Change Patient Data

• Patient Summary Screen
  
• Patient Name and Address Information
  
• Guarantor Information
  
• Billing Information
  
• Case Management
  
• Primary and Secondary Insurance
  
• Insurance Policy Information
  
• Images
  
• History
  
• Recalls
  
• Referrals
  
• Authorizations
  
• Service Scripts
  
• Employers
  
• DMS
  
• Letters
  
• Transactions
  
• Summary

Prompt	Response	Req	Len
Last Name	Type the patient's last name.		60
Suffix	Enter the patient's Suffix.		10
First Name	Type the patient's first name.		35
Middle Name	Type the patient's middle name.		25
Address Line One	Type the address for the patient.		35
Address Line Two	Type any additional address information.		35
Zip Code	Type the five digit zip code or the zip+four. If you type the zip+four, the dash is automatically inserted before the last four digits.		10
City	The city automatically populates based on the Zip Code entered, or you can type the name of the city.		20
State Code	The state automatically populates based on the Zip Code entered, or you can type the state code or select from the drop-down list. Click Validate Address to convert the address entered into the standard United States Postal Service format. The Address Line One will be converted; the information in Address Line Two (if standard) moves up to the end of Address Line One; the Zip Code is converted to Zip+4 and the City and State are converted based on the Zip Code. If a standard match cannot be found, messages display to explain. If you disagree with the converted address, you can change it back and save it without the validation changes. These changes will prevent claims from being rejected or added to the Exception report due to an invalid address or state code.		3
County	Select the county code from the County list.		5
Country Code	Type the country code or select from the Country list.		2
Subdivision	If you selected a country other than the US, select a subdivision from the list.		2
Telephone	Type the patient's telephone number.		20
Cell Phone	Type the patient's cell phone number.		20
Patient Identifier	Type an optional practice-defined identification number or alternate name to search for this patient when using Patient Look-up. For example, a patient's official name on his insurance is William, but the patient only goes by 'Bud'. Type 'Bud' in this field so this patient can be located with Patient Look-up.		20
Social Security#	Type the patient's nine digit social security number with or without dashes.		11
Birth Date	Type the patient's birth date in a MM-DD-CCYY format or click the calendar icon to select a date. The century will automatically be set to '1900' if only two digits are entered for the year and the year is later than the current year. For example, 06-25-58.		10
DOD	Type the patient's date of death in a MM-DD-CCYY format or click the calendar icon to select a date.		10
E-Mail Address	Type the patient's e-mail address.		50
Race	Select the applicable race from the list. This field is currently used for UDS reporting by Community Health Centers.		1
Sex	Select the applicable option to indicate the sex of the patient.		1
Race Other	Select an additional race for the patient, if applicable.		1
Sex Orientation	Select the applicable option to indicate the sex orientation of the patient.		1
Ethnicity	Select the applicable ethnicity from the list. This field is currently used for UDS reporting by CHCs.		1
Sex Orientation-Other	If you selected 'Something Else - Please Describe' for the Sex Orientation field, enter the description.		1
Language	Type the code you want or select from the Language list. The available selections in the drop-down list are maintained in the Language Code Table.		3
Gender Identity	Select the applicable option to indicate the gender identity of the patient.		1
Patient Status	Select the applicable patient status code from the Status list. If the patient's Status is changed to Deceased, all future appointments and recalls are automatically deleted.		2
Gender Identity-Other	If you selected 'Additional Gender Category or Other - Please Specify' for the Gender Identity field, enter an explanation.		1
Rel to Guarantor	Select the code for the patient's relationship to the guarantor from the Relationship list. If you select '0 - Same' for the relationship, the patient's name, address, social security number, and e-mail address will automatically be stored in the Guarantor's information. If you make changes to any of these fields on the Patient Information screen, the Guarantor Information screen will automatically be updated. If you make changes to any of these fields on the Guarantor Information screen the Patient Information screen will automatically be updated. If you select a relationship other than 0 Same and you make changes to any of these fields in the Patient Information screen, you will be asked if the Guarantor information should be updated. If you select a relationship other than 0 Same and you make changes to any of these fields in the Guarantor Information screen, you will be asked if the Patient information should be updated.		2
Class	Type the code you want or select from the Class list. The selection list includes items from the Patient Class Table.		3
Responsible Doctor	Type the code you want or click the magnifying glass to search the table.		4
Primary Care Doctor	Type the code you want or click the magnifying glass to search the table.		6
Referral Source	Type the code you want or click the magnifying glass to search the table.		6
Referral Type	Type the code you want or select from the Referral Type list. The selection list includes the referral source codes that have been marked as a Referral Type in the Referral Source Table.		6
Default Location	Type the code you want as the patient's default location or select from the Location list.		6
Default Diagnosis	Type the code you want as the patient's primary, chronic diagnosis code or click the magnifying glass to search the table. If you do not want to store an ongoing primary diagnosis for this patient, type '0' for 'No Diagnosis Recorded'. The diagnosis code stored in this field is used for reporting purposes and defaults in the 'Diag 1' field in the Procedure Entry Function unless you have the 'Default DX's at Chg Entry' check box selected in CGM webPRACTICE Default Values (System, Database Maintenance Menu). If you have this check box selected, then it overrides this 'Default Diagnosis' field and it places the last posted diagnosis code in the 'Diag 1' field in the Procedure Entry Function.		10
Date of First Visit	Type the date you want or click the calendar icon to select a date. This field defaults in the Patient Registration function to the date stored in the Date of First Visit field in CGM webPRACTICE Default Values (System, Database Maintenance Menu). If no date is stored there, then this field defaults in Patient Registration with the current date (the date the patient is pre-registered or registered). In addition, if you schedule any future appointments for the pre-registered patient account (prior to registering the account), the future appointment date overrides any previous default date.		10
Date Acct Last Reviewed	Informational only - indicates when you last reviewed the account data with the patient to confirm it is current. The date is automatically updated when you click the Account Reviewed Action Column button.		10

