3. Charge History Screen
The main screen in oops shows a history of account transactions. The most recent transactions appear at the top. Charges are grouped by date of service. Claim submission history, billing messages, and payments all appear beneath the charges to which they are linked. Every item has a line number for quick selection.
Press Page Up or Page Down to scroll through the history. You can also use the up and down arrow keys to scroll ten lines or the right and left arrow keys to scroll up or down line-by-line.
3.1. Understanding Charges
As shown in the example above, charges are grouped by date of service. Each charge shows the patient name, procedure name, diagnosis code, provider initial, amount charged, and amount due. Since all items in oops have a number line at the left, you can easily select specific charges with which to work.
Status Indicators: You may see several letters or an asterisk (*) between the date of the charge and the patient's name. These indicate basic insurance status information about the charge:
- A
The letter A indicates that the charge is flagged as an accident. Accident information will appear on the insurance claim. Press [F5 -- Visit Status], enter the number of the charge, and then press Page Down to review or change the accident information.
- P
The letter P indicates that some portion of the charge is currently pending an insurance company. Once the charge has been fully paid off or no longer pends an insurance company, the P will disappear.
- C
The letter C indicates that the charge has a copay charge linked to it. The C appears whether the copay has been paid off yet or not. Copays are not procedures, they generally occur as part of the amount due for an office visit or physical procedure.
- *
An asterisk (*) indicates that the charge currently pends a Medicaid policy.
3.2. Understanding Payments and Adjustments
Payments and adjustments appear in oops with information similar to charges: a description, a date, a provider, and an amount. All linked payments will appear underneath the charges towards which they are applied.
If a single payment is applied to more than one charge, it will be indicated using item numbers:
The numbers listed with the payment indicate which charges the payment pays off. The 6/15/05 payment shown above at number 1 is applied to both the physical copay charge on 5/24/05 as well as the OV Problem Focus copay charge on 4/26/05.
 | Unlinked Payments |
|---|---|
If a payment is not applied to any charge, it is called an "open-item" payment or unlinked. Open-item payments appear after charge entries and do not have dates in front of them. Linked payments appear underneath the charges they pay off and have posting dates in front of them. Partner calculates both open-item and linked payments towards an account's final balance, but it will be difficult for you to discover to which charges open-item money is applied. You should use [F7 -- Relink Payment], described below, to link any open payments. You should also link every payment when it is first posted in pam. |
3.3. Reading Billing Messages and Other Items
In addition to charge and payment information, oops displays billing messages and other important data. For example, you will see entries indicating when a claim was sent, when an electronic clearinghouse received a claim, and when a personal bill was generated.
In the example above, the charge was sent by ECS to Proxymed (a claim clearinghouse) and then to USHC on 4/26/05. A USHC insurance payment and adjustment were posted in pip on 5/24/05, and a personal bill (for the unpaid copay amount) was printed on 6/15/05. Note that the USHC check number is also shown.
| E - Toggle Billing History |
|---|---|
With all the different steps a claim passes through, your oops screen can get very cluttered. Press E to hide billing history notes. The oops listing will collapse and show you only charge and payment information. Press E again to reveal the billing information. To increase the number of visible lines in oops, you could also learn about making your Partner window bigger by reading Larger Partner Windows. |
3.4. Functions from the Charge History Screen
From this screen, you can perform (or begin) the following actions:
- [F1 -- Jump to Item] or J
Press F1 and enter an item number or a date. You will be taken to that item/date in the history.
- [F2 -- Print TOS HCFA] or T
Press F2 and enter charge item numbers to print a HCFA form immediately. Seperate item numbers with a space.
- [F3 -- Batch HCFA] or H
Press F3 and enter charge item numbers to prepare charges that you will generate a claim for using the ecs or hcfa program. Batching adds a "tag" that you can later turn into a claim, either paper or electronic.
- [F4 -- Insurance Status] or I
Press F4 and enter charge item numbers to view the Insurance Status screen. On the Insurance Status screen, you can change the responsible party of a charge or modify the copay amount. Whenever you change insurance status, you should batch the updated charges for resubmission or print a new claim. Read the Insurance Status Screen section below for more information.
Press F4 and enter a claim response item number to view portions of the related electronic claim report. Read the Electronic Claim Responses section below for more information.
- [F5 -- Visit Status] or V
Press F5 and enter charge item numbers to view the Visit Status screens. On the Visit Status screens, you can view and change diagnosis and other HCFA specific information related to a charge, such as billing provider, referring provider, authorization numbers, accident dates, etc. Read the Visit Status Screens section below for more information.
- [F6 -- Unlink Payment]
Press F6 and enter the item number of a linked payment to unlink it. You might want to do this when cleaning up an account balance problem.
- [F7 -- Relink Payment]
Press F7 and enter an item number of an unlinked payment that you wish to link up to a particular charge. You will be asked to select unpaid charges to which the payment should be linked. You can then designate how much of the payment should be applied to each of the charges you selected.
For an example of relinking a payment, read the "Problem: The Wrong Procedure Was Posted, Payment Needs Relinking" tutorial below.
- [F8 -- Delete Item(s)] or D
Press F8 and enter item numbers to delete items from the account history. You will be asked to confirm your choices before they are deleted. Once deleted, items can not be retrieved. Partner keeps a log of which user deleted an item and how that action affected the account's balance. You can review this log by running the daysheet or dsscan programs. Contact PCC for more assistance.
| Entering Item Numbers |
|---|---|
When entering items numbers for the operations above, such as batching a claim or changing insurance status, you can either type in each of the numbers separated by spaces or commas, like "1 2 3 4 5 6" or "1,2,3,4,5,6", or you can use a range, such as "1-6". You can also combine these methods: "1,3-5". |