VistA Edge PMS Vist A User Manual Vs 0.9
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VistA-Edge™ PMS User Manual Version 0.9 (Beta Release – NOT for Production use) February 2010 www.vista-edge.com support@vista-edge.com Edgeware Technologies Cutting Edge in Healthcare Information Technology Solutions Edgeware Technologies VistA-Edge™ PMS License Revision Date: 1 February 2010 Copyright © 2010 Edgeware Technologies (India) Pvt. Ltd. All Rights Reserved. Permission is granted to copy, distribute and/or modify this document under the terms of the GNU Free Documentation License, Version 1.3 or any later version published by the Free Software Foundation; with no Invariant Sections, no Front-Cover Texts, and no Back-Cover Texts. A copy of the license is included in the section entitled "GNU Free Documentation License". VistA-Edge™ is a trademark of Edgeware Technologies (India) Pvt. Ltd. Other trademarks are the property of their respective owners. Page 2 of 40 Edgeware Technologies VistA-Edge™ PMS INDEX License............................................................................................................................................ 2 Introduction................................................................................................................................... 4 Working with the system.............................................................................................................. 6 Logging in to the VistA-Edge™ PMS ..........................................................................................6 The Main Screen ............................................................................................................................7 The Quick links provided include:.............................................................................................. 8 The File menu................................................................................................................................ 9 The Master Menu........................................................................................................................ 12 The Transaction Menu ............................................................................................................... 19 The Reports menu....................................................................................................................... 32 The Help menu ............................................................................................................................ 34 Annexure I ....................................................................................................................................36 Enter Encounter Details in CPRS ............................................................................................. 36 Page 3 of 40 Edgeware Technologies VistA-Edge™ PMS Introduction The VistA-Edge™ PMS is designed to register patients for a visit, to schedule patient visits (creating and canceling appointments) and capture billing data sent from VistA to generate Form CMS-1500 for billing. VistA-Edge™ PMS is can also be used independent of VistA, by manually entering the billable services provided to the patient. Figure 1: Data Flow diagram Page 4 of 40 Edgeware Technologies VistA-Edge™ PMS The Open Source HL7 Engine - Mirth is used to send Patient registrations and appointments to VistA. The appointment interface assumes that the ‘Providers’ setup in the PMS is mapped to the required Clinics in VistA. Details on Location mapping can be found later in this manual. Mirth is also used to receive, billing details (Procedures and Diagnosis) entered in CPRS, sent out from VistA. This manual is organized in the way most people will use the “Practice Management System”. It begins with how to log on to the system and how to work step by step on different tasks you will perform. Page 5 of 40 Edgeware Technologies VistA-Edge™ PMS Working with the system Logging in to the VistA-Edge™ PMS On startup the following Login screen will pop up. Enter the User Name and Password and click the ‘OK’ button to log in. The default login credentials are: Username: Password: admin admin Note: Password is case sensitive. 1.Enter the user name. Page 6 of 40 2.Enter the password. 3. Click ‘OK’ Edgeware Technologies VistA-Edge™ PMS The Main Screen After successful login, the Main screen, as shown below, will be visible. The Screen title will Display the username of the login account used. This screen has various menus: • The File Menu, • Masters Menu, • Transactions Menu, • Reports Menu, and • Help Menu In addition to the Menu’s there are quick links to frequently used options made available on the main screen. Each Menu has different options under it. Menu’s to perform a specific task. Page 7 of 40 Edgeware Technologies VistA-Edge™ PMS The Quick links provided include: • Provider • Facility • Insurance • CPT-ICD • Chargecode • Registration • Appointment • Pre Claim Info • Generate Claim • Payment • Unposted • Receipt • Help – link to the User Manual Page 8 of 40 Edgeware Technologies VistA-Edge™ PMS The File menu On clicking the ‘File’ Menu, the ‘User Management’ and ‘Exit’ option will be displayed as seen below: The User Management Option can be used to create additional users, delete existing users and to change password of users in the system. The system comes with a default super user named ‘admin’ with password ‘admin’. There are two possible levels of users in the system: 1. Normal User – cannot create or reset any additional users passwords. 