Prompt	Response	Req	Len
Last Name	Type the guarantor's last name.		60
Suffix	Type the Guarantor's suffix. It may be up to 10 characters.		10
First Name	Type the guarantor's first name.		35
Middle Name	Type the guarantor's middle name.		25
Address Line One	This address is used for the mailing address for the patient's statement unless the 'Primary Address' field in the Billing Information screen is cleared. If you selected '0 - Same' in the 'Rel to Guarantor' field in the Patient Name and Address Information screen, the patient's name, address, social security number, and e-mail address will default in the Guarantor Information fields. You can edit the guarantor's address if it is different from the address displayed. If you selected '0 - Same' in the 'Rel to Guarantor' field in the Patient Name and Address Information screen and if you make changes to any of these fields on the Patient Information screen, the Guarantor Information screen will automatically be updated. If you make changes to any of these fields on the Guarantor Information screen the Patient Information screen will automatically be updated. If you select a relationship other than 0 Same and you make changes to any of these fields in the Patient Information screen, CGM webPRACTICE will ask if the Guarantor information should be updated. If you make changes to any of these fields in the Guarantor Information screen, CGM webPRACTICE will ask if the Patient information should be updated.		35
Address Line Two	Type any additional secondary address information.		35
Zip Code	Type the five digit zip code or the zip+four. If you type the zip+four, the dash is automatically inserted before the last four digits.		10
City	The city automatically populates based on the Zip Code entered, or you can type the name of the city.		15
State Code	The state automatically populates based on the Zip Code entered, or you can type the state code or select from the drop-down list. Click Validate Address to convert the address entered into the standard United States Postal Service format. The Address Line One will be converted; the information in Address Line Two (if standard) moves up to the end of Address Line One; the Zip Code is converted to Zip+4 and the City and State are converted based on the Zip Code. If a standard match cannot be found, messages display to explain. If you disagree with the converted address, you can change it back and save it without the validation changes. These changes will prevent claims from being rejected or added to the Exception report due to an invalid address or state code.		3
County	Select the county code from the County list.		5
Country Code	Type the country code or select from the Country list.		2
Subdivision			3
Telephone Number	Type the phone number for the guarantor.		20
Social Security #	Type the guarantor's nine digit social security number with or without dashes.		11
Birth Date	Type the guarantor's birth date in a MM-DD-CCYY format or click the calendar icon to select a date. The century will automatically be set to '1900' if only two digits are entered for the year and the year is later than the current year. For example, 06-25-58.		10
E-Mail Address	Type the guarantor's e-mail address.		40
Secondary Address One	Type any secondary address information. For example if the patient spends six months of the year at his primary residence and six months of the year at a vacation residence, you can type the address of the vacation residence. You would then clear the Primary Address check box on the patient's Billing Information screen and the statements would then go to the patient at this vacation residence address.		35
Two	Type any additional address information.		35
Zip Code	Type the five digit zip code or the zip+four for the secondary address. If you type the zip+four, the dash is automatically inserted before the last four digits.		10
City	The city automatically populates based on the Zip Code entered, or you can type the name of the city for the secondary address.		15
State Code	The state automatically populates based on the Zip Code entered, or you can type the state code or select from the drop-down list for the secondary address. Click Validate Address to convert the address entered into the standard United States Postal Service format. The Address Line One will be converted; the information in Address Line Two (if standard) moves up to the end of Address Line One; the Zip Code is converted to Zip+4 and the City and State are converted based on the Zip Code. If a standard match cannot be found, messages display to explain. You can still choose to override what is converted by Validate Address by typing in any address information you choose.		3
County	Select the county code from the County list.		5
Country Code	Type the country code or select from the Country list.		2
Subdivision			10
Telephone Number	Type the phone number for the secondary address.		20

Prompt	Response	Req	Len
Billing Group	Type the code you want or click the magnifying glass to search the table. If the Billing Type for your database is set up as 'Family' or 'Linking' and you change the Billing Group for any of the family members, you will be given the option to update the Billing Group on any or all of the other family members.		3
Fee Schedule (Alternate Fee)	Type the fee schedule code you want or select from the Fee Schedule list. This is required if you store any Alternate Fees in this Fee Schedule. The only way the Alternate Fees will default in the Chg Amt field in the Procedure Entry Function is if the Fee Schedule is entered here.		5
Medicare Patient	If this patient has Medicare, select this check box. This field is used to determine the proper 'accept assignment' setting when posting procedures. For more information, see the Accept Assignment Protocol help section under Introduction, System Processes.		1
Benefits Assignment	If you have the patient's signature on file, select this radio button. If this radio button is selected, 'Signature on File' prints in Box 12 and 13 of the CMS-1500 form (and its electronic equivalent).		1
Release of Information	If you have the patient's signature on file to authorize the release of medical information to other organizations, select this check box.		1
Alert User	If you want the Internal Comment to appear every time this patient's account is accessed, select this check box. If a DMS Alert, HIPAA, or Family Income record containing a Review Date exists on the patient account, the Alert User field will be overridden and the Alerts window will automatically appear each time the patient's account is accessed.		1
Internal Comment	Type any comment text you want to display whenever this patient's account is accessed using Patient Look-up.		45
Report Comment	Type any comment text you want to print whenever this patient's account is printed on a report.		45
Account Description	Type an additional account description, if applicable.		45
Send Statement	If you want this patient to receive a statement, select this check box.		1
Suppress Collections	If you want to suppress this patient account from entering the collection process, select this check box.		1
Primary Address	If you want to use the guarantor's primary address for all correspondence, select this check box.		1
Print Aging Message	If you want to print aging messages on this patient's statement, select this check box.		1
Finance Charges	If you want finance charges to generate for this account, select this check box. If you select this check box, it can still be overridden by selecting the Suppress Finance Charges check box in the Billing Group Code Table for the patient's Billing Group. The Service Charge Control File (System, Database Maintenance Menu) must also be completed for finance charges to be added to the account.		1
Statement Comment	Type any comment text you want to appear on this patient's statement.		45
Erase Statement Comment	If you want to erase the statement comment after it has printed, select this check box.		1
Employment Status	Select the patient's employment status from the Employment Status List.		1
Guarantor's Employer	Type the guarantor's employer.		30
Employer's Address	Type the guarantor's employer's address.		30
Employer's Address 2	Type the guarantor's employer's address 2.		30
Zip Code	Type the zip for the guarantor's employer's address.		30
City	The guarantor's employer's city automatically populates based on the Zip Code entered, or you can type the name of the city.		20
State	The guarantor's employer's state automatically populates based on the Zip Code entered, or you can type the state code or select from the drop-down list. Click Validate Address to convert the address entered into the standard United States Postal Service format. The Address Line One will be converted; the information in Address Line Two (if standard) moves up to the end of Address Line One; the Zip Code is converted to Zip+4 and the City and State are converted based on the Zip Code. If a standard match cannot be found, messages display to explain. You can still choose to override what is converted by Validate Address by typing in any address information you choose.		3
Telephone Number	Type the telephone number of the guarantor's employer.		20

