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Lytec 2011 User Manual
April 2011
McKesson Provider Technologies Physician Practice Solutions 5995 Windward Parkway Alpharetta, Georgia 30005 Sales: (800) 735-1991 Support: (800) 895-6700 Fax: (916) 267-6281 Web site www.lytec.com
Table Of Contents
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Contents
Getting Started With Lytec ............................................................................................................... 1
Welcome to Lytec 2011 ............................................................................................................... 1
New in this Version ...................................................................................................................... 1
ARRA Reporting........................................................................................................................... 1
ARRA Audit .................................................................................................................................. 1
BillFlash ........................................................................................................................................ 2
HIPAA X12 Version 5010 ............................................................................................................. 6
Restructured windows and moved fields .................................................................................. 6
New Fields added ..................................................................................................................... 9
Menu Changes ....................................................................................................................... 11
Additional Options .................................................................................................................. 13
Other Changes ....................................................................................................................... 13
Single SQL Instance .................................................................................................................. 14
Database Migration and Conversion ...................................................................................... 14
Remodeled windows .............................................................................................................. 16
Command Line Parameters and INI file changes .................................................................. 19
Unified Installation ...................................................................................................................... 22
HL7 Communications Manager ................................................................................................. 23
Revenue Management Click Reduction .................................................................................... 27
Revenue Management 5010 ERA Changes .............................................................................. 28
Revenue Management Configuration and Setup Changes ....................................................... 33
Navigating in Lytec ................................................................................................................. 33
Lists Tab ................................................................................................................................. 37
Edit Tab .................................................................................................................................. 40
Scheduling Tab ...................................................................................................................... 41
Billing Tab ............................................................................................................................... 42
Payments Tab ........................................................................................................................ 46
Reports Tab ............................................................................................................................ 47
Tools Tab................................................................................................................................ 53
Admin Tab .............................................................................................................................. 57
Help Tab ................................................................................................................................. 58
Setting up the Program .................................................................................................................. 60
Setting up the Program .............................................................................................................. 60
Creating a Practice .................................................................................................................... 60
Opening a Practice .................................................................................................................... 60
Customizing Your Program ........................................................................................................ 61
Patients Window Tab Order ................................................................................................... 61
Window Position and Size ...................................................................................................... 61
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Edit Layout.............................................................................................................................. 61
Charges and Payments Layout .............................................................................................. 62
Report Ranges ....................................................................................................................... 62
Setting up the Practice .................................................................................................................. 63
Assigning Rules ......................................................................................................................... 65
Setup Activities After Data Conversion ...................................................................................... 67
Security ...................................................................................................................................... 68
User Types ............................................................................................................................. 69
User Preferences ................................................................................................................... 69
Preferences ................................................................................................................................ 69
Entering and Editing Practice Information ................................................................................. 71
Setup Scenarios ..................................................................................................................... 71
Entering Practice Information ................................................................................................. 72
Entering a Practice IDs Grid Entry ......................................................................................... 72
Entering and Editing Practice Information for a Billing Service ................................................. 74
EDI Receivers ............................................................................................................................ 75
To Complete a Basic Setup for an EDI Receiver ................................................................... 76
Entering and Editing Insurance Company Information .............................................................. 77
Setup Scenarios ..................................................................................................................... 77
Entering Data on the Information Tab .................................................................................... 77
Entering and Editing Facility Information ................................................................................... 79
Setup Scenarios ..................................................................................................................... 79
Entering Contact Information .................................................................................................. 80
Entering Information on the Facility IDs grid .......................................................................... 80
Entering and Editing Provider Information ................................................................................. 82
Setup Scenarios ..................................................................................................................... 82
Entering Provider Information................................................................................................. 82
Entering Provider IDs Grid Entries ......................................................................................... 83
Entering and Editing Referring Physician Information ............................................................... 85
Setup Scenarios ..................................................................................................................... 85
Entering Contact Information .................................................................................................. 86
Entering Information on the Referring Physicians IDs Grid ................................................... 86
Transaction Codes ..................................................................................................................... 87
Description Tab ...................................................................................................................... 88
Defaults Tab ........................................................................................................................... 89
Appointments Tab .................................................................................................................. 89
Inventory Tab ......................................................................................................................... 90
Fee Schedules Tab ................................................................................................................ 90
Diagnosis Codes ........................................................................................................................ 90
Entering an Attorney, Employer, or Other Addresses................................................................ 91
Guarantors ................................................................................................................................. 92
Patients ...................................................................................................................................... 93
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Responsible Party .................................................................................................................. 94
Patient Information Tab .......................................................................................................... 94
Insurance Tabs ....................................................................................................................... 95
Associations Tab .................................................................................................................... 95
Claim Information Tab ............................................................................................................ 96
Diagnosis / Reminders Tab .................................................................................................... 99
Contacts Tab .......................................................................................................................... 99
Appointments Tab .................................................................................................................. 99
Patient Images ....................................................................................................................... 99
Custom Fields Tab ................................................................................................................. 99
Entering Transactions .................................................................................................................. 100
Entering Charges and Payments ............................................................................................. 100
Open Item Transaction Entry ............................................................................................... 100
Creating a Billing .................................................................................................................. 100
Charges and Payments Window Buttons ................................................................................ 101
Billing Button......................................................................................................................... 101
Detail Button ......................................................................................................................... 101
Print Button ........................................................................................................................... 101
New Button ........................................................................................................................... 101
Save Button .......................................................................................................................... 101
Close Button ......................................................................................................................... 101
Window Reset ...................................................................................................................... 102
Apply Insurance Payments ...................................................................................................... 102
Using the Apply Insurance Payment window ....................................................................... 102
Apply Patient Payments ........................................................................................................... 104
Prepayments ............................................................................................................................ 106
Entering Prepayments .......................................................................................................... 107
Applying Prepayments in the Apply Patient Payment Wizard .............................................. 107
Applying Prepayments to a Billing in Charges and Payments ............................................. 108
Applying Prepayments to a Detail Item in Charges and Payments ..................................... 108
Printing a Prepayment Receipt............................................................................................. 108
Pending Transactions .............................................................................................................. 109
Pending Transaction Errors .................................................................................................. 109
Billing Claims and Statements ..................................................................................................... 110
Billing Claims and Statements ................................................................................................. 110
Billing Insurance Claims ........................................................................................................... 110
Technical Criteria for Processing Insurance Claims ............................................................ 110
Paper Claims ............................................................................................................................ 110
Through the Billing Tab ........................................................................................................ 110
Through Charges and Payments ......................................................................................... 112
Electronic Claims ..................................................................................................................... 113
Billing Statements .................................................................................................................... 114
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Paper Statements .................................................................................................................... 114
Through the Billing Tab Menu .............................................................................................. 115
Electronic Statements .............................................................................................................. 118
Transmitting an Electronic Statement File to BillFlash ......................................................... 118
Statement Pre-Run Report ...................................................................................................... 119
Managing Overdue Balances ...................................................................................................... 120
Managing Overdue Balances ................................................................................................... 120
Put Billings in A/R Management .............................................................................................. 120
Assign Billings to an Agent ...................................................................................................... 121
Assign ................................................................................................................................... 121
Charges and Payments ........................................................................................................ 121
Detail .................................................................................................................................... 121
Print ...................................................................................................................................... 122
Window Reset ...................................................................................................................... 122
Close .................................................................................................................................... 122
A/R Management Activities ...................................................................................................... 122
Tasks .................................................................................................................................... 122
Billing .................................................................................................................................... 123
Charges/Payments ............................................................................................................... 123
Detail .................................................................................................................................... 123
Print List ................................................................................................................................ 123
Window Reset ...................................................................................................................... 123
Close .................................................................................................................................... 123
Checking Eligibility ....................................................................................................................... 124
Eligibility Verification Setup ...................................................................................................... 124
Ways to Verify Eligibility ........................................................................................................... 124
Scheduling Tasks ........................................................................................................................ 126
Scheduling a Backup ............................................................................................................... 126
Scheduling a Lytec Report ....................................................................................................... 127
Scheduling an Advanced Reporting Report ............................................................................. 127
Scheduling an Eligibility Verification Inquiry ............................................................................ 127
Scheduling Appointments ............................................................................................................ 129
Calendar ................................................................................................................................... 129
Wait List ................................................................................................................................... 130
Entering an Appointment ......................................................................................................... 131
Appointment Grid Views and Buttons ...................................................................................... 132
Appointment Grid Views ....................................................................................................... 132
Appointment Grid Buttons .................................................................................................... 132
Appointment Detail View .......................................................................................................... 133
Appointment Grid Buttons ........................................................................................................ 134
Appointment Button .............................................................................................................. 134
Resource Button ................................................................................................................... 135
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Print Button ........................................................................................................................... 135
Go To Button ........................................................................................................................ 136
Custom View ........................................................................................................................ 136
Template ............................................................................................................................... 136
Search .................................................................................................................................. 136
Preparing Reports........................................................................................................................ 139
Preparing Reports .................................................................................................................... 139
Printer Setup......................................................................................................................... 139
Printing Reports ....................................................................................................................... 140
Filtering a Report .................................................................................................................. 140
Tracking Finances .................................................................................................................... 141
Day Sheet ............................................................................................................................. 141
Transaction Journal .............................................................................................................. 144
Monthly/Yearly Summary ..................................................................................................... 146
Analyzing Revenue .................................................................................................................. 147
Practice Analysis .................................................................................................................. 148
Referring Physician Analysis ................................................................................................ 150
Insurance Reimbursement Analysis ..................................................................................... 151
Printing Patient Information ...................................................................................................... 152
Patient Ledger ...................................................................................................................... 153
Patient Statistics ................................................................................................................... 154
Patient Payment Annual Detail............................................................................................. 155
Responsible Party Report .................................................................................................... 156
Aging Patient and Insurance Balances .................................................................................... 157
Patient Aging ........................................................................................................................ 157
Insurance Aging ................................................................................................................... 159
Service Aging Report ........................................................................................................... 161
AR Totals .............................................................................................................................. 163
Lists .......................................................................................................................................... 165
Custom Reports ....................................................................................................................... 165
Running Utilities ........................................................................................................................... 166
Inactive/Archived Patients ........................................................................................................ 166
Delete Inactive Patients ........................................................................................................ 166
Archive Inactive Patients ...................................................................................................... 167
Unarchive Patients ............................................................................................................... 167
Delete Archived Patients ...................................................................................................... 168
Paid/Archived Billings .............................................................................................................. 169
Delete Paid Billings .............................................................................................................. 169
Archive Paid Billings ............................................................................................................. 170
Unarchive Billings ................................................................................................................. 170
Delete Archived Billings ........................................................................................................ 171
Delete Managed Care Payments ............................................................................................. 172
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Delete Appointments ................................................................................................................ 172
Rebuild Data Files .................................................................................................................... 173
Index ............................................................................................................................................ 175
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Preface
Where to Find Help
Online Help
No matter where you are in Lytec, help is not far away. Access the online Help screens to find detailed information on each feature in the program. Online Help is available in two different ways:
Context-Sensitive Help
For help in a particular part of the program, click the area for which you need help and press F1. The help topic for that area should appear.
