select Edit CPT Codes and Charges. Select the radio button a little below halfway down the page to Add New Code and put in a fake CPT code such as 001 or 999 or the like. Put in a description of something such as "Extended ICD-9 Codes" and no charge. This way you can add that CPT to the visit also, if there are more than 4 diagnosis, and select the additional diagnosis for that CPT, in effect giving you 8 slots for diagnosis codes, or more if you put it in multiple times. Sorry if I am not making sense, I feel like I am not doing a very good job of explaining how this would help, but I promise it would :P

GuitarPaul,

thanks for your quick reply. I tried what you suggested, but it still only listed 4 ICD-9 codes on the invoice. Maybe this is the absolute max permitted in that field on the invoice? If you've got further suggestions, I'd be willing to give them a go . . .

On the invoice, I think the maximum number is 4, on the HCFA 1500 it is 6. I think I remember that the electronic submission would do 7 different CPT's
ICDs are picked by the CPT but I don't know if insurance companies will look past the 4th anyway.

On the Accounts tab, in the second line (where you added your fake CPT code) select inside the ICD-9 code box and see if you have the others to choose from. You can also search for more from there. Basically you would end up with diagnosis codes that are different on the CPT that is real and the one that is fake. That doesn't make it look like they are all for the same procedure, it makes it look like you put separate ICD-9s for each procedure. On the invoice it will look fine, and I have tried it with 8 codes (4 different ones for a 99213 and 4 different ones for a 001). If you try to print a HCFA/CMS1500 it will only let you use 4 though. If you can't get it to work I can post screenshots tomorrow or something.

I am also a cash practice practice too. I am curious about you giving your patients the 1500 form. I tried to do that in the beginning and insurance companies could not seem to see that they needed to reimburse the patient. I have added the EIN to the superbill (on the address line) and this has worked excellent. Only one piece of paper used!!!

GuitarPaul, got your suggestion to work. Thanks for your help!

HIFM,

honestly I'm in the very beginnings of my practice and have not had any medicare patients yet. I am following the billing model of a mentor of mine and it sounds like I may need to look into this a little further. I would be curious if you could enlighten me as to how you billing works. Maybe you could help me prevent any mis-steps. thanks!

Glad to be of service. I am here because these people are here for me when I need help. I figured what better way to return the favor!

Hi Rob, I initially printed the CMS1500 form and it was confusing for the patient and the insurance company. They would try to send us the reimbursement. I very rarely see Medicare as they know they will not be reimbursed for my visit. All of mine are pay at the time of service and I have no billing. I print the invoice and give it to them. If they have BCBS NC we give them that particular form, otherwise they do that on their own. My practice too is based off of another and this is how he does it too. So far it really works. Of course some companies balk at paying since I am not a provider but most are out of network and those companies love paying me verses a full price practice. Keep me posted and let me know if you have any questions. Alex

Alex, thanks for the reply. I have been talking to some collegues and was told that CMS has an internet based electronic submission process. As I expect that I will have a good many medicare patients, I plan to use this if I can. Thanks for the offer of further help.

A couple 'invoice' questions:

We are a multiple provider clinic.

1) Is there a way to print an invoice before signing off on the note? Often it is not possible to complete the note before the patient leaves; and if an invoice is needed, we are stuck.

2) Currently we are trying to figure the best flow for our billing. We have a 'chargemaster' (charge slip/order form) that follows the patient during the visit and is used to record, lab, supplies, xrays, etc by the ancillary staff. Providers then use AC to code the CPT/ICD codes and print an invoice.

The invoice and 'chargemaster' then go to our billing department for them to enter into medisoft. It's all a bit cumbersome. Does anyone have a simpler way?

Hi Rob,
How are you finding Gettysburg?
My father was raised in York, PA about 30-40 min from you.
We've been to that part of southern PA hundreds of times when visiting my late-grandparents. I have a friend that lives in Danville, PA doing a peds residency at Geisinger medical center. I've been down to visit a number of times this year. There is no easy way to get the Danville (A.K.A. TheMiddleOfNoWhere, PA) haha.

you can use the online invoicing platform http://www.fetchflow.com/support/question/How-do-I-schedule-recurring-invoices.html which is absolutely free. You can make your own excel invoice which you can export in any format and can use it manually for invoicing.

Welcome to the board, memphgis!

It might be useful to look at your settings and provide a name in your postings.

Yes, it's true you can go external, but in the interest of time, either staying in the system, or completely bypassing the AC system ( using an external paper based or electronic) seem to be the preferred options.

Fetch flow does look interesting, but it's a lot easier when the cot an icd are already entered