Prompt	Response	Req	Len
Case Type	Type the code you want or select from the Case Type list.		5
Case Description	Type a description of the case.		45
Accident Type	Select the applicable Accident Type option or select None if this case is not related to an accident.		1
Accident State	If you selected Auto for the Accident Type, select the state where the accident occurred from the Accident State list.		3
Primary Diagnosis	Type the code you want or click the magnifying glass to search the table.		10
Date Last Worked	Type the date the patient last worked or click the calendar icon to select a date.		10
Date of Ill, Inj, Lmp	Type the date of illness, injury, or last menstrual period or click the calendar icon to select a date.		10
Date of First Visit	Type the date of the patient's first visit to your practice for this case or click the calendar icon to select a date.		10
Date First PCP Visit	Type the date of the patients first Primary Care Physician (PCP) visit for this case or click the calendar icon to select a date.		10
Start Total Disability	Type the date the patient started total disability or click the calendar icon to select a date.		10
End Total Disablity	Type the date that total disability ended for the patient or click the calendar icon to select a date.		10
Start Partial Disability	Type the date the patient started partial disability or click the calendar icon to select a date.		10
End Partial Disability	Type the date that partial disability ended for the patient or click the calendar icon to select a date.		10
Start Light Duty	Type the date the patient started light duty or click the calendar icon to select a date.		10
End	Type the date that light duty ended for the patient or click the calendar icon to select a date.		10
Date Unable to Work	Type the date the patient became unable to work or click the calendar icon to select a date.		10
Date Able to Work	Type the date the patient became able to work or click the calendar icon to select a date.		10
Discharge Date/MMI	Type the discharge date or the date of Maximum Medical Improvement (MMI) or click the calendar icon to select a date.		10
Restrictions	Type any applicable restrictions for this case.		40
Permanent Restrictions	Type any applicable permanent restrictions for this case.		40
Billing Group	Type the code you want or click the magnifying glass to search the table. (When you enter charges in the Procedure Entry Function, the billing group for the selected case will automatically be stored on each of the charges tied to the case.)		8
Fee Schedule	The Fee Schedule is used to provide Alternate Fees and Allowable amounts whenever this Case is selected for a patient. Type the code you want or click the magnifying glass to search the table.		5
Insurance Primary	Select the primary insurance carrier that applies to this case from the Primary Carrier list. All primary carriers stored on the account will display along with the policy number. If a carrier has been terminated, the termination date displays next to the policy number. You should select a primary insurance if the charges assigned to this case should be billed to a primary insurance carrier different from the regular primary insurance stored on the patient account and the policy has the Special Billing check box selected in the Insurance Policy Information screen. You should leave this field blank if the charges assigned to this case should be billed to the regular primary insurance on the account or select No Insurance if the charges should not be billed to a primary insurance carrier at all.		5
Secondary	Select the secondary insurance carrier that applies to this case from the Secondary Carrier list. All secondary carriers stored on the account will display along with the policy number. If a carrier has been terminated, the termination date displays next to the policy number. You should select a secondary insurance if the charges assigned to this case should be billed to a secondary insurance carrier different from the regular secondary insurance stored on the patient account and the policy has the 'Special Billing' check box selected in the Insurance Policy Information screen. You should leave this field blank if the charges assigned to this case should be billed to the regular secondary insurance on the account or select No Insurance if the charges should not be billed to a secondary insurance carrier at all.		5
Tertiary	Type the tertiary insurance carrier code that applies to this case or select from the Tertiary list. All tertiary carriers stored on the account will display along with the policy number. If a carrier has been terminated, the termination date displays next to the policy number. You should select a tertiary insurance if the charges assigned to this case should be billed to a tertiary insurance carrier different from the regular tertiary insurance stored on the patient account and the policy has the 'Special Billing' check box selected in the Insurance Policy Information screen. You should leave this field blank if the charges assigned to this case should be billed to the regular tertiary insurance on the account or select No Insurance if the charges should not be billed to a tertiary insurance carrier at all.		5
Statement Billing	If you want transactions for this case to be included on the patients statement, select this check box.		1
Comment	Type any applicable comment for this case. This field is strictly informational and does not populate into any other function or print anywhere.		50
Doctor	Type the code you want or select from the Doctor list.		3
Therapist	Type the code you want or select from the Therapist list.		3
Referring Doctor	Type the code you want or click the magnifying glass to search the table.		5
Claim Number	Type the claim number for this case. For electronic workers' compensation claims only, this claim number will override the Policy Number stored in the Insurance Policy Information for the applicable insurance policy.		25
Adjuster Code	Type the name for the adjuster.		5
Case Manager Code	Type the code for the case manager.		5
Adjuster Name	Type the phone number for the adjuster.		130
Case Manager Name	Type the name for the case manager.		130
Adjuster Phone	Type the fax number for the adjuster.		20
Case Manager Phone	Type the phone number for the case manager.		20
Adjuster Fax	Type the name for the case manager.		20
Case Manager Fax	Type the fax number for Case Manager.		20
Employer	Type the termination date of this case or click the calendar icon to select a date.		5
Termination Date	Type the code you want or select from the Protocol list. For additional information see the Protocol Table functions under the Tables menu.		10
Protocol	Type the code you want or select from the Protocol list.		8