Main Help File
To access the main help file, click Help and and Help Topics.
The main help file will appear displaying the Contents tab. Use the Contents tab to view categorized topics for the program. Use the Index and Search tabs to find out additional or specific information about the program.
Training
There are various training options available. Please contact your local Value-Added Reseller or the Lytec Sales Department at 800-333-4747 for information concerning these options.
Independent Value-Added Resellers
There are Value-Added Resellers in your market area who are knowledgeable and efficient in selling, installing, troubleshooting, and supporting your Lytec program. You can contact the Lytec Sales Department at 800-333-4747 for the name of a qualified Value-Added Reseller in your area to give you hands-on help.
Technical Support
Call Support at (800) 895-6700 between the hours of 8:00 a.m. and 8:00 p.m Eastern Standard Time. You will hold for a technical support representative who has specific knowledge about the issue for which you are calling.
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Copyright Lytec and documentation Copyright © McKesson Corporation and/or one of its subsidiaries. All Rights Reserved.
END USER LICENSE AGREEMENTS
LYTEC 2011 END USER LICENSE AGREEMENT
NOTICE: BEFORE PROCEEDING, PLEASE READ THE FOLLOWING LEGAL AGREEMENT WHICH CONTAINS RIGHTS AND RESTRICTIONS ASSOCIATED WITH YOUR USE OF THE MCKESSON SOFTWARE AND ANY DOCUMENTATION PROVIDED TO YOU BY MCKESSON INFORMATION SOLUTIONS, LLC OR ITS AFFILIATES.
This End-User License Agreement ("EULA") is a legal agreement between you, either an individual or a single entity ("End User" or "You") and McKesson Information Solutions LLC, on behalf of itself and the McKesson Affiliates ("McKesson") for the Software and Clinical Content, as those terms are defined in Section 1.1.1 below, that McKesson provides to End User. By installing, copying, or otherwise using the Software or Clinical Content, You agree to be bound by the terms of this EULA. If You do not agree to the terms of this EULA, You may not install or use the Software.
AS FURTHER DESCRIBED BELOW, USE OF THE SOFTWARE ALSO OPERATES AS YOUR CONSENT TO THE TRANSMISSION, FROM TIME TO TIME, OF CERTAIN COMPUTER AND SOFTWARE USAGE INFORMATION TO MCKESSON.
If You have previously entered into a written license agreement directly with McKesson or any of its predecessors, including but not limited to Physicians Micro Systems, Inc., for license of the Software, then this EULA does not apply to You, even if You click "accept" to continue installation.
If You did not obtain the Software either directly from McKesson or from an authorized McKesson reseller, or if You have not paid either McKesson or an authorized McKesson reseller in full for this license, then this EULA offer is rescinded and You are not authorized to install or use this Software. The term of this EULA ("Term") commences on the date the End User first installs the Software and continues until terminated pursuant to Section 2.5.1.
SECTION 1: SOFTWARE
1.1 Software and Clinical Content.
1.1.1 Definitions
(a) "Clinical Content" means medical or clinical information such as terminology, vocabularies, decision support rules, alerts, drug interaction knowledge, care pathway knowledge, standard ranges of normal or expected result values, and any other clinical content or rules provided to End User for use with the Software, together with any related Documentation. Clinical Content may be either (a) owned by McKesson or (b) owned by a third party and sublicensed to End User under this EULA.
(b) "Concurrent User" means a Permitted User identified by a unique user ID issued by End User that is one user out of a maximum number of users permitted to access the Software simultaneously.
(c) "Confidential Information" means any information or material, other than Trade Secrets, that is of value to McKesson and is not generally known to third parties, or that McKesson obtains from any third party that McKesson treats as confidential whether or not owned by McKesson. Confidential Information shall not include information that You can show is: (1) known by You at the time of receipt from McKesson and not subject to any other nondisclosure agreement between the parties; (2) now, or which hereafter becomes, generally known to the public through no fault of You; (3) otherwise lawfully and independently developed by You without
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reference to Confidential Information; or (4) lawfully acquired by You from a third party without any obligation of confidentiality.
(d) "Data Center" means one data center located in the United States only and operated by End User.
(e) "Documentation" means user guides or operating manuals containing the functional specifications for the McKesson owned software and Clinical Content, as may be reasonably modified from time to time, provided to End User.
(f) "Facility" means one discrete location, in the United States only, where healthcare services are administered by a Provider or Providers or operated by End User as applicable.
(g) "McKesson Affiliates" means NDCHealth Corporation (but specifically excluding PST Services, Inc.) and any U.S. entities that, now or in the future, are controlled by either McKesson Information Solutions LLC or NDC Health Corporation.
(h) "Permitted User" means any individual (a) End User employee, (b) consultant or independent contractor who has need to use the Software based upon a contractual relationship with End User, so long as (i) such consultant or independent contractor is not a McKesson competitor, (ii) End User remains responsible for use of the Software by such consultant or independent contractor, and (iii) such consultant or independent contractor is subject to confidentiality and use restrictions at least as strict as those contained in this EULA,
(c) physician with admitting privileges at a Facility, (d) employee of such physician, and (e) medical professional authorized to perform services at a Facility.
(i) "Provider" means specially trained and licensed personnel (e.g., medical doctor, doctor of osteopathy, physician assistant, physical therapist, dietician, and advanced registered nurse practitioner) directly billing for patient care services either (i) under his or her name, (ii) the name of the practice, or (iii) under the name of a supervisory Provider. "Full-time Providers" are Providers working 20 hours a week or greater. "Part-time Providers" are Providers working less than 20 hours a week or a doctor in residency training.
(j) "Software" means (i) software in object code form only that accompanies this EULA, and (ii) related Documentation (collectively, "Software").
(k) "Term" has the meaning set forth in the fifth paragraph of the Introductory Section.
(l) "Trade Secret" means any information of McKesson or that McKesson has acquired from a third party which is not commonly known by or available to the public, which (1) derives economic value, actual or potential, from not being generally known to and not being readily ascertainable by proper means by other persons who can obtain economic value from its disclosure or use, and (2) is the subject of efforts that are reasonable under the circumstances to maintain its secrecy. Trade Secret shall include, but not be limited to, Software, Documentation, Clinical Content and the terms and conditions of this EULA.
1.1.2 License Grant.
(a) Perpetual License. Subject to the terms of this EULA, McKesson grants to End User, and End User accepts, a limited, nonexclusive, nontransferable, non-sublicensable, perpetual license to use the Software and Clinical Content (excluding the Revenue Management Direct Software and related Clinical Content) for End User's internal purposes. Depending on the intended usage, Clinical Content may be provided in either paper or electronic formats.
