Versions Compared

Key

  • This line was added.
  • This line was removed.
  • Formatting was changed.

...

Table of Content Zone

Incident Date/Time

The Incident Date will default to the day the incident was created, but it can be manually overridden. Additionally, there is a preference to automatically set the Incident Date to the Procedure Date of the first procedure entered in the incident. This preference can be found within the MacPractice menu > Preferences > Ledger > Incident tab > Check "Set incident date to the date of the first transaction".

IncDateTime.png

Incident Name

The Incident Name can be whatever you like. The name and date will be displayed in the Incident menus throughout MacPractice, so it should give you an idea of the purpose of the incident. Common incident names include the year (for offices who use one incident per year), or the reason for the patient's visit. You can set the incident name that will be assigned to new incidents by default in the Incidents tab of the Ledger preferences.

You can search for and create a new incident name by entering it in the Incident Name text menu. You can also go to References > Incident Name to manage the existing names and create new ones.

IncName.png

Incident Type

The Incident Types are used to identify the type of procedures that are being included in the selected incident. For example you may have a "Routine Visit", "Surgery" or "Consultation". In some areas of MacPractice, such as the Claim Manager allows you to filter by an Incident Type as well. 

You can search for and create a new type by entering it in the Incident Type text menu. You can also go to References > Incident Type to manage the existing types and create new ones.

IncType.png

Referral

The Referral field allows you to enter a referral for the incident. The referral entered in the incident will be pulled into the New Charge window automatically, when charges are entered under the selected incident. If the referral is not listed on the incident, it must be added manually to each charge.

If the referral is listed on the charge, the information will be printed in Boxes 17, 17a, and 17b on the CMS Claim Form.

 

IncRef.png

First Encounter Checkbox

If this was the first time that the patient was seen in the office, be sure to check the box notating that this was the First Encounter.

This is also a necessary step to add patients to the Denominator of the /wiki/spaces/MPHelpDesk/pages/86245395 for MIPS attestation.

IncFirstEnc.png

Box 19 on CMS-1500 Claim Form Field

Text entered in the "Box 19 on Insurance Form" field will be printed in Box 19 of the CMS Claim Form.

IncBox19.png

Facility Tab

The Facility field allows you to select a facility that will be used in the new charge window when you select a Place of Service other than "Office".  If the facility is not listed on the incident, it must be added manually to each charge.

Once this information is filled out, it will pull into Box 18 on the CMS Claim Form, or Box 56 on the ADA Claim Form

You may also choose to have the facility pull to all charges entered in the incident, regardless of place of service. To enable this preference, go to the MacPractice menu > Preferences > Ledger > New Charge tab > Check the box labeled "Always pull facility from incident".

FacilityTab.png

Facility/Facility ID Display

Once a facility has been selected, it will be displayed here to ensures that all of the relevant information for the Facility will pull into the claims appropriately.

The information on an existing facility may be edited by double clicking on the name of a Facility inside the selector window and unlocking the record. You can also add a new facility by clicking the green plus in the Facility selector window. Creating or editing a Facility here is the same as adding/editing in the Facility Reference.

Admission Source/Type

The options selected in the Admission Source and Admission Type fields will generate a numeric code based on the selection you made and add it to the claim if necessary. 

Admitted Date/Time 

*Not present in MacPractice DDS*

Within these fields, you will enter the date and time the patient was admitted.

Discharge Date/Time

*Not present in MacPractice DDS*

Within these fields, you will enter the date and time the patient was discharged.

FacilityTab.png

Reason For Treatment Tab

The Reason for Treatment area determines what is populated in Boxes 40, 45, 46 and 47 of the ADA Claim Form, and Boxes 10a, 10b, 10c , and 14 on the CMS 1500 Claim Form.

Condition Related To

Select the closest available option here relating to the condition you are treating the patient for. 

When "Auto Accident" or "Other Accident" is selected within the Condition Related To menu, the corresponding box checked in Box 45 on the ADA Claim Form and Part 3 (Section 3) on the CDA Claim Form.

Based on the selection in the Condition Related To menu, either Boxes 10a, 10b, or 10c on the CMS Claim Form will be checked.

Accident Date

Here you will add the date of the accident or treatment. Some "Condition Related To" options will require a date and will show red text when required.

The date entered in this box will pull into Box 46 on the ADA Claim Form and Box 14 on the CMS Claim Form when an injury is selected as the "Condition Related To".

Accident State

Select the state the accident occurred here. This is also a required field for some "Condition Related To" and will show red text when required. 

The state selected in this menu will populate into Box 47 on the ADA Claim Form and Box 10b on the CMS Claim Form.

Occupational Illness/Injury Checkbox

When checked, the "Occupational Illness/Injury" will be checked in Box 45 on the ADA Claim Form.

This checkbox is available in MacPractice MD, DC, and 20/20, but it does not pull onto claim forms. 

Prosthesis Checkbox

When checked in the Incident, "Yes" will be checked in box Box 43 on the ADA Claim form

This checkbox is available in MacPractice MD, DC, and 20/20, but it does not pull onto claim forms. 

Orthodontics Checkbox

*Not present in MacPractice MD, DC or 20/20*

When checked in the Incident, "Yes" will be checked in box  Box 40 on the ADA Claim form and Part 3 (Section 5) of the CDA Claim form.

Initial Placement Checkbox

*Not present in MacPractice MD, DC or 20/20*

When the Initial Placement box is checked, the claim will consequently have the "Yes" box checked in Box 43 on the ADA Claim Form and Part 3 (section 4) of the CDA Claim form

IncReason.png

...

MacPractice 20/20 and MacPractice DC only have access to the "CMS Claims" tab. 

CMS Claims Tab

The information entered into these sub-tabs will be included on the CMS-1500 Claim Form as well as on eClaims. 

...

Within this tab, you will be able to enter the prior authorization information in order for it to pull into Box 23 of the CMS Claim form and Box 2 of the ADA Claim Form.

...

Adding a Prior Authorization

...

To include a prior authorization number on a claim, create a claim as you normally would (click here for more information on claim creation). In the claim creation window, select the prior authorization number you wish to include on the claim from the Prior Auth pop-up menu. The number of remaining visits will be listed in parenthesis after the authorization number.

...

Each time the authorization number is used on a claim, the Remaining Visits will be decreased by one. If you delete a claim that was associated to a prior authorization, you will be asked if you wish to add a visit back to the prior authorization record. Click Yes to add a visit back to the Remaining Visits; click No to leave the Remaining Visit count as-is.

...

Resource Tab

The Resource tab allows you to enter information that may be necessary for electronic claims submissions.

...

These fields are used to indicate to the payor what is being sent to them and how it is being sent. For more information on how to add paperwork to your eClaims, visit our Paperwork documentation. 

  • Attachment Control Number

  • Attachment Transmission Code

    • None

    • Available on Request

    • By Mail

    • Electronically Only

    • E-Mail

    • By Fax

  • Attachment Type Code

    • None

    • Support Data for Verification

    • Admission Summary

    • Prescription

    • Physician Order

    • Referral Form

    • Certification

    • Dental Models

    • Diagnostic Report

    • Discharge SUmmary

    • Explination of Benifits

    • Models

    • Nursing Notes

    • Operative Notes

    • Support Data for Claim

    • Physical Therapy Notes

    • Prosthetic or Orthotic Certification

    • Physical Therapy Certification

    • Radiology Film

    • Radiology Report

    • Report of Tests and Analysis Report

...