• Image Icon (if one has been stored for the policy)
  
• Insurance Carrier Code (CGM webVERIFY status icon will also display if your practice has a current CGM webVERIFY subscription. If you point to the icon, a ScreenTip will state the current status.)
  

  CGM webVERIFY Eligibility Status icons: (CGM webVERIFY clients only)

  Verification Failed - Red

  Verification Passed - Green

  Verification Outdated - Grey

  Verification Partial - Yellow

  Never Verified - Clear - denotes a policy that has never been verified. If you point to the icon, a ScreenTip will state either, 'Never Verified' or 'Never Verified. Carrier does not contain a CGM webVERIFY Identifier.' You can click the Status icon to check eligibility for the carrier
  

  The status icon reflects the status of the specific result being viewed, not the current eligibility status for the policy.

  
  
• (P)-If Primary Carrier, (S)-If Secondary Carrier, (T)-If Tertiary Carrier
  
• Insurance Carrier Name
  
• Policy Number
  
• Effective Date
  
• Termination Date (if one has been entered)

Prompt	Response	Req	Len
Insurance Carrier Code	Type the code you want or click the magnifying glass to search the table. NOTE: You cannot edit or delete this code if claims have been submitted to this carrier. You have to terminate this carrier instead. You cannot edit or delete this code if this carrier is tied to a case. You must remove the carrier from the case and as long as there are no claims submitted for this carrier, you can edit or delete the code.		5
Policy Holder (L, S, F, M)	Type the policy holder's last name, suffix, first name, and middle name.. NOTE: If Same is selected for the Rel to Guarantor field on the Patient Name and Address Information screen, but the policy holder's name differs from the patient name, an alert message displays.		60
Policy Holder Employer	Type the employer code you want or select from the Employer list. This list pulls from the employer information stored in the patient's Employers DMS record.		6
Employer's Name	If you do not have the Employers information completed on this account, you can still type the name of the employer or any additional employer information.		40
Group Number	Type the group number for this policy.		50
Policy Number	Type the patient's policy number for this insurance carrier. The patient's social security number defaults in this field unless the guarantor's social security number is different from the patient's, and in that case the guarantor's number defaults. If the Policy # Format field is completed in the Insurance Carrier table for this carrier, then the policy number entered here must match that format, otherwise an alert message displays. For more information, see Maintain Insurance Carriers.		20
Pat. Rel to Policy Holder	Select the patient's relation to the policy holder.		2
Policy Holder Sex	Select the option to indicate the policy holder's sex.		1
Policy Holder Birth Date	Type the policy holder's birth date in the format of MM-DD-YYYY or click the calendar icon to select a date.		10
Policy Holder is Employer	If the policy holder is the patient's employer, select this check box. If you select this check box, the policy holder's employer information will be sent in the electronic insurance claim file instead of the policy holder's name. For example, if the claim is for a worker's compensation case, the employer is actually the policy holder and needs to be reported on the claim. NOTE: If you select this check box, but Same is selected for the Rel to Guarantor field on the Patient Name and Address Information screen, an alert message displays.		1
Carrier Type	Select the option to indicate the carrier type for this policy. If you attempt to change the Carrier Type when there are existing claims for that patient and carrier, that have a status of In Process, Locked, Exception or On Hold, you will receive the following message:  Unable to change the carrier type. Claims have already been filed for this carrier. If there are claims that meet these criteria, you will not be allowed to change the carrier type.   In addition, if the insurance carrier is tied to a Case, you will not be allowed to change the carrier type.		1
Effective Date	Type the effective date of the policy or click the calendar icon to select a date.		10
Termination Date	Type the termination date for this policy or click the calendar icon to select a date. If you enter a termination date for this carrier, the account is checked to see if any charges were filed to this carrier after the termination date. If there were, a Deny dialog displays stating the open charges for the carrier will be denied and require you to select a Practice Denial code and an optional Insurance Denial code, to deny those charges. The charges that were filed to this carrier after the termination date will be denied, the patient's insurance ledger is updated to reflect 'D' for denied and the charges are moved to the patient balance. No secondary claim will be generated. If this policy is for a secondary insurance carrier and you want the policy information to still print on the insurance claim for the primary insurance carrier, type the same date in the Termination Date field that exists in the Effective Date field. If you do not want the secondary policy information to print on the insurance claim for the primary insurance carrier, you must make the termination date at least one day later than the effective date.		10
Card Issue Date	Type the card issue date for the policy or click the calendar icon to select a date. If you practice has a current subscription to CGM webVERIFY, some payers require this date when processing eligibility requests. If the field is left blank, the Effective Date of the policy will be submitted instead.		10
Medicare Supplemental Type	This field is required only if this policy is for an Electronic Secondary Medicare carrier. Select the type of policy from the Insurance Type Code list. This field is required by Medicare. If you do not select a type from the list, the claim is automatically sent with 12 - Working Aged Beneficiary or Spouse with Plan.		2
Insurance Type	This field is required only if the policy is Medicare, Medicaid, or commercial Medicare		2
Special Billing	If this policy should only be billed for certain Cases, select this check box.		1