(b) Revenue Management Direct Term License. Subject to the terms of this EULA and the Subscription Agreement, as defined below, McKesson grants to End User, and End User accepts, a limited, nonexclusive, nontransferable, non-sublicensable, license to use the Revenue Management Direct Software and related Clinical Content for End User’s internal purposes for a specific license term (the "License Term") specified in a separate subscription agreement between You and McKesson (the "Subscription Agreement"). The License Term will renew automatically as set forth in the Subscription Agreement.
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(c) The license grant in this Section is expressly subject to the following conditions: (i) the Software may be installed only on equipment at Facilities and Data Centers as specified in Section 1.1.3(c) below, (ii) the Software and Clinical Content may be accessed or used only by Permitted Users in the U.S., (iii) use of the Software and Clinical Content is limited by the usage-based variable(s) as specified in Section 1.1.3(c) below, and (iv) the Software and Clinical Content may be used to provide service bureau or other similar services, or hosted by a third party (e.g. outsourcing or facility management service provider), only if expressly permitted in a separate writing by McKesson.
(d) Third Party Software. Any software that is owned by a third party and provided to End User with the Software is subject to that license and terms and conditions accompanying such Third Party Software. McKesson may substitute different software for any Third Party Software, if McKesson reasonably demonstrates the need to do so.
1.1.3 Software License Restrictions.
(a) Copying and Modification. End User shall not to duplicate the Software, except as required for its use in accordance with this Agreement, provided that End User may make one (1) backup copy of the Software solely for archival purposes. Such back-up copy shall include McKesson's copyright and other proprietary notices, and shall be subject to all the terms and conditions of this EULA. End User will not alter any trademark, copyright notice, or other proprietary notice on the Software or Documentation, and will duplicate each such trademark or notice on each copy of the Software and Documentation.
(b) Facility Limitation. The Software will be installed only at Facilities and Data Centers as set forth in Section 1.1.3(c) below, except that the Software may be installed on a temporary basis at an alternate location in the U.S. if End User is unable to use the Software at such Facility or Data Center due to equipment malfunction or force majeure event. End User will promptly notify McKesson of the alternate location if such temporary use continues for longer than 30 days.
(c) The following additional restrictions apply to the Software as set forth below:
i. Lytec SU (single user): Single machine; unlimited named users; no Concurrent Users; No remote access.
ii. Lytec MU (multiple user): Up to 3 Concurrent Users; Installation on a networked system (i.e., no limits on number of machines) present at one or more Facilities or Data Centers, all directly controlled by End User.
iii. Lytec Professional: Up to five Concurrent Users; Installation on a networked system (i.e., no limits on number of machines) present at one or more Facilities or Data Centers, all directly controlled by End User.
iv. Lytec Client Server: Available to the number of Concurrent Users purchased from
McKesson or the McKesson reseller; Installation on a networked system (i.e., no limits on number of machines) present at one or more Facilities or Data Centers, all directly controlled by End User.
v. Lytec MD: Available to the number of Providers and Concurrent Users purchased from
McKesson or the McKesson reseller; One Provider license includes 5 concurrent users; additional Providers or Concurrent Users must be licensed.
vi. Medisoft Basic or Medisoft Original: Single machine; unlimited named users; no concurrent users; No remote access.
vii. Medisoft Advanced: Single machine; unlimited named users; no concurrent users; No remote access.
viii. Medisoft Network Professional: Available to the number of Concurrent Users purchased from McKesson or the McKesson reseller; Installation on a networked system (i.e., no limits on number of machines) present at one or more Facilities or Data Centers, all directly controlled by End User.
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ix. Practice Partner: Available to the number of Providers purchased from McKesson or the McKesson reseller; add-on licenses for some End Users may be licensed on Concurrent User basis if original license was Concurrent User based- please check with Your McKesson reseller; Installation on a networked system (i.e., no limits on number of machines) present at one or more Facilities or Data Centers, all directly controlled by End User.
(d) Current Procedural Terminology (CPT). The Software may include the Current Procedural Terminology (CPT) code set, maintained by the American Medical Association through the CPT Editorial Panel, describing medical, surgical, and diagnostic services and designed to communicate uniform information about medical services and procedures among physicians, coders, patients, accreditation organizations, and payers for administrative, financial, and analytical purposes (the "CPT"). End User may only use the CPT code set consistent with these terms and conditions set forth on Exhibit A.
1.2 Export Law Assurances. End User may not use or otherwise export or re-export the Software or Documentation except as authorized by United States law and the laws of the jurisdiction in which the Software or Documentation was obtained. In particular, the Software or Documentation may not be exported, transshipped or re-exported (1) into (or to a national or resident of) those countries subject to a comprehensive economic sanctions program administered by the U.S. Department of the Treasury, Office of Foreign Assets Control ("OFAC") (Countries subject to OFAC embargo or sanctions can change at any time and can be reviewed by consulting materials available at http://www.treas.gov/ofac/index.html and http://www.bis.doc.gov); or (2) to anyone on the U.S. Treasury Department list of Specially Designated Nationals or the U.S. Department of Commerce Denied Persons List or Entity List, each as they may be amended from time to time and which may be found at http://www.treas.gov/ofac/index.html and http://www.bis.doc.gov.
1.3 Warranty. McKesson warrants to End User that the computer media on which the original Software is recorded will be free of defects in material and workmanship for a period of 30 days from the date of purchase under normal conditions of use and service. If the media becomes defective within 30 days from the date of purchase, if proof of original purchase can be verified, as End User's sole remedy and McKesson’s sole obligation McKesson will replace the Software or at its option, McKesson may refund to End User the original McKesson purchase price.
1.4 Disclaimer. EXCEPT AS STATED IN THE WARRANTY OF SECTION 1.3, THE MCKESSON SOFTWARE AND CLINICAL CONTENT IS PROVIDED "AS IS WITH ALL FAULTS" AND IN ITS PRESENT STATE AND CONDITION. NO WARRANTY, REPRESENTATION, GUARANTEE, CONDITION, UNDERTAKING OR TERM, EXPRESS OR IMPLIED, STATUTORY OR OTHERWISE, AS TO THE CONDITION, QUALITY, DURABILITY, ACCURACY, COMPLETENESS, PERFORMANCE, NON-INFRINGEMENT OF THIRD PARTY RIGHTS, MERCHANTABILITY, QUIET ENJOYMENT, OR FITNESS FOR A PARTICULAR PURPOSE OR USE OF THE MCKESSON SOFTWARE OR CLINICAL CONTENT IS GIVEN OR ASSUMED BY MCKESSON AND ALL SUCH WARRANTIES, REPRESENTATIONS, CONDITIONS, UNDERTAKINGS AND TERMS ARE HEREBY EXCLUDED TO THE FULLEST EXTENT PERMITTED BY LAW, AS ARE ANY WARRANTIES ARISING FROM COURSE OF DEALING OR USAGE. MCKESSON DOES NOT WARRANT THAT DEFECTS IN THE MCKESSON SOFTWARE OR CLINICAL CONTENT WILL BE CORRECTED. NO ORAL OR WRITTEN INFORMATION OR ADVICE GIVEN BY MCKESSON OR ANY MCKESSON REPRESENTATIVE OR RESELLER SHALL CREATE A WARRANTY. MCKESSON DOES NOT WARRANT THAT THE SOFTWARE OR CLINICAL CONTENT WILL YIELD ANY PARTICULAR BUSINESS OR FINANCIAL RESULT. TO THE EXTENT THAT UPDATED VERSIONS OF THE SOFTWARE OR CLINICAL CONTENT ARE DEVELOPED AND RELEASED BY MCKESSON, END USER ASSUMES ALL RISKS ASSOCIATED WITH USING OLDER VERSIONS OF THE SOFTWARE, INCLUDING BUT NOT LIMITED TO THE RISK OF USING OUTDATED CLINICAL CONTENT.
1.5 Audit. Upon reasonable advance notice and no more than twice per calendar year, McKesson may conduct an audit to ensure that End User is in compliance with this EULA. Such audit will be conducted during regular business hours, and End User will provide McKesson
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with reasonable access to all relevant equipment and records. If an audit reveals that End User's use of any Software or Clinical Content during the period being audited exceeds the usage-based variable(s) licensed by End User, then McKesson may invoice End User for all such excess use based on McKesson's prevailing rate(s) in effect at the time the audit is completed, and End User will pay any such invoice. If such excess use exceeds five percent of the licensed use, then End User will also pay McKesson's reasonable costs of conducting the audit.
