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Managing Patient Cases in the Medical Office: Insurance, Account, and Condition Information

Chapter 5 covers essential aspects of entering insurance, account, and condition information in a medical office. It defines a case as a grouping of transactions linked to a specific condition. New cases are established when a patient presents with a new condition or when there's a change in their insurance. The chapter also details various case command buttons for editing, creating, deleting, copying, and printing cases. Information stored in each case folder is categorized under personal data, account details, diagnosis codes, insurance policies, condition status, and miscellaneous notes, including lab work and comments.

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Managing Patient Cases in the Medical Office: Insurance, Account, and Condition Information

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Presentation Transcript

  1. Computers inthe Medical Office Chapter 5: Entering Insurance, Account, and Condition Information

  2. What is a Case? • A grouping of transactions that relate to a particular condition

  3. When is a new case created? • New cases are set up when a patient is treated for a new condition, or when there is a change in insurance • Patients may have more than one case open at a time

  4. Case Command Buttons • Edit Case • New Case • Delete Case • Copy Case • Print Grid • Close

  5. Case Folder

  6. Personal Tab Account Tab Diagnosis Tab Policy 1 Tab Policy 2 Tab Policy 3 Tab Condition Tab Miscellaneous Tab Medicaid and TRICARE Tab Comment Tab EDI Tab Information Stored in Case Folder

  7. Personal Tab Contains a description of the case, the guarantor, and other information about the patient’s work, school, and marital status

  8. Account Tab Lists basic information about the patient's account, including referring and attending providers

  9. Diagnosis Tab Records up to four diagnosis codes

  10. Policy 1 Tab Contains information about the patient’s primary insurance carrier

  11. Policy 2 Tab Contains information about the patient’s secondary insurance carrier

  12. Policy 3 Tab Contains information about the patient’s tertiary insurance carrier

  13. Condition Tab Shows information relating to the general status or condition of the patient

  14. Miscellaneous Tab Records outside lab work and the entry of lab charges, as well as other information

  15. Medicaid and TRICARE Tab Displays information regarding Medicaid and TRICARE claims

  16. Comment Tab Enter case notes on this tab.   This note will print on statements if you format the statement to include case comments.

  17. EDI Tab Enter electronic claim information specific to this case

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