2.1 How to Generate a DOS Encounter: Insured Patients

ENTER CHARGES
Enter Charges is "Ground Zero" where you can fully manage all charges. This is where you will:

• Create new charges

• View details of any DOS encounters previously created

• Delete charges

• Edit charges

There are 2 different ways in ChiroFusion to generate charges for a DOS Encounter using CPT & ICD Codes. Charges can automatically be generated at the time a Provider is signing an Exam/SOAP note, and also generated manually directly in billing.

2.1 How to Generate a New DOS Encounter: Insured Patients

There are 2 different ways in ChiroFusion to generate charges for a DOS Encounter using CPT & ICD Codes. Charges can automatically be generated at the time a Provider is signing an Exam/SOAP note, and also generated manually directly in billing.
OPTION 1: AUTO-GENERATING A DOS ENCOUNTER CHARGE WHEN SIGNING AN EXAM/SOAP
This feature is a one-time short cut for generating charges & if a report is signed/saved without checking the ‘Move Visit To Billing Queue’ then charges can only be created/edited directly in billing for that DOS.

1. As the Provider, when completing an Exam/SOAP note you will click on Sign to preview your report, & then click on Save Report

   1. A pop-up box will appear, prompting you to enter your PIN, along with a checkbox that reads 'Move Visit To Billing Queue'.

2. By checking this box & clicking Save, a copy of your report will be saved to the patients' Medical File, and charges for that DOS will automatically be sent over to billing under 'Approve Charges'.

 
The charges will be based on the ICD & CPT Codes you have included in your report, and the fees that have been set in billing will automatically be applied to your correlating procedure codes.
In order for a DOS Encounter to be sent over to Billing as 'Insured' a patient must have Primary Insurance (and/or Secondary Insurance) saved on their profile, & also attached to their case.
Go To: BILLING > ENTER CHARGES
 
OPTION 2: MANUALLY GENERATING A DOS ENCOUNTER CHARGE DIRECTLY IN BILLING

1. Search for patients within Global search by using the search bar, the advanced search options or clicking the letter of the patient’s last name.  You will then click within the line to select the patient.

   1. If the patient has multiple cases, you will need to go to the right hand side to select the case you would like to generate charges for.

2. For Multi-Provider accounts, click on the 'Provider' drop-down & select the Provider that is to appear as the 'Rendering Provider'.

3. Click Create New Visit & select the Date of Service from the calendar.

4. Financial: Displays the case and insurance company information 

   1. If the patient has more than one insurance, you can select the insurance company from the drop down

   2. Fee Schedule Group:  Select a Fee schedule group to charge the patient with (Optional)

   3. Deductible:  This is not an active field but will show the deductible for reference that was entered in the patients profile

   4. Apply Patient Co-Pay: If there is a co-pay identified on the Primary Insurance page in a patients profile, this will appear as an option to select. Check the box to apply the co-pay amount to patient responsibility, or leave it unchecked & the co-pay amount will not be applied.

Adding ICD Codes:

1. Search the ICD codes from the box by the code or Description or by selecting from the Favorite List

2. Click “Add” 

3. You can enter up to 12 ICD diagnosis codes by code or by description.

4. Click Add after each code entered.

Reordering or Removing ICD Code

1. To reorder ICD codes, you can click/drag/drop into the order you want

2. To remove a cpt code, you will select the check box and then click delete.

Favoriting an ICD Code

1. Once an ICD code is in the ICD code box you can click on the check box

2. You will then go down and click on Add To Favorite

   1. This Favorite list will be per facility.

Adding CPT Procedure Codes:

1. Search the code by code or description or by using the Favorite List

   1. CPT codes can be placed as a favorite on the Fee schedule, this is also per facility.

2. Information from the fee schedule will pull but can be edited

   1. You can change the place of service

   2. Modifiers- You are able to attach up to four modifiers per code.  They will add in the order you select them.  

   3. DX Pointers- Will default to ABCD but you are able to edit to any order you want.  This is pulling from the letters next to the ICD codes above.

   4. Std. Fee: This will pull from fee schedule but can be adjusted

   5. Units:  Will default to 1 but can be edited

   6. File:  This tells the system if you would like the code to appear on the claim form or not

3. Click add

Note:  If a CPT code is not in your fee schedule you will be able to manually enter in the code for this specific date of service.
Editing CPT Codes

• To change the order, you are able to click/drag/drop into the order you would like.

• To edit the details you will click on the pencil icon to the right of the line item.

• Click Finish Edits

Adding an Extra Charge to DOS

1. Click Add Extra Charge

2. A new window will appear where you can select the category or the name of the extra charge you want

3. Once added you can make edits to the units, price, and select/deselect if you want sales tax applied.

4. You can add multiple extra charges to the box.

5. Click Save and close

 
To finalize Charges

• Click Save to save the changes so they appear in the Approve Charges

  • You will receive a notification at the bottom of the screen showing your changes have been saved

• Click Save and Approve to bypass the Approve Charges screen and see the charge in patient accounting.

  • You will receive a notification that the charge has been saved and approved.  

  • There will be an option to collect payment that will take you straight to Patient Accounting for the DOS.

Optional:  To Place a Visit on hold
At times, you may not have all the information required to generate a charge the way you need.  You can put these visits On Hold until the information is available.

• At the top of the page there is a drop down menu for On Hold

• Select Reason

• To unselect: click the X next to the reason to remove

View Details of any DOS Encounters Previously Created

• Search/Select desired patient

• Click on the "DOS" dropdown and select the DOS in which you would like to view

Deleting a Date of Service Encounter

• Search/Select desired patient

• Click on the "DOS" dropdown and select the DOS

• Click "Delete Visit"

NOTE: If there is a payment or adjustment on the patient's account for that DOS, you can not delete the encounter

Editing Charges

• *Please see section (attach link here) in the billing manual for instructions editing charges (Refiling & Editing / Approve Charges)