SECTION 2: GENERAL TERMS
2.1.1 Confidential Information, Trade Secrets. You shall not use (except as permitted in connection with Your performance hereunder), disclose or permit any person access to any Trade Secrets (including, without limitation, the Software, Clinical Content and Documentation) while such information retains its status as a Trade Secret. During the Term and for a period of five (5) years thereafter, except as otherwise mandated by law, You shall not use, disclose, or permit any person access to any Confidential Information, except as permitted in connection with Your performance hereunder. You acknowledge that if You breach this Section 2.1.1, McKesson may have no adequate remedy at law available to it, may suffer irreparable harm, and will be entitled to seek equitable relief. You agree to protect such Confidential Information and Trade Secrets with no less diligence than You protect Your own confidential or proprietary information. If disclosure of Confidential Information is required under provisions of any law or court order, You will notify McKesson sufficiently in advance so McKesson will have a reasonable opportunity to object.
2.1.2 Software Usage Information. During registration or activation of software, and then on a regular basis, the Software will send information about the Software and Your use of the Software, to McKesson ("Usage Information"). This Usage Information helps prevent the unlicensed or prohibited use of the Software and also assists McKesson in offering End User other features and services. Usage Information sent by the Software may include the following: Customer # / serial number; software name; software version; date data was collected; total number of appointments in database; total number of visits in database; total number of transactions in database; for each item in the doctor list: number of appointments in last n days, number of visits in last n days, number of charges in last n days; for each clearinghouse in the system: number of claims submitted in last n days, number of eligibility queries submitted in last n days. Usage Information transmitted shall not include any individually identifiable information or any protected health information. End User may opt out of the collection of Usage information by sending notice to McKesson in accordance with Section 2.7 to the attention of the General Manager, Physician Practice Solutions. The notice must include the Software serial number.
2.1.3 Retained Rights. End User's rights in the Software will be limited to those expressly granted in this EULA. McKesson and its suppliers reserve all intellectual property rights not expressly granted to End User. All changes, modifications, improvements or new modules made or developed with regard to the Software, whether or not (a) made or developed at End User's request, (b) made or developed in cooperation with End User, or (c) made or developed by End User, will be solely owned by McKesson or its suppliers. End User acknowledges that the Software contains trade secrets of McKesson, and End User agrees not to take any step to derive a source code equivalent of the Software (e.g., disassemble, decompile, or reverse engineer the Software) or to permit any third party to do so. McKesson retains title to all material, originated or prepared for the End User under this EULA. End User is granted a license to use such materials in accordance with this EULA.
2.1.4 Maintenance Fees. Subject to payment of applicable fees, McKesson provides software maintenance services for Practice Partner Software, Medisoft Clinical Software and Lytec MD Software through an authorized McKesson reseller, or from McKesson, if You obtained the Software directly from McKesson. The scope and fees for such software maintenance services are set forth in a separate written agreement between You, and either the McKesson reseller or McKesson, as applicable.
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2.2 Limitation of Liability.
2.2.1 Total Damages. MCKESSON'S TOTAL CUMULATIVE LIABILITY UNDER, IN CONNECTION WITH, OR RELATED TO THIS EULA WILL BE LIMITED TO (A) THE TOTAL FEES PAID (LESS ANY REFUNDS OR CREDITS) BY END USER FOR THE SOFTWARE GIVING RISE TO THE CLAIM, WHETHER BASED ON BREACH OF CONTRACT, WARRANTY, TORT, PRODUCT LIABILITY, OR OTHERWISE.
2.2.2 Exclusion of Damages. IN NO EVENT WILL MCKESSON BE LIABLE TO END USER UNDER, IN CONNECTION WITH, OR RELATED TO THIS EULA FOR ANY SPECIAL, INCIDENTAL, INDIRECT, OR CONSEQUENTIAL DAMAGES, INCLUDING, BUT NOT LIMITED TO, LOST PROFITS OR LOSS OF GOODWILL, WHETHER BASED ON BREACH OF CONTRACT, WARRANTY, TORT, PRODUCT LIABILITY, OR OTHERWISE, AND WHETHER OR NOT MCKESSON HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGE.
2.2.3 Material Consideration. THE PARTIES ACKNOWLEDGE THAT THE FOREGOING LIMITATIONS ARE A MATERIAL CONDITION FOR THEIR ENTRY INTO THIS EULA.
2.3 Professional Responsibility and Clinical Content Disclaimer. END USER ACKNOWLEDGES AND AGREES THAT ANY CLINICAL CONTENT FURNISHED BY MCKESSON HEREUNDER (WHETHER SEPARATELY OR INCLUDED WITHIN THE SOFTWARE) IS AN INFORMATION MANAGEMENT AND DIAGNOSTIC TOOL ONLY AND THAT ITS USE CONTEMPLATES AND REQUIRES THE INVOLVEMENT OF TRAINED INDIVIDUALS. END USER FURTHER ACKNOWLEDGES AND AGREES THAT MCKESSON HAS NOT REPRESENTED ITS SOFTWARE AS HAVING THE ABILITY TO DIAGNOSE DISEASE, PRESCRIBE TREATMENT, OR PERFORM ANY OTHER TASKS THAT CONSTITUTE THE PRACTICE OF MEDICINE.
2.4 Internet Disclaimer. CERTAIN SOFTWARE PROVIDED BY MCKESSON UTILIZES THE INTERNET. MCKESSON DOES NOT WARRANT THAT SUCH SOFTWARE WILL BE UNINTERRUPTED, ERROR-FREE, OR COMPLETELY SECURE. MCKESSON DOES NOT AND CANNOT CONTROL THE FLOW OF DATA TO OR FROM MCKESSON'S OR END USER'S NETWORK AND OTHER PORTIONS OF THE INTERNET. SUCH FLOW DEPENDS IN LARGE PART ON THE INTERNET SERVICES PROVIDED OR CONTROLLED BY THIRD PARTIES. ACTIONS OR INACTIONS OF SUCH THIRD PARTIES CAN IMPAIR OR DISRUPT END USER'S CONNECTIONS TO THE INTERNET (OR PORTIONS THEREOF). ACCORDINGLY, MCKESSON DISCLAIMS ANY AND ALL LIABILITY RESULTING FROM OR RELATED TO SUCH EVENTS.
2.5 Termination.
2.5.1 Termination. McKesson may terminate the EULA immediately upon notice to End User if End User: (a) materially breaches the EULA and fails to remedy such breach within 60 days after receiving notice of the breach from the terminating party, (b) materially breaches any other contract End User has entered into with McKesson, (c) infringes McKesson's intellectual property rights and fails to remedy such breach within ten (10) days after receiving notice of the breach from the terminating party, (d) materially breaches the EULA in a manner that cannot be remedied, or (e) commences dissolution proceedings or ceases to operate in the ordinary course of business.
2.5.2 Obligations upon Termination or Expiration. Upon the termination or expiration of this EULA, End User will promptly (a) cease using all Software and Clinical Content, (b) purge all Software and Clinical Content from all computer systems (including servers and personal computers), (c) return to McKesson or destroy all copies (including partial copies) of the Software and Clinical Content, and (d) deliver to McKesson written certification of an officer of End User that End User has complied with its obligations in this Section.
2.6 Discount Reporting. An order form or quote may contain a discount that End User is required to report in its cost reports or another appropriate manner under applicable federal and
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state anti-kickback laws, including 42 U.S.C. Sec. 1320a-7b(b)(3)(A) and the regulations found at 42 C.F.R. Sec. 1001.952(h). End User will be responsible for reporting, disclosing and maintaining appropriate records with respect to the discount and making those records available under Medicare, Medicaid or other applicable government health care programs.
2.7 General. This EULA is governed by and will be construed in accordance with the laws of the State of Georgia, exclusive of its rules governing choice of law and conflict of laws and any version of the Uniform Commercial Code; each party agrees that exclusive venue for all actions, relating in any manner to this EULA will be in a federal or state court of competent jurisdiction located in Fulton County, Georgia. End User will not assign this EULA without the written consent of McKesson; McKesson may, upon notice to End User, assign this EULA to any McKesson Affiliate or to any entity resulting from reorganization, merger, or sale, and may subcontract its obligations. Failure to exercise or enforce any right under this EULA is not a waiver of such right. Neither party is liable for failing to fulfill its obligations due to acts of God or other causes beyond it reasonable control, except for End User's obligation to make payment. All notices relating to the parties' legal rights and remedies under this EULA must be provided in writing and delivered by: (a) postage prepaid registered or certified U.S. Post mail; or (b) commercial courier. All notices to McKesson will be sent to the following address with a copy to McKesson's General Counsel: 5995 Windward Parkway, Alpharetta, GA 30005. This EULA is the complete and exclusive agreement between the parties with respect to the subject matter hereof and may be may be modified, or any rights under it waived, only in a mutually-signed written agreement.
