Selecting encounter options sets up several defaults to aid in efficiency when creating a new encounter. Note that these are simply defaults and a user can override the information. Also, if the encounter is created from an appointment ticket number or enters a patient's name when creating a new encounter, all of the pre-existing defaults prevail and override these settings. See also the FAQs about the new CMS-1500 form version 02/12.
To set encounter options
- Click Settings >Options > Encounter Options.
- Choose settings. See below. These settings will become the default for each encounter that is created.
- When finished, click Save.
- Providers: Select the default scheduling, rendering and supervising providers from the drop-down lists.
- Service Location: Select the default service location from the drop-down list.
- Time Format: Select the 12 hour or 24 hour time format. This will switch all encounters to the selected time format, and previously entered encountered will display in the converted format.
- Procedure Lists:
- Show procedure descriptions - Check this box if you want procedure descriptions to display on the procedure's grid of the encounter record.
- Show diagnosis description - Check this box if you want the diagnosis descriptions to display on the procedure's grid of the encounter record.
- Copay: Check this box if you want to automatically bill the patient for missed copays. For more information on managing copays, see the Managing Copays feature guide.
- Show all encounters upon empty search on All tab - Check this box of you want all encounters to show on the All tab of the Find Encounter window.
- Enable check codes upon approval - Check this box if you want the system to automatically perform code checking upon approval of an encounter without having to manually click Check Codes on the encounter form.
- Claim Formats: Select which claim formats you want to be available for the practice. Also determines which formats are available when selecting Default Encounter Format and Default Printing Format (below). Selecting both formats gives the option to users to change the "Claim Type" for a payer when creating new encounters.
- Default Encounter Format: Select the claim format that will be the default layout (and most commonly posted encounter format) when creating a new encounter.
- Default Printing Format: Select the claim format that will be the default (and most commonly printed encounter form) when printing paper claims. Note that this setting is simply a default setting for printing; the claim type is still designated by the payer. See also Print Paper Claims for information on batch printing for multiple claim types.
- Default Revenue Code: For UB-04 claims only. Select a default revenue code. Note that the revenue code may change depending on the service provided.
Additional Options: Eligibility Check
If you are interested in turning on these enhanced eligibility options, contact your Account Manager. Once turned on, you will see these additional fields.
- Show eligibility info and related issues on encounter - check this box if you want to see the eligibility status of the primary and secondary insurance on the encounter form. You will also see a link to run an eligibility check and to view the eligibility report on the encounter form. And all encounters and claims with eligibility issues will be flagged throughout the PM. See Encounter with Eligibility Info Enabled to learn more.
- Enable auto eligibility checks when saving an encounter - check this box if you want to automatically check eligibility each time an encounter moves from one status to another (e.g. New to Draft, Draft to Approved, Draft to Reviewed) and the patient’s eligibility information was not for the month of service.
- a change is made and on the encounter and the encounter is saved. The additional check provides a safeguard against wrong eligibility information and encourages clean claims.