Bill this Carrier	Select the billing option you want to use for this policy when creating insurance claims. Y - Yes, create an insurance claim for all procedures that have accounting dates falling within the effective and termination dates for this policy and store entries for each procedure in the insurance ledger showing all activity. N - No, do not create an insurance claim for any procedures for this policy. C - Courtesy, create an insurance claim for all procedures that have accounting dates falling within the effective and termination dates for this policy but do not store any activity in the insurance ledger. E - Electronic, this option is for Medigap or Crossover secondary insurance carriers, when the primary carrier automatically forwards the insurance claim electronically to the secondary carrier. This option functions the same as selecting Yes, BUT AN ACTUAL INSURANCE CLAIM IS NOT CREATED IN EITHER THE ELECTRONIC OR PAPER CLAIM FILE. When a Secondary policy is added to a patient account, the Bill this Carrier option is automatically set to E, IF the secondary Insurance Carrier code has a Medigap number entered in the Insurance Carrier Table and ONLY IF the primary carrier on the patient's account is Medicare. Note: The Primary Insurance Default check box must be selected in System, Database Maintenance Menu, CGM webPRACTICE Default Values, otherwise this functionality will not work.		1
Accept Assignment	If you want to accept assignment for this carrier for this patient, select this check box. There are other fields within CGM webPRACTICE that can override this accept assignment setting. For additional information see the Accept Assignment Protocol help section under Introduction, System Processes.		2
Ins Liability/Default Pmt %	Type the default insurance liability percentage followed by a forward slash '/' and then the default payment percentage. This field defaults with the value entered for the Liability/Default Pmt % field in the Insurance Carrier Table.   This is actually a two-part question. The first part - Ins Liability determines what portion of a procedure should go in the insurance balance. If the entire balance is to remain in the insurance balance until the insurance pays, then the response should be 100. If you are collecting a portion at the time of service, the entry should be the portion that will remain in insurance balance. For example: if you are collecting 20% up front, the liability should be 80. The second portion - Default Pmt % is what percentage the carrier actually pays. These two responses should be separated by a forward slash '/'. For example, if this carrier was Medicare, and you do not collect any money at the time of visit, your entry should be 100/80. This is the default response for all Medicare patients, thus maintaining consistency and eliminating errors. If you leave this field blank, the system treats it as if '100' was entered, which means the entire balance would remain in the insurance balance until the insurance pays.		10
Deductible $	Type the deductible amount for this policy.		10
Co-Payment Amount $	Type the patient's co-payment amount for this policy, if applicable. This amount displays in the Copay field in the Insurance sections on the Patient Summary screen with the Specialist Co-pay amount in Co-Payment/Specialist Co-payment format. 20.00/35.00, for example. This amount also defaults in Patient Check In/Out, depending on the doctor the patient is scheduled with. Click Additional Co-Pays in the Action Column to add co-pay information for specific types of service.		10
Spec Co-Pay $	Type the patient's co-payment amount for specialists under this policy, if applicable. This amount displays in the Copay field in the Insurance sections on the Patient Summary screen with the standard Co-pay amount in Co-Payment/ Specialist Co-payment format. 20.00/35.00, for example. This amount also defaults in Patient Check In/Out, depending on the doctor the patient is scheduled with. Click Additional Co-Pays in the Action Column to add co-pay information for specific types of service.		10
Patient Co-Ins Liability %	Type the patient co-insurance liability percentage. When the insurance policy is for a Medicare carrier that has the Insurance Form Type set to ‘C’, enter a value from 0 to 100.		10
Cov Last Ver thru CGM webVERIFY	If your practice subscribes to CGM webVERIFY, the date this policy's coverage was last verified on will display. If not, type the date you last verified coverage or click the calendar icon to select a date.		10
Coverage Verified thru CGM webVERIFY By	This field is informational only and reflects the user code of the person who last verified this policy - if your practice subscribes to CGM webVERIFY.		10
Coverage Last Verified on	This field is for practices that do not subscribe to CGM webVERIFY and want to store a date to indicate when coverage was last verified with this carrier for this patient. Type the date or click the calendar icon to select a date.		10
Coverage Last Verified By	This field is informational only is for practices that do not subscribe to CGM webVERIFY. It reflects the user code of the person who was logged in the last time a date was added or changed for the Coverage Last Verified on field.		10
Comment	Type any applicable comment for this policy. This field is strictly informational and does not populate into any other function or print anywhere.		40

• Collection Letters (if using DMS letters)
  
• Eligibility (if using CGM webVERIFY)
  
• Statements (if using electronic patient statements)
  
• Superbills (if using electronic superbills)
  
• E-mail (if sending new patient e-mail messages - see E-mail Integration)

• You can customize the text color and font style for the various types of transactions using the Configure Colors function.
  
• If there are any DMS Notes stored on an account, two asterisks (**) display following the patient's name. Click Notes in the Action Column to review the DMS Notes.
  
• To view the transactions for 'All Cases', or only those related to a particular case, select the case option from the case list box in the upper-right corner above the format list box. The case number for each transaction is listed in the Case column in the transaction history screen.
  
• If you hover over a transaction row and if there are any Notes stored with the same accounting date, those notes will display. If you hover over a transaction row and if there are any INOTES stored with the same date of service, those notes will display.
  
• If you hover over the procedure code or procedure description, the procedure code, brief description, and equivalent code (if one exists) displays.
  