2.8 Government Customer Rights. If this Software is provided under a federal government contract, then McKesson intends that any Software provided under this EULA constitute "commercial item(s)" as defined in Federal Acquisition Regulation ("FAR") 2.101, including any Software, Clinical Content, Documentation or technical data. Additionally, all Software, Clinical Content, Documentation, or technical data provided by McKesson under this EULA will be considered related to such "commercial item(s)". If End User seeks rights in Software, Clinical Content, Documentation, or technical data provided by McKesson under this EULA, then McKesson grants only those rights established under any FAR or FAR Supplement clauses which are flowed down to McKesson under this EULA consistent with the delivery of "commercial item(s)." If End User contends that any Software, Clinical Content, Documentation, or technical data provided under this EULA does not constitute "commercial item(s)" as defined in FAR 2.101, then End User promptly will notify McKesson of the same, and identify what rights End User contends exist in such Software, Clinical Content, Documentation, or technical data. No rights in any such Software, Clinical Content, Documentation, or technical data will attach other than rights related to "commercial item(s)" unless End User provides such notice to McKesson, and McKesson expressly agrees in writing that such rights are granted under this EULA.
EXHIBIT A
CPT CODES AND TERMINOLOGY
SECTION 1: USER IS AN INDIVIDUAL WHO:
1.1 accesses, uses, and/or manipulates CPT codes and/or descriptions contained in the Software either at the input (the point at which data is entered into the Software), the output (the point at which data, reports, or the like are received from the Software), or both phases of using the Software; or
1.2 accesses, uses, and/or manipulates the Software to produce or enable an output that could not have been created without CPT embedded in the Software even though CPT may not be visible or directly accessible; or
1.3 makes use of an output of the Software that relies on or could not have been created without the CPT embedded in the Software even though CPT may not be visible or directly accessible (excepting that which would constitute fair use, internal reports, and claim forms for specific patients).
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SECTION 2:
2.1 The Clinical Content and/or Software may incorporate the CPT terminology developed and copyrighted by the American Medical Association ("AMA"). The CPT codes and terminology are provided pursuant to a license agreement between McKesson and the AMA. If End User requires additional User licenses, End User may purchase additional licenses from McKesson and the parties will negotiate in good faith the terms and conditions under which McKesson will make available such additional User licenses.
2.1.1 End User acknowledges that the AMA reserves all rights, whether statutory or common-law, in the CPT terminology and that no rights therein are hereby conveyed to End User except to the extent that End User has been granted a license to the Software. THE AMA MAKES NO REPRESENTATIONS OR WARRANTIES EXPRESS OR IMPLIED, WITH RESPECT TO CPT, INCLUDING, WITHOUT LIMITATION ANY WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. END USER FURTHER ACKNOWLEDGES THAT THE AMA SHALL NOT BE LIABLE TO END USER FOR ANY DAMAGES OF ANY NATURE WHETHER DIRECT, INDIRECT, SPECIAL, PUNITIVE, OR CONSEQUENTIAL, ARISING FROM THIS AGREEMENT. The AMA shall not by reason of the incorporation of the CPT terminology in the Software or by any other reason be deemed a party to this Agreement and End User shall look solely to McKesson for the performance of any obligations due End User hereunder.
2.2 In the event that one or more of the provisions contained in the Agreement shall for any reason be held invalid or unenforceable in any respect, such invalidity or unenforceability shall not affect the validity or enforceability of this Exhibit.
2.3 CPT only © 2000, 2001 etc. American Medical Association. All Rights Reserved. No fees schedules, basic units, relative values or related listings are included in CPT. AMA does not directly or indirectly practice medicine or dispense medical services. AMA assumes no liability for data contained or not contained herein.
2.4 CPT is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a)(June 1995) and DFARS 227.7202-3(a)(June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.
REVENUE MANAGEMENT END USER LICENSE AGREEMENT
THIS SUBSCRIPTION AGREEMENT ("SUBSCRIPTION AGREEMENT") IS A LEGAL AGREEMENT BETWEEN YOU, EITHER AN INDIVIDUAL OR A SINGLE ENTITY ("END USER" OR "YOU") AND NDCHEALTH CORPORATION dba MCKESSON PROVIDER TECHNOLOGIES ("MCKESSON"). THIS SUBSCRIPTION AGREEMENT SETS FORTH YOUR RIGHTS AND OBLIGATIONS WITH RESPECT TO YOUR SUBSCRIPTION TO THE REVENUE MANAGEMENT SOFTWARE AND SERVICES ("SUBSCRIPTION SERVICES"). BY INSTALLING, COPYING, OR OTHERWISE USING THE SUBSCRIPTION SERVICES, YOU AGREE TO BE BOUND BY THE TERMS OF THIS SUBSCRIPTION AGREEMENT. IF YOU DO NOT AGREE TO THE TERMS OF THIS SUBSCRIPTION AGREEMENT, YOU MAY NOT INSTALL OR USE THE SUBSCRIPTION SERVICES.
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Please note that this Subscription Agreement is in addition to, and not in lieu of, the McKesson Physician Practice Solutions End User License Agreement ("EULA") which is incorporated herein by reference.
WE MAY FROM TIME TO TIME AMEND, SUPPLEMENT OR MODIFY THE TERMS AND CONDITIONS OF THIS SUBSCRIPTION AGREEMENT. IF WE MAKE MATERIAL CHANGES TO THIS SUBSCRIPTION AGREEMENT, WE WILL POST AN UPDATED VERSION OF THIS SUBSCRIPTION AGREEMENT AND WE MAY PROVIDE YOU WITH FURTHER NOTICE OF THE CHANGES VIA EMAIL. NOTWITHSTANDING THE FOREGOING, IT IS YOUR RESPONSIBILITY TO CHECK THIS SUBSCRIPTION AGREEMENT PERIODICALLY FOR CHANGES. YOUR CONTINUED USE OF ANY SUBSCRIPTION SERVICES FOLLOWING THE POSTING OF ANY UPDATED SUBSCRIPTION AGREEMENT CONSTITUTES YOUR ACCEPTANCE TO BE BOUND BY THE TERMS AND CONDITIONS OF SUCH UPDATED SUBSCRIPTION AGREEMENT. ANY AND ALL USE OF THE SUBSCRIPTION SERVICES AFTER THE POSTING OF AN UPDATED SUBSCRIPTION AGREEMENT WILL BE SUBJECT TO THE TERMS AND CONDITIONS OF SUCH UPDATED SUBSCRIPTION AGREEMENT.
1.1 License Term. Subject to the terms of this Subscription Agreement, McKesson grants to You, and You accept, a limited, nonexclusive, nontransferable, non-sublicensable, license to use the Subscription Services and the Subscription Content for Your internal purposes for a one year term commencing on the date of your initial installation and/or acceptance of the Subscription Services ("License Term"). The License Term shall automatically renew on the same terms and condition of this Subscription Agreement in accordance with Section 9.2 below.
2.1 Authorized End Users: You hereby represent, warrant and covenant that (i) you are a natural person, 18 years of age or older, and a legal resident of the United States of America, and (ii) You are and will be during the term of this Subscription Agreement in full compliance with the terms and conditions of the EULA and this Subscription Agreement. We are relying on the foregoing representations and agreements and would not allow You to use the Subscription Services if such representations and agreements were not true.
3.1 Permitted Uses: You have a limited, nontransferable, nonexclusive, revocable, nonsublicenseable right to access and use the services and information that McKesson makes available in connection with the Subscription Services which You have selected solely for Your personal, noncommercial use in accordance with the terms of this Subscription Agreement. McKesson and its licensors retain all right, title and interest in and to any and all content or other works of authorship made available as part of the Subscription Services (the "Subscription Content"). No right, title or interest in any Subscription Content is transferred to You as a result of Your exercising any of the rights granted to You in this Subscription Agreement.
4.1 Additional Restrictions: The limited rights granted to You pursuant to this Subscription Agreement does not include any resale or commercial use of the Subscription Services or any Subscription Content; any collection and use of any Subscription Content, descriptions, or prices; any derivative use of the Subscription Services or Subscription Content; any downloading or copying of account information for the benefit of another entity or person; or any use of data mining, robots, or similar data gathering and extraction tools. You may not reproduce, duplicate, copy, sell, resell, distribute or make available to any third party, modify, reverse engineer, decompile, disassemble or create derivative works of or otherwise exploit for any commercial purpose the Subscription Services, the Subscription Content, or any portion of the foregoing, without express written consent of McKesson. Any unauthorized use by you shall result in the automatic termination of this Subscription Agreement and the permission and/or license granted by McKesson to you without the need for further action by McKesson.