2. Super User – Can create additional users of both user levels. Page 9 of 40 Edgeware Technologies VistA-Edge™ PMS Use add button to add new user • Add user(s) - To add a user to the system enter the username, password, choose the User Level and click the ‘Add’ button. • Search user(s) – To search for an existing user enter the username and click the ‘Search’ button. • Change password – After searching for the user whose password is to be reset, use the ‘Click here to change password’ link to reset the user password. Enter the new password and use the ‘Update’ button to save changes. • Delete User - After searching for the user whose account is to be deleted, use the ‘Delete’ button to remove the user from the system. Page 10 of 40 Edgeware Technologies VistA-Edge™ PMS The ‘Exit’ option as the name suggests can be used to close and exit from the PMS system. Page 11 of 40 Edgeware Technologies VistA-Edge™ PMS The Master Menu Clicking the ‘Master’ Menu, will display following options as seen below: 1. 2. 3. 4. 5. Provider Facility Insurance Company CPT-ICD Link Charge Codes Page 12 of 40 Edgeware Technologies VistA-Edge™ PMS Provider option On clicking the “Provider” option, the following screen pops up. This screen is used to add the details about the Provider in the system. 1. Enter Code, which is unique for each provider. 2. Enter details about the provider like last name, first name, address, city, NPI, IDs and credentials, etc in the respective boxes. 3. Click on Save Button to save the given information in Provider Master Table. Page 13 of 40 Click on Search Button to search for existing records from the Provider Master Table, if already entered. Edgeware Technologies VistA-Edge™ PMS Facility Option On clicking the “Facility” option, the following screen pops up. This screen is used to enter the Address and other details of the Facilities and Revenue center. 1. Enter Unique Charge Code. 3. Click on Save Button to save the given information in Facility Master Table. 2. Enter the facility name and other details. Click on Search Button to search for the existing records from the Facility Master Table. Billing Facility: To indicate if the Facility is to be included as a Billing Provider/Facility (section 33 on the 1500 Health Insurance Claim Form) Service Facility: To indicate if the Facility is to be included as a Service Facility (section 32 on the 1500 Health Insurance Claim Form) Page 14 of 40 Edgeware Technologies VistA-Edge™ PMS A facility can be created as a Billing Service, a Service Facility, or as both depending on the requirement. Insurance Company option On clicking the “Insurance Company” option, the following screen pops up. This screen is used to add the details about the various Insurance Company(s) of patients in the system. Click on Search Button to search for the existing records from the Insurance Company Master Table. The Insurance Company Master contains the following fields: Company Details Section • • • • • • • Code – Enter a unique value assigned to every insurance company. Type – From the drop down menu type of insurance is selected. For example Medicare, Medicaid, BCBS etc. Name – Enter the Name of the insurance company. Address- Enter the Address Zip- Enter the Zip code. City- Enter the City State- Enter the State. Page 15 of 40 Edgeware Technologies VistA-Edge™ PMS • Fax- Enter the Fax Number. • Phone- Enter the Phone Number. • Contact Person: Name of the contact person in the insurance company. Click on the “Save” button to save the Insurance Company details. CPT-ICD Link option On clicking the CPT-ICD Link, the following screen will be available. From here we can select CPT’s in the database and link it with corresponding ICD(s). This information once entered can be used in the ‘Generate Claim’ screen to link the CPT’s sent from VistA or entered manually for claims. Page 16 of 40 Edgeware Technologies VistA-Edge™ PMS Charge Code option On clicking the “Charge Codes” option, the following screen pops up. This screen is used to select the billable services provided by the doctor. It is mandatory to have charge codes associated with the CPT codes used to be able to add them on the patient Bill for a claim. 1. Enter Unique Charge Code. 4 Click on save button to 2. Click on down arrow save the and choose CPT Code information in Charge from the list of CPT Code Master Codes, it will display the description of that Table. code. Follow the same process for rest of the list boxes on the screen. 3. Enter the Description of Charge Code. Similarly enter for the rest of the descriptions fields as well. Page 17 of 40 5. Enter Comments and Price. Edgeware Technologies VistA-Edge™ PMS The “Search” button can be used to lookup specific charge codes, if searched according to the parameters selected in the screen. If no parameter is selected or the screen is reset, then clicking the “Search” button will display the complete list of stored charge codes. The “Search” button functions in the same way in other Master options as well, i.e, Facility, Insurance Company and Provider Masters. NOTE: Due to licensing issues, CPT codes have not been added to the Database. Page 18 of 40 Edgeware Technologies VistA-Edge™ PMS The Transaction Menu Clicking the ‘Transaction’ Menu will display five options as seen below: 1. 