• The 'I' column contains a code (flag) for the insurance filing status and a code for the accept assignment indicator. If you hover over these codes, their description displays.
  • Insurance Status Codes:
    • B = Balance Transfer - This charge has been transferred from the Insurance Balance to the Patient Balance with the Transfer Insurance Balances function.
      
    • C = Collection Status - If you use Patient Collections, this indicates the transaction is in the collection process.
      
    • D = Denied - This procedure has been denied by one of the patient's insurance carriers. The insurance ledger indicates the carrier and the denial reason.
      
    • E = Electronically Filed - This procedure has been filed to the patient's insurance carrier electronically.
      
    • F = Filed - This procedure has been filed to the patient's primary insurance carrier.
      
    • H = Held - This procedure has been held from being billed to the insurance company with a Claim Hold date entered in the Procedure Entry Function.
      
    • P = Pended - The insurance carrier has responded in some form, but has not yet paid nor denied the claim.
      
    • * = Refiled - This procedure has been refiled to one of the patient's insurance carriers. The insurance ledger indicates which carrier.
    • S = Secondary Filed - This procedure has been filed to the patient's secondary insurance carrier.
      
    • T = Tertiary Filed - This procedure has been filed to the patient's tertiary insurance carrier.
      
    • V = Void - This transaction has been voided.
  • Assignment Status:
    • Y = Yes - Assignment was accepted on this procedure.
      
    • N = No - Assignment was not accepted on this procedure.
  
  
• You can view the saved image for any transaction by clicking the image icon in the Img column and the image displays in a new window. When you finish viewing the image, click the 'X' in the upper-right corner of the Image Management window and the transaction history screen re-displays. The various types of images that can viewed in Transaction History are:
  
  • Patient Collection Letters - you must use DMS letters and have the Adj Code for Letters field completed in the Patient Collections Integration function.
  
  
  • Electronic Patient Collection Letters - If you use CGM ECOLLECTIONS to send your patient collection letters electronically.
    
  • Insurance Collection Letters - you must use DMS letters and have the Adj Code for Letters field completed in the Insurance Collections Integration function.
    
  • Electronic Patient Statements - you must send electronic patient statements and have the Adj Code for Stmts field completed in the CGM webPRACTICE Default Values function.
    
  • Electronic Superbills - if you hover over the superbill image icon (sb), the superbill number and any superbill notes display.
    
  • Explanations of Benefits - if a payment already has an EOB image scanned and attached to it, the scanned image will override the auto-generated version.



• NOTE: The 'Act' (Actions) column at the far right of the screen can only be accessed in the History function in Change Patient Data.
  
• The Account Balance, Total Charges, Insurance Balance, and Patient Balance are listed across the bottom of the screen.
  
  
  

You can view the detail of any transaction by selecting it. To select a transaction, click anywhere in the row containing the transaction information. The transaction detail displays in a new window. When you have finished reviewing the detail, click Close and the Transaction History screen re-displays.

• 
  
• Transaction History Detail for Charges: The top section of this screen includes: the accounting date; date of service; procedure code and description; the diagnosis code(s) (if you hover over the diagnosis code, the description of the diagnosis displays); the procedure amount and the (# of units @ that amount); the amount allowed by the insurance company, if an insurance payment was posted; the performing provider's code and name/the insurance doctor's code; the location code and description; the department code and description; the service script date (if one was entered); the referring doctor's code and name; the date of illness/injury (if one was entered); the superbill number; the insurance flag code; the alternate description if you entered anything in the Remarks field when posting a payment or an adjustment; the batch number; the accept assignment indicator; the edited field reflects what you entered in the Editing Reason field if you edited the transaction; the amount remaining (balance due) on this transaction; and the claim delay date, if one was entered on the original procedure entry or the claim delay reason code if the claim was refiled with a claim delay reason. You can click on the image icon next to View Superbill to view the electronic superbill, (if your practice uses them and if one is attached to the charge).
  
  The middle section displays all of the payments and adjustments posted to the charge with the accounting date; the payment or adjustment code and description; the performing provider code; the location code; the diagnosis code; the amount of the total payment or adjustment; the amount of the payment or adjustment applied to this specific transaction; the insurance flag code; and the image icon, if there is an image attached to that payment. If you hover over the row(s) containing the payment or adjustment information and if there are Notes stored on the account with the same accounting date, those notes will display. You can view the detail of the payment or adjustment transaction by clicking anywhere in the row containing the transaction information.
  
  The bottom section of the screen displays the insurance ledger showing payments, adjustments, filings, refilings and denials of the transaction/claim with the date that the activity took place (not the accounting date, payment date or date of service); the insurance carrier code and name; the action taken on the transaction and the amount of the action.
  
  
  
• Transaction History Detail for Payments: The top section of this screen includes: the accounting date; payment date; payment code and description; the payment amount; the insurance carrier code; the alternate description if you entered anything in the Remarks field when posting the payment or if the payment was reversed, the Reversal Reason will display; the batch number, the amount remaining (balance due) on this transaction; the claim delay date, if one was entered on the original procedure entry or the claim delay reason code if the claim was refiled with a claim delay reason; and the check number. If there is an EOB attached to this payment there is a View EOB field and you can click on the image icon next to it to view the explanation of benefits.
  
  The bottom section of this screen includes the accounting date, date of service; the procedure code and description; the performing provider code; the location code; the diagnosis code; the charge amount; the amount of the payment applied to this specific transaction; the insurance flag code and accept assignment indicator; and the image icon, if there is an image attached to the transaction. If you hover over the doctor code, the location code, or the insurance flag, the description of these codes will display.
  
  
  
• Transaction History Detail for Adjustments: The top section of this screen includes: the accounting date; adjustment date; adjustment code and description; the adjustment amount; the alternate description if you entered anything in the Remarks field when posting the adjustment or if the adjustment was reversed, the Reversal Reason will display; the batch number; the amount remaining (balance due) on this transaction; and the claim delay date, if one was entered on the original procedure entry or the claim delay reason code if the claim was refiled with a claim delay reason.
  