5.1 Technological Limitations: McKesson will use reasonable efforts to keep the Subscription Services operational. However, certain technical difficulties may, from time to time, result in temporary service interruptions. McKesson also reserves the right at any time and from time to time to modify or discontinue, temporarily or permanently, functions of any of the Subscription Services or the Subscription Services in its entirety with or without notice. If McKesson
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permanently discontinues the Subscription Services or this Subscription Agreement (other than in the case of a termination of Your account for cause), McKesson will provide a pro-rata refund to You of the unused portion of any pre-paid Subscription Fee (as defined below). You agree that McKesson shall not be otherwise liable to You or to any third party for any of the direct or indirect consequences of any modification, suspension, discontinuance of or interruption to the Subscription Services.
6.1 Your Information: You agree to provide us with accurate and complete information required to register for the Subscription Services and at other times as required in connection with using the Subscription Content ("Registration Information"). You also agree to maintain and update Your Registration Information as necessary to keep it accurate, current and complete.
7.1 Subscription and Billing: You shall pay McKesson's current charges for all use of the Subscription Services as such charges are in effect from time to time. You can find specific details regarding Your subscription, including, without limitation, the current fees for Your subscription, at anytime by clicking on the "billing info" tab in the subscription manager window. You shall pay for all Subscription Services ordered through Your account.
8.1 Payment Methods; Credit Cards; Taxes: Prior to using any Subscription Services, You must provide McKesson with the applicable payment using one of the following credit cards: Visa, MasterCard, or American Express.
8.2 When subscribing to a Subscription Services You shall provide accurate and complete payment information, including all of the following: (i) Your name (as it appears on the card), (ii) Your credit card number, (iii) the credit card type, (iv) the credit card's expiration date and (v) any activation numbers or codes which are needed to charge Your card. You hereby agree that by submitting that information to us, You authorize us to charge Your credit card at our convenience but within thirty (30) days of credit card authorization. You agree to pay all applicable fees and charges incurred in connection with Your subscription to a Subscription Services at the rates in effect when the charges were incurred. IF MCKESSON DOES NOT RECEIVE PAYMENT FROM YOUR CREDIT CARD ISSUER OR ITS AGENT, YOU AGREE TO PROMPTLY PAY ALL AMOUNTS DUE UPON DEMAND BY MCKESSON. You are solely responsible for paying any taxes which may be imposed on Your subscription, including, without limitation, sales, value-added or use taxes.
9.1 Billing: As a subscriber, You agree that we are permitted to charge Your credit card an annual subscription fee, any applicable sales tax and any other charges You may incur in connection with Your use of the Subscription Services (collectively, the "Subscription Fee"). The Subscription Fee will be billed automatically to Your credit card monthly, quarterly, or annually unless and until You cancel Your subscription. All fees and charges are nonrefundable.
9.2 Automatic Renewals: Unless You cancel or McKesson terminates Your subscription in accordance with this Subscription Agreement, Your subscription to the Subscription Services will be automatically renewed for successive annual subscription terms on a yearly basis. For Your convenience, we will charge the then-current annual subscription fee to the credit card You provide to us during registration (or to a different credit card if You have changed Your account information in accordance with this Subscription Agreement) in monthly, quarterly, or annual payments. Notwithstanding anything herein to the contrary, McKesson shall have the right to change our prices and billing methods applicable to the Subscription Services from time to time and such changes are effective immediately upon notice to you in writing or via email delivery to You. McKesson shall use commercially reasonable efforts to notify You of any increases in the fee for Your renewal Subscription Services, at least ten (10) days prior to renewal so that You have an opportunity to cancel Your Subscription Services.
9.3 Unauthorized Charges: You agree that any discrepancies appearing on Your credit card statement will be deemed accepted by You for all purposes unless You notify McKesson of any such discrepancies within sixty (60) days after they first appear on such statement. You hereby release McKesson from all liabilities and claims of loss resulting from any error or discrepancy that is not reported to us within sixty (60) days of its first appearance on a credit card statement.
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10.1 Disclaimer: THE SUBSCRIPTION SERVICES AND SUBSCRIPTION CONTENT IS PROVIDED "AS IS WITH ALL FAULTS" AND IN ITS PRESENT STATE AND CONDITION. NO WARRANTY, REPRESENTATION, GUARANTEE, CONDITION, UNDERTAKING OR TERM, EXPRESS OR IMPLIED, STATUTORY OR OTHERWISE, AS TO THE CONDITION, QUALITY, DURABILITY, ACCURACY, COMPLETENESS, PERFORMANCE, NONINFRINGEMENT OF THIRD PARTY RIGHTS, MERCHANTABILITY, QUIET ENJOYMENT, OR FITNESS FOR A PARTICULAR PURPOSE OR USE OF THE SUBSCRIPTION SERVICE OR SUBSCRIPTION CONTENT IS GIVEN OR ASSUMED BY MCKESSON AND ALL SUCH WARRANTIES, REPRESENTATIONS, CONDITIONS, UNDERTAKINGS AND TERMS ARE HEREBY EXCLUDED TO THE FULLEST EXTENT PERMITTED BY LAW, AS ARE ANY WARRANTIES ARISING FROM COURSE OF DEALING OR USAGE. MCKESSON DOES NOT WARRANT THAT DEFECTS IN THE SUBSCRIPTION SERVICE OR SUBSCRIPTION CONTENT WILL BE CORRECTED. NO ORAL OR WRITTEN INFORMATION OR ADVICE GIVEN BY MCKESSON OR ANY MCKESSON REPRESENTATIVE OR RESELLER SHALL CREATE A WARRANTY. MCKESSON DOES NOT WARRANT THAT THE SUBSCRIPTION SERVICE OR SUBSCRIPTION CONTENT WILL YIELD ANY PARTICULAR BUSINESS OR FINANCIAL RESULT. TO THE EXTENT THAT UPDATED VERSIONS OF THE SUBSCRIPTION SERVICE OR SUBSCRIPTION CONTENT ARE DEVELOPED AND RELEASED BY MCKESSON, END USER ASSUMES ALL RISKS ASSOCIATED WITH USING OLDER VERSIONS OF THE SUBSCRIPTION SERVICE OR SUBSCRIPTION CONTENT, INCLUDING BUT NOT LIMITED TO THE RISK OF USING OUTDATED SUBSCRIPTION CONTENT.
11.1 Limitation of Liability:
11.1 Total Damages. MCKESSON'S TOTAL CUMULATIVE LIABILITY UNDER, IN CONNECTION WITH, OR RELATED TO THIS SUBSCRIPTION AGREEMENT WILL BE LIMITED TO (A) THE TOTAL FEES PAID (LESS ANY REFUNDS OR CREDITS) BY YOU FOR THE SUBSCRIPTION SERVICES GIVING RISE TO THE CLAIM, WHETHER BASED ON BREACH OF CONTRACT, WARRANTY, TORT, PRODUCT LIABILITY, OR OTHERWISE.
11.2 Exclusion of Damages. IN NO EVENT WILL MCKESSON BE LIABLE TO YOU UNDER, IN CONNECTION WITH, OR RELATED TO THIS SUBSCRIPTION AGREEMENT FOR ANY SPECIAL, INCIDENTAL, INDIRECT, OR CONSEQUENTIAL DAMAGES, INCLUDING, BUT NOT LIMITED TO, LOST PROFITS OR LOSS OF GOODWILL, WHETHER BASED ON BREACH OF CONTRACT, WARRANTY, TORT, PRODUCT LIABILITY, OR OTHERWISE, AND WHETHER OR NOT MCKESSON HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGE.
11.3 Material Consideration. THE PARTIES ACKNOWLEDGE THAT THE FOREGOING LIMITATIONS ARE A MATERIAL CONDITION FOR THEIR ENTRY INTO THIS SUBSCRIPTION AGREEMENT.
12.1 Termination; Cancellation:
12.2 Termination: You acknowledge and agree that McKesson may suspend or terminate Your access to and use of the Subscription Services at any time, with or without cause, in McKesson’s absolute discretion and without notice, including for any breach of this Subscription Agreement. The relevant version of this Subscription Agreement shall continue to apply to the applicable prior use of the Subscription Services.
12.2 Cancellation: You may cancel Your subscription to the Subscription Services at anytime. You must cancel Your subscription before it renews in order to avoid billing of subscription fees applicable to the subsequent annual renewal term to Your credit card.
12.3 Refunds: All fees and charges which You have paid for Subscription Services are nonrefundable; provided, however, in the event McKesson terminates Your access to the Subscription Services without cause prior to the completion of Your subscription and You have prepaid for more than one month of Subscription Services, You will receive a pro-rata refund for any prepaid and unused Subscription Services fees.