2. 3. 4. 5. Patient Registration Appointment Pre-claim info Generate Claim Payment Posting Page 19 of 40 Edgeware Technologies VistA-Edge™ PMS Patient Registration option On clicking the “Patient Registration” option, the following screen pops up. This screen is used to register the patients by adding their details in the system. The screen has the following three tab buttons: 1. Basic Demographics 2. Additional Demographics 3. Insurance Coverage(s) 2.After entering the required details about the patient, click on the save button to register the patient. 1.Enter the last name, first name, sex and other relevant information about the patient in the boxes. Click on this button if you want to search for the already registered patient. Page 20 of 40 Edgeware Technologies VistA-Edge™ PMS We can register a patient by filling all the mandatory fields in all the demographics tabs, marked as (*) .If we try to register a patient without entering any of the mandatory fields, then it will display an error message and the patient will not get registered. A unique patient ID is generated by the system, which will be used in VistA as well. The patient registration screen also has an option for searching registered patients. On clicking the “Search Patient” button on this screen, the following screen will pop up. We can edit/update the patient information by selecting the patient by using the “Search Patient” Button. 1.After entering the Search Parameters, click the ‘Search’ button to search for the required patient. 2.Click on this button if you want to make a new registration. Clicking this button will take you to the patient registration screen. Once the patient has been added to the system, the patient demographics can be updated as and when required. Page 21 of 40 Edgeware Technologies VistA-Edge™ PMS Additional Demographics tab On clicking the “Additional Demographics” tab, the following screen is made available. This screen has the option for storing more information about the patient. 1.Enter all the required details about the patient like Address, Phone No., religion, nationality, etc in the respective boxes. 2.Click on the save button to save the information about the patient. Page 22 of 40 Edgeware Technologies VistA-Edge™ PMS Insurance Coverage(s) tab On clicking the “Insurance Coverage(s)” tab, the following comes up. This screen is used for storing the Insurance Coverage(s) details of the patient for different Insurance companies and assigning them as Primary, Secondary or Tertiary. It also has the option for storing information about the Policy Holders. 1.Select the Company and the Plan Type from the down menu and enter other relevant details like Policy Type, Source, Policy Holder's details, etc in the respective boxes. Page 23 of 40 2.Click on the save button to save the Insurance Coverage(s) details of the patient. Edgeware Technologies VistA-Edge™ PMS Appointment option On clicking the “Appointment” option, the following screen pops up. To lookup patients, click the “Search Patient” button. Once the patient is selected choose the concerned provider from the “Provider” drop down box, enter the appointment date and time, click the “Book” button to create the appointment. For new patients, we have to first register them by clicking the “New Registration” button before making the appointment. 1.Click on ‘Book’ button to Book an appointment for the required patient. 2.Click on the save button to save the Encounter Details of the patient. Page 24 of 40 Edgeware Technologies VistA-Edge™ PMS The Visit details section allows the entry of ‘Check in Time’ and ‘Check out time’. Please note: If the VistA-Edge™ PMS is not interfaced with VistA (that is the PMS is being used independently for Billing), when the patient arrives at the clinic, the Encounter Time is to be filled in, using this screen. Pre Claim Info option On clicking the “Pre Claim Info” option, the following screen pops up. This screen is used to store the visit details of the patient with the concerned provider. After the appointment has been made and the doctor sees the patient, a Visit Number is created. After filling the details mentioned on the screen, a Case Id is generated. The software will automatically assign the Case ID for the first case as “HRN.001”, “HRN.002” for the second visit, so on and so forth. Only after the Case for the patient is created can the ‘Generate Claim’ option be used for generating the claim. 2.Enter the required details like Patient Condition details, Current Illness, Facility, Billing Service, etc about the patient in the respective boxes. 3.Click on the save/update button to save the visit details of the patient. Page 25 of 40 1.Click on this button to search for the required patient. Edgeware Technologies VistA-Edge™ PMS Generate Claim option On clicking the “Generate Claim” option, the following screen pops up. This screen is used to store the billing information. Once the patient is selected, the ‘Patient Demographics’, Insurance Details and ‘List of Visits’ will be populated. Select the Visit for which the CMS 1500 form is to be generated. The ‘Encounters of’ drop down box can be used to filter the List of visits, for those received from VistA, entered in the PMS, or both. Note: Please refer to Annexure 1 for details on how the Billing details are captured and sent from VistA In Case billing data is not received from VistA, they can be entered using this screen. First select the visit and then enter the CPT and ICD codes to be billed for the selected visit. 2.Enter the CPTs and select the ICDs from the drop down menu box of the ICDs. 3.Click on the save button to save the Billing information. Page 26 of 40 1.Click on this button to search for the required patient. Edgeware Technologies VistA-Edge™ PMS Populated ‘Generate Claim’ Screen: ‘Encounters of’ drop down The ‘ICD’ block The Visit Date is the date of service. To Generate the CMS Form 1500 • If PMS is not interfaced with VistA: o Select the Visit (created using the ‘Pre-Claim info’ option) o Enter the CPT code for the procedures performed on the patient during the visit. To do so single click the first field in CPT column and type the appropriate CPT o Enter additional details (Units of procedure etc.) o Assuming that the CPT-ICD Link master is in place, the possible ICD codes can be selected for each entered CPT Code by clicking the drop down menu under ICD. o Assuming that the Chargecode master is updated, select the appropriate Chargecode for each CPT/procedure. o The charges will be picked up and total calculated automatically. Page 27 of 40 Edgeware Technologies VistA-Edge™ PMS o Use the ‘Save’ button to save the claim data entered. This will enable the ‘Print Claim’ option. o Use the ‘Print Claim’ option to print the HCFA 1500 form. • If billing information is sent from VistA: o To see the list of CPT’s sent from VistA only select ‘VistA’ from the ‘Encounters of’ drop down box. o The List of Diagnoses sent from VistA will be displayed in the ICD Block. o Click on the ‘CPT’ column to see and select the each CPT to be added to the Claim. o For each CPT selected, add the related ICD, units, chargecode and other details. o The charges will be picked up and total calculated automatically. o Use the ‘Save’ button to save the claim data entered. This will enable the ‘Print Claim’ option. o Use the ‘Print Claim’ option to print the HCFA 1500 form. This form after a thorough check can be printed on a CMS 1500 FORM, which can be sent to the concerned payer. Sample CMS-1500 Form Page 28 of 40 Edgeware Technologies VistA-Edge™ PMS Payment posting option This option can be used to enter the receipts of payments into the system and to post the corresponding amount to the patient claim. Depending on the Payer is Insurance the details of the specific insurance company can also be linked to the receipt. Page 29 of 40 Edgeware Technologies VistA-Edge™ PMS Page 30 of 40 Edgeware Technologies VistA-Edge™ PMS Page 31 of 40 Edgeware Technologies VistA-Edge™ PMS The Reports menu Clicking the ‘Reports’ Menu will display two options as seen below: 1. Detailed Receipt Report (a.) Receipt Report (b.) Unposted Receipt Report Receipt Report: Page 32 of 40 Edgeware Technologies VistA-Edge™ PMS On selecting the report to print, the user can enter the date range for which the report is to be generated. Unposted Receipt Report: Page 33 of 40 Edgeware Technologies VistA-Edge™ PMS The Help menu Clicking the ‘Help’ Menu will display two options as seen below: 1. Contents 2. About Clicking the ‘Contents’ option will open up the “VistA-Edge™ PMS User Manual”. Page 34 of 40 Edgeware Technologies VistA-Edge™ PMS About option On clicking the “About” option, the following screen pops up. This screen will display the information about the product and the contact details for any type of support required. Page 35 of 40 Edgeware Technologies VistA-Edge™ PMS Annexure I Enter Encounter Details in CPRS Once logged in to CPRS, go to the ‘Notes’ Tab and click the “New Note” button to enter a note. Select a suitable note title. New Note Notes Tab This will open a blank note as can be seen in the screenshot below Page 36 of 40 Edgeware Technologies VistA-Edge™ PMS Click the ‘Encounter” button to invoke the Encounter form. Enter the Diagnosis and procedure(s) for the Encounter using the respective tabs. Page 37 of 40 Edgeware Technologies VistA-Edge™ PMS Ensure you assign a provider for the procedures documented in the Encounter. Click ‘OK’ when you have finished entering the Encounter details. This will show a popup to confirm the primary provider for the Encounter. If you are the primary provider click ‘yes’ or use the “Select Primary” button to select the Primary provider for the visit. Page 38 of 40 Edgeware Technologies VistA-Edge™ PMS The details entered in the Encounter form will be visible in the bottom of the Notes block. Encounter Details Add the relevant text to your note (can be done using templates) and Sign the note. Page 39 of 40 Edgeware Technologies VistA-Edge™ PMS On signing the note the Diagnosis and Procedure information entered in the Encounter form are sent out of VistA to the VistA-Edge™ PMS, assuming that the interface is setup and functional Page 40 of 40
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