  The bottom section includes the accounting date, date of service; the procedure code and description; the performing provider code; the location code, the diagnosis code, the charge amount; and the amount of the payments and adjustments applied to that charge; the insurance flag and accept assignment indicator; and the image icon, if there is an image attached to the transaction. If you hover over the doctor code, the location code, or the insurance flag, the description of these codes will display.
  
  
  

Date of Service Look-up Function - With this function, you can review specific transactions for a selected date or date range. For example, the account may contain multiple transactions for the month of May, but you want to focus only on the charges posted for May 29th, and any payments or adjustments allocated to those charges. To select a date, type the date of service in the From and Thru fields or click the calendar icon to select a date in the upper-right section of the transaction history window. Click Refresh in the Action Column to display the transactions for the selected date(s). The account totals listed across the bottom of the screen are for the selected date(s) only. Click Print in the Action Column to print the transaction history for the selected date(s).

Transaction History Screen Formats - You can view the Transaction History screen in a variety of formats. Select the format you want from the format list box located in the upper-right corner under the case list box.

• 
  
• All Transactions - All transactions are displayed, including any reversed or voided transactions. The accounting date, service date, case code, billing group code, transaction code and description, original amount of the transaction, insurance balance, patient balance, insurance flag, accept assignment indicator, and any image icon for each transaction are displayed.
  
  
  


• Charges only - Only the charges on the account are displayed. The accounting date, service date, case code, billing group code, procedure code and description, original amount of the charge, insurance balance, patient balance, insurance flag, accept assignment indicator, and any image icon for each transaction are displayed.
  
  
  


• Insurance w/Doctor - All transactions (except those that have been reversed or voided) are displayed. The location code and doctor code are displayed in addition to the accounting date, service date, case code, transaction code and description, original amount of the charge, insurance balance, patient balance, insurance flag, accept assignment indicator, and any image icon for each transaction are displayed.
  
  
  


• Insurance Collections - All charges that are currently in an insurance collections status are displayed. You can select claims for a specific insurance carrier or 'All Carriers' in the insurance carrier list box to the right of the account demographic information. If you select a specific carrier, the details of the patient's policy with that carrier are displayed in the top-middle portion of the screen. The accounting date, service date, case code, procedure code and description, original amount of the charge, location code, doctor code, insurance balance, patient balance, insurance flag, accept assignment indicator, insurance collection status code and any image icon for each transaction are displayed.
  
  
  


• Insurance Format - All charges, payments and adjustments (except those that have been reversed or voided) are displayed in the insurance format. The accounting date, service date, case code, billing group code, transaction code and description, original amount of the transaction, insurance balance, patient balance, insurance flag, accept assignment indicator, and any image icon for each transaction are displayed.
  
  
  


• Ledger Display - All charges, payments and adjustments (except those that have been reversed or voided) are displayed in a ledger format. This format displays the service date, transaction code and description, original amount of the transaction, the total payment and adjustment amounts applied to each transaction, the balance on each transaction, insurance flag, and the accept assignment indicator. The insurance ledger and transaction detail are also displayed below each transaction.
  
  
  


• Ledger - Detailed - All charges, payments and adjustments (except those that have been reversed or voided) are displayed in a detailed ledger format. This format displays the same information as the standard Ledger Display, but in addition, the performing (PDr) and insurance (IDr) doctor codes are displayed for each charge immediately following the charge description and the balance is broken down into two columns for the insurance balance and patient balance.
  
  
  


• Payments only - Only the payments on the account are displayed. The accounting date, service date, case code, billing group code, transaction code and description, original amount of the payment, any unapplied portion of the payment in the insurance or patient balance, and any image icon for each payment are displayed.
  
  
  

Action Column Functions

• Notes - Click Notes to review the Note DMS Records on the account.
  
• INotes - Click INotes to review the Insurance Notes on the account.
  
• Print - Click Print to print the transaction history on the account for a specified range of accounting dates.
  
• Refresh - Click Refresh to refresh/update the screen.

• Billing Group: If you want to change the Billing Group tied to the transaction, select this action. If the Billing Period for this date of service has been closed, a message displays to inform you that you must re-open the closed billing period before changing the Billing Group. Type the Billing Group code you want or click the magnifying glass to search the table.
  
  
  
• Edit a Charge: You can only edit charge transactions from this screen. When you select Edit a Charge, the standard Edit an Encounter screen displays.
  
  
• Reverse: You may only reverse payments or adjustments using this function.
  
  
  

Recalls
With the Recalls function, you can add, edit, delete, or review a recall record in detail, without having to exit this function to access Maintain Patient Recalls. For information about patient recalls, see Maintain Patient Recalls.

Referrals
With the Referrals function, you can add, edit, delete, or review an outgoing patient referral record in detail, without having to exit this function to access Maintain Referrals on the Managed Care menu. For information about outgoing patient referrals, see Maintain Referrals.

Authorizations
With the Authorizations function, you can add, edit, delete, or review an authorization record in detail, without having to exit this function to access Maintain Authorizations on the Managed Care menu. For information about authorization records, see Maintain Authorizations.

Service Scripts
With the Service Scripts function, you can add, edit, delete, or review a service script record in detail, without having to exit this function to access Maintain Service Scripts on the Managed Care menu. For information about Service Scripts, see Maintain Service Scripts.

Employers
With the Employers function, you can add, edit, delete or review an employer record in detail. If there are any previously stored employers on the patient account, the Employer Information summary screen lists them. To select an employer record, click anywhere in the row containing the employer information.

To add a new employer, click Add Employer in the Action Column.

Data Field Information


Prompt	Response	Req	Len
Employer Code	Type the code you want or click the magnifying glass to search the table.		8
Employer Name	This field is informational only and reflects the employer's name as it is stored in the Employer Code Table.		40
Address Line One	This field is informational only and reflects the employer's address as it is stored in the Employer Code Table.		40
Address Line Two	This field is informational only and reflects any additional address information for the employer as it is stored in the Employer Code Table.		40
City	This field is informational only and reflects the employer's city as it is stored in the Employer Code Table.		30
State	This field is informational only and reflects the employer's state as it is stored in the Employer Code Table.		3
Zip Code	This field is informational only and reflects the employer's zip code as it is stored in the Employer Code Table.		10
Contact Name	This field is informational only and reflects the contact name for the employer as it is stored in the Employer Code Table.		30
Contact Phone	This field is informational only and reflects the phone number for the contact person for the employer as it is stored in the Employer Code Table.		20
Contact Fax	This field is informational only and reflects the fax number for the contact person for the employer as it is stored in the Employer Code Table.		20
Employee Phone	Type the employee's work telephone number and extension.		20
Employee Fax	Type the employee's work fax number.		20
Occupation	Type the employee's occupation.		40
Hire Date	Type the date the employee began working for this employer or click the calendar icon to select a date.		10
Termination Date	Type the date the employee was terminated from this employer, if applicable, or click the calendar icon to select a date.		10
Supervisor	Type the name of the employee's supervisor.		30
Comments	Type any applicable comment for this employer record.		50
Comments	Type any additional applicable comment for this employer record.		50
Employee Relationship	Select the option to indicate if this is the patient's employer, the guarantor's employer or the insured's employer.		1




Transactions
With the Transactions function, you can enter and post procedures, payments and adjustments for the patient currently selected, without having to exit this function to access the Procedure Entry Function. When you click Transactions, the options in the Action Column change to allow you to select Procedures, Payments, or Adjustments. Click Change to return to the standard Change Patient Data Action Column functions.

Summary
With the Summary function, you can review a summary of account and payment activity, account balance aging by patient, insurance, and total balance, and any comments stored on the account. The Insurance Aging is based on the Accounting Date. The Patient Aging is based on the date that the balance entered the Patient Balance.


Letters
With the Letters function, you can select and print a letter for the patient. Upon accessing this function, the Letters summary screen displays, listing all the letters currently stored in the DMS Letter Processor. To select a letter to print, click anywhere in the row containing the letter information. The Printers dialog box displays so you can choose the printer to print the letter to.


Change Patient Data for Family Billing Type
The only difference in this function is the addition of the Family and Family Review functions in the Action Column of the Patient Summary Screen.

Click Family to review or modify how a patient's account is attached to a family/master account. You cannot change family grouping from the master account. The screen includes the account number and name of the current patient and the account number and name of the master account for this patient.

If you select Yes to remove this patient as a family member, the second question ('Do you wish to change Master Accounts?') disappears. Click Save and the screen refreshes to the Change Patient Data patient summary screen for the patient, and the account has been removed from the family account.


• You can add the patient back to the master account or to another master account by clicking Family. The Change Grouping - Family screen displays and says that 'The patient does not have a Master Account'. Select the Yes option to answer 'Do you wish to setup a Master Account for this patient?' Click Save and the screen refreshes to the Change Patient Data look-up screen so you can search for an account to attach the patient to. As soon as you select the account, a message displays stating that the patient is added to the account as a family member.
  
  
If you select Yes to change master accounts and click Save, the Change Grouping - Family look-up screen displays so you can search for a master account to move the patient to. As soon as you select the account, a message displays stating that the master account is changed.

Click Family Review and the Review Family Grouping screen displays so you can review a summary of all of the family members on the account. You can access this summary from any family member's account. It includes the patient's account number, name, balance, insurance balance and total balance. You can also access any of the family member's accounts by selecting the account you want. The screen refreshes to the Change Patient Data screen for that patient. You can review or make any necessary changes to the account. Click Family Review to get back to the family summary list; if you click Cancel, the screen refreshes to the Change Patient Data patient look-up screen.


Change Patient Data for Linking Billing Type

The only difference in this function is the addition of the Family and Family Review functions in the Action Column of the Patient Summary Screen.

Click Family to review or modify how a patient's account is attached to a master account. You cannot change linking from the master account. The screen includes the account number and name of the current patient and the account number and name of the master/linked account for this patient.

If you select Yes to remove link from this patient, the second question ('Do you wish to change linked accounts?') disappears. Click Save and the screen refreshes to the Change Patient Data summary screen for the patient and the account has been 'un-linked' from the linked account.


• You can add the patient back to the master account or to another master account by clicking Family. The Change Grouping - Linking screen displays and says that 'This patient has not been Linked to another account.' Select the Yes option to answer 'Do you wish to setup a Master Account for this patient?' Click Save and the screen refreshes to the Change Patient Data look-up screen so you can search for an account to attach the patient to. As soon as you select the account, a message displays stating that the patient has been linked.
  
  
If you select Yes to change linked accounts and click Save, the Change Grouping - Linking look-up screen displays so you can search for a master account to link the patient to. As soon as you select the account, a message displays stating that the linked account is changed.

Click Family Review and the Review Family grouping screen displays so you can review a summary of all linked members on the account. You can access this summary from any account. It includes the patient's account number, name, balance, insurance balance and total balance. The Insurance Balance aging is based on the Accounting Date. The Patient Balance aging is based on the date that the balance entered the Patient Balance. NOTE: The balance aging displays for Linking databases only. You can also access any of the linked member's accounts by selecting the account you want. The screen refreshes to the Change Patient Data screen for that patient. You can review or make any necessary changes to the account. Click Family Review to get back to the family summary list; if you click Cancel, the screen refreshes to the Change Patient Data patient look-up screen.