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13.1 Governing Law and Forum for Disputes: This Subscription Agreement is governed by and will be construed in accordance with the laws of the State of Georgia, exclusive of its rules governing choice of law and conflict of laws and any version of the Uniform Commercial Code; each party agrees that exclusive venue for all actions, relating in any manner to this Subscription Agreement will be in a federal or state court of competent jurisdiction located in Fulton County, Georgia. You agree that you will not assign this Subscription Agreement without the written consent of McKesson; McKesson may, upon notice to You, assign this Subscription Agreement to any McKesson Affiliate or to any entity resulting from reorganization, merger, or sale, and may subcontract its obligations. Failure to exercise or enforce any right under this Subscription Agreement is not a waiver of such right. Neither party is liable for failing to fulfill its obligations due to acts of God or other causes beyond it reasonable control, except for End User's obligation to make payment. All notices relating to the parties' legal rights and remedies under this Subscription Agreement must be provided in writing and delivered by: (a) postage prepaid registered or certified U.S. Post mail; or (b) commercial courier. All notices to McKesson will be sent to the following address with a copy to McKesson's General Counsel: 5995 Windward Parkway, Alpharetta, GA 30005.
14.1 General Provisions: Failure by McKesson to enforce any provision(s) of this Subscription Agreement shall not be construed as a waiver of any provision or right. In the event that any portion of this Subscription Agreement is held to be unenforceable, the unenforceable portion must be construed as nearly as possible to reflect the original intent, the remaining portions remain in full force and effect, and the unenforceable portion remains enforceable in all other contexts and jurisdictions. This Subscription Agreement constitutes the entire agreement between You and McKesson with respect to the Subscription Services and supersedes all prior oral or written understandings, communications or agreement not specifically incorporated herein. Any claim under this Subscription Agreement must be brought within one (1) year after the date upon which the cause of action arose or shall be deemed waived.
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Getting Started With Lytec
Welcome to Lytec 2011
Lytec is a practice management solution that helps you better manage your business by streamlining your management activities into one easy-to-use system. Among other tasks, you can use Lytec to schedule appointments, bill insurances and patients, post payments, manage accounts receivable, and print reports.
The topics featured in this book are intended to help you set up your practice, begin entering transactions, create claims, and apply payments. The topics in this book do not completely document Lytec. For more information, look up related information in Search field of the Help file and access other parts of the Help system. TIP: This manual uses F1 to call your attention to topics that you can look up in the online help file for more information.
New in this Version
ARRA Reporting
Lytec 2011 includes four new reports to help you to remain compliant with upcoming ARRA requirements, specifically the requirements for electronically verifying the eligibility of your patients for insurance and for electronically sending claims to insurance providers. These include:
Appointment Eligibility Analysis - Detail
Appointment Eligibility Analysis - Summary
Electronic Claims Analysis - Detail
Electronic Claims Analysis - Summary
Each of these reports offers several filters for controlling the information that shows. In addition, several summary values appear on each report.
ARRA Audit
Auditing for ARRA has been updated in Lytec 2011. When ARRA Auditing is enabled, the following report types are audited:
All Crystal Reports--the user, use, and ranges of the report are part of the audit trail.
Custom Reports--the user, use, and ranges specified are part of the audit trail.
Exporting and printing of Notes--all File Export calls, including Exporting to Quicken and Quick Books Pro, as well the 4 note types are audited.
Auditing for ARRA has been simplified with a single checkbox to turn auditing on or off. No longer do you have to select each report individually. To turn on ARRA auditing, simply select the ARRA Audit box on the Audit Trail Settings window:
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The user may now specify what ranges were included for each report when the Audit Trail Report is printed. To include ranges select the Incl. Ranges button on the Print Audit Trail Report window.
BillFlash
Statements sent to patients electronically through Lytec 2011 will now use BillFlash. You can enroll in BillFlash within Lytec now, as well as upload your statement files from Lytec automatically. You can view and approve the uploads at BillFlash by clicking links from within Lytec, and BillFlash will print and mail your statements to your patients.
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Within Lytec, you can control several aspects of what prints on your statements, including
which credit cards you accept
service messages you want to print
printing of account summaries and aging
printing up to six messages you want to appear on statements.
Options on the Billing, Statement Processing menu allow you to enroll with BillFlash, view and approve statements that have uploaded to BillFlash, see your BillFlash account settings, and view reports, such as the Disposition report. Each one of these menu options will open a different page at the BillFlash website.
Several changes have been made to the program:
The Create Statement File option accessed from Billing, Statement Processing has been removed.
Transmit File on the same menu has been renamed to Transmit Statement.
Five new options for BillFlash have been added to this menu. This menu now looks like this:
Lytec security has been modified. The option for Create Statements File has been removed and Transmit File has been changed to Transmit Statement.
The process for creating and transmitting statements has been updated.
Several windows in Lytec have quick access to the eView page of the BillFlash website. Most of these windows include a new eView button; others have an eView icon. These windows are:
Charges and Payments (eView icon)
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Patient Ledger (eView button)
Apply Patient Payment (eView Button)
Apply Insurance Payment (eView Button)
A/R Management Tool (eView Button)
Patient Lookup (eView Button)
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Scheduler Appointment (option on context menu)
A new tab has been added to Preferences for several BillFlash options. These control what information is printed on your statements, including which credit cards you handle, what sorts of messages you want to appear on your statements, and whether or not you want aging or summaries to appear.
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New fields, such as the fields on the Preferences - BillFlash tab, are available for use in Custom Lytec Report Design. In addition, the report BillFlash LY1 StandardStmt v10+.lcs has been modified for the new data fields. Users may modify the other reports as necessary.
HIPAA X12 Version 5010
The following are changes made to Lytec 2011 to accommodate the upcoming change from the Health Insurance Portability and Accountability Act (HIPAA) Accredited Standards Committee (ASC) X12 version 4010A1 to ASC X12 version 5010 and National Council for Prescription Drug Programs (NCPDP) version 5.1 to NCPDP version D.0.5010. HIPAA X12 version 5010 and NCPDP version D.0 are new sets of standards that regulate the electronic transmission of specific healthcare transactions, including eligibility, claim status, referrals, claims, and remittances. Covered entities, such as health plans, healthcare clearinghouses, and healthcare providers, are required to conform to HIPAA 5010 standards.
These changes include restructured windows or moved fields, menu changes, new fields, additional options, and other changes.
Restructured windows and moved fields
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Several windows have been restructured, renamed, and/or rearranged to accommodate the updates.
Billing Options (Charges and Payments): The More Information button has been removed from the Billing Information tab and Billing More Information 1 and 2 have been made separate tabs on the Billing Options page.
All Insurance Narrative windows and menu options have been renamed to EDI Notes. These EDI Notes windows may be accessed from three places:
Lists, Patients, EDI Notes (select a Patient and the window will be called Billing EDI Notes)
Charges and Payments, Billing, EDI Notes (the window will be called Billing EDI Notes)
Charges and Payments, Detail, EDI Notes (the window will be called Detail EDI Notes)
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The Print Insurance Narratives window is now called Print EDI Notes.
Clicking Add from a Billing EDI Notes window will open the Assign Billings to Narrative window; while clicking Add from the Details EDI Notes window will open the Assign Details to EDI Note window.
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Add/Edit Insurance Narrative has changed to Add/Edit EDI Notes. In addition, several new fields are available and you can now select four different Types of Note: PWK (paperwork), CN1 (Contract), MEA (Test Results)[not available from Billing options], and NTE (Line Note). Each of these options has a different set of fields.
New Fields added
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Several new fields have been added throughout the program. Below is a table describing the window where the new field is located, the field name, and its purpose. These new fields are available on custom reports.
Parent Form Field Name Purpose
Practice Information Window, Practice Settings Tab
Email address Allows you to enter an email address for the practice.
Practice Information Window, Practice Settings Tab
Phone Extension Allows you to enter an extension for the phone number, up to 5 digits.
Guarantor Window Race Allows you to select the guarantor's race
Guarantor Window Ethnicity Allows you to select the guarantor's ethnicity
Insurance Companies Window, Information Tab
Email address Allows you to enter the email address of the insurance company.
Patient Window, Patient Information Tab
Suffix Allows you to enter any suffix after the patient's name.
Patient Window, Patient Information Tab
Race Allows you to select the patient's race.
Patient Window, Patient Information Tab
Ethnicity Allows you to select the patient's ethnicity.
Patient Window, Patient Information Tab
Language Allows you to select the patient's preferred language.
Patient Window, Patient Secondary Insurance Tab
Medicare Secondary Reason Allows you to select a reason.
Charges and Payments, Billing Options
Medicare Secondary Reason Allows you to select a reason.
Patient Window, Insurance Tabs
Group Name Allows you to enter the group name of the patient's insurance.
Patient Window, Claim Information Tab
Patient Signature Source Allows you to indicate if the source of the patient's signature is on file.
Patient Window, Claim Information Tab, More Information Tab 1
Initial Treatment Date Allows you to enter the date the patient was initially treated.
Patient Window, Claim Information Tab, More Information Tab 1
First Contact Date Allows you to enter the date on which the practice first had contact with the patient.
Patient Window, Claim Information Tab, More Information Tab 1
Condition Codes 1-12 Allow you to enter up to 12 condition codes. These are used on the professional claim.
Patients Window, Claim Information Tab, More Information 2 Tab
Condition Description 1 and 2 Allows you to enter descriptions of the patient's condition.
Charges and Payments Window, More Detail
Related Procedure Allows you to indicate if there was a procedure related to the use of anesthesia.
Charges and Payments Related Surgical Procedure 1 Allows you to enter
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Window, More Detail and 2 information regarding procedures associated with the use of anesthesia.
Charges and Payments Window, More Detail
Prescription Date Allows you to enter the date of the prescription.
Charges and Payments Window, More Detail
Batch # Allows you to enter the batch number of the prescription or medication
Charges and Payments Window, More Detail
Type Allows you to select the type of the prescription
Charges and Payments, Billing Options
Medicare Secondary Reason Allows you to select a reason.
Charges and Payments, Billing Options
Group Name Allows you to enter the group name of the patient's insurance.
Charges and Payments Window, More Information Tab 1
Initial Treatment Date Allows you to enter the date that the patient was initially treated.
Charges and Payments Window, More Information Tab 1
First Contact Date Allows you to enter the date that the practice first had contact with the patient.
Charges and Payments Window, More Information Tab 1
Condition Codes 1-12 Allow you to enter up to 12 condition codes. These are used on the professional claim.
Charges and Payments Window, More Information Tab 2
Condition Description 1 and 2 Allows you to enter descriptions of the patient's condition.
Appointment Window (new, edit, insert)General Tab
Service Type Code Allows you to enter a code for the type of service.
Repeat Appointment window, Appointment Tab
Service Type Code Allows you to enter a code for the type of service.
Reschedule Appointment window, Appointment Tab
Service Type Code Allows you to enter a code for the type of service.
Appointment Reason Code Service Type Code Allows you to enter a code for the type of service.
Menu Changes
Insurance Narrative changed to EDI Notes on Lists, Patient menu.
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Print Insurance Narratives has changed to Print EDI Notes on the Print Insurance Claims drop-down menu.
Insurance Narrative has changed to EDI Notes on the Charges and Payments window, Billing button flyout menu.
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Additional Options
Additional Claim Filing Indicator Codes have been added to the Insurance Type drop down menu on the Insurance Companies Window, Information tab.
Added Unknown as an option in the Sex field on the Patient Window (Patient Information tab).
New values are available for Special Program Code on the Patient Window, Claim Information Tab, More Information Tab 1.
Nature of Condition on the Patients Window, Claim Information Tab, More Information 2 Tab, has new values. In addition, these values are available on the Charges and Payments Window, More Information Tab 2.
Added four new Permanent Diagnosis Codes on the Patient Window, Diagnosis/Reminders Tab. In addition, these new codes have been added to Charges and Payments, More Detail.
Added four new Diagnosis Codes to the Linked Transactions window. There are now 12 codes.
Added four new Diagnosis Codes to the Pending Transactions, More Detail window. There are now 12 codes.
Other Changes
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Middle Initial field changed to Middle Name field on Provider window (Provider Information tab), Provider Quick Edit, Referring Physician window (Referring Physician Information tab), Guarantor window, Guarantor Quick Edit, Facilities window (Facility Information tab), Patient window (Patient Information Tab).
Relation to Insured field on the Patient Window, Insurance Tabs and the Charges and Payments, Billing Options window has been changed to a drop-down to facilitate data entry and avoid claim errors.
Medicaid Referral Number changed to Referral Number on the Patients Window, Claim Information Tab, More Information 2 Tab. This change was also made on the Charges and Payments Window, More Information Tab 2.
Referral Codes changed to Conditional Codes on the Patients Window, Claim Information Tab, More Information 2 Tab. In addition, there are now 5 codes instead of 3. These same changes have been made on the Charges and Payments Window, More Information Tab 2.
Timely Filing Indicator on the Patients Window, Claim Information Tab, More Information 2 Tab is now a drop down with pre-coded options. This change has also been made on the Charges and Payments Window, More Information Tab 2.
Renamed Anesthesia Minutes to Minutes on the Charges and Payments, More Detail window.
Prescription # field on the Charges and Payments Window, More Detail window now has up to 50 characters.
The NDC Units field on the Charges and Payments Window, More Detail window has new numerical formats.
The Measurement field on the Charges and Payments Window, More Detail window allows the following values: International Unit, Gram, Milligram, Milliliter, and Unit.
The following fields have been added to the Billing Detail table so they may be added to the Charges and Payments Detail Layout grid: Date Last Seen, Test Date, last X-Ray Date, Initial Treatment Date, Obstetric Anesthesia Additional Units.
Single SQL Instance
Lytec 2011 now runs using a single SQL instance that it does not control or manage. In previous versions, Lytec controlled the SQL instance and loaded several databases into it, making it impossible for any other programs to use it. Now, all user and SQL instance-specific functionality has been removed from Lytec; and Lytec merely uses the SQL instance credentials that are given to it.
Changing the way Lytec works with SQL resulted in several changes to the program and several changes to screens:
UDL files and paths are no longer used and that functionality has been removed. The Lytec User Login database is no longer needed. In addition, there is no longer a Lytec User Database or Lytec Practice List.
Lytec 2011 will handle SQL Server 2008 and any practice database that is being converted will be set to the highest compatibility, including SQL Server 2008.
Lytec 2011 will create only the Admin and Report users.
When a practice is restored, its SQL compatibility level will be raised.
Database Migration and Conversion
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Practices from previous versions of Lytec need to have their databases migrated to the new SQL instance. The first time Lytec is launched, the Migrate Legacy Databases form opens, allowing the user to select any available practice to be migrated. It can also be manually initialized from the main window by selecting Migrate Legacy Databases:
When Lytec 2011 is initially started, it will check for a LYTEC_SQL instance. If it is found, the Data Migration Wizard will open and show you a list of all existing databases.
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Select which databases you want to migrate and click Migrate. The databases will be moved to the new SQL instance and practices will be ready to be converted to the new format.
NOTE: You should run this utility only on the server computer.
Once the databases have been migrated to the new SQL instance, you must convert the actual practice data to the new format.
Remodeled windows
Several windows have been modified to accommodate the changes to the SQL instance, including the removal of UDL functionality and the storing of the Practice List DB inside Lytec Shared Data.
Practice List
The Sort By field has been removed, as has the UDL field.
New Practice Window
The Server and Data Path fields have been removed, since all databases are on the same server.
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Find Practice
Similarly, the Server and Database fields, as well as the check box for Save practice information to a UDL file, have been removed. The user will now simply select the database.
Find Practice List
The Find Practice List window has been replaced with the Specify Default SQL Credentials window. You will use this window on initial start up of Lytec 2011 (server and client machines) to specify the server where the instance is located.
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Note: you can open this window to change the credentials by pressing the F7 key when Lytec is starting up or when no practice is open.
Manage Logins
The old Manage Logins window would allow you to view passwords, as well as change them. The new Manage Logins window will only allow you to set new passwords for the Admin and Reports users, and you must know the SQL SysAdmin Credentials to make the changes. In addition, only these two users will be created on initialization of Lytec.
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Command Line Parameters and INI file changes
These parameters have been updated because of the changes, including the removal of UDL functionality. You can see the new parameters by typing Lytec.exe / at the appropriate command prompt.
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You can use the OnlyShowDatabases command to create a filtered practice list, as seen below: Note that certain buttons have been disabled when database filtering is used.
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INI file changes
For the INI file, the following setting has been changed from
[Practice List]
Can Change Practice List=Yes
to
[App Settings]
Can Change Server=Yes
The following INI file settings have been added:
[App Settings]
Server=
User=
Password=
OnlyShowDatabases=
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The following INI file settings are no longer used:
[App Settings]
Allow Open=Yes
[Application Identification Information]
Database Schema Name=Lytec2010
[Data Access Configuration]
Record Cache=20
Unified Installation
Installation of Lytec, particularly Lytec MD, has been simplified. Both Lytec and Practice Partner and any support applications are installed in one short procedure. Users are presented a series of simple dialogs that enable them to make informed choices of which Lytec product and applications to install. Installation of SQL happens behind the scenes, with the installer determining which version of SQL to install.
In addition, the user may now select any path for installing Practice Partner. In the past, the path P:\ppart had to be used but now the user can select a different drive and folder name. The user must remember this name for proper setup of Lytec MD.
Note: if you are using Communications Manager and you set your path to anything other than P:\ppart, you must specify the PP Server Location path in Communications Manager. This path will default to P:\ppart. To do so,
1. In Communications Manager, click Connections.
2. Select Edit for the LytecMD connection.
3. Enter the correct path in the PP Server Location field. Or use the Browse button to locate the path.
4. Click Done.
If you do nothing when you create your LytecMDl connection, the system assumes P:\ppart. Initially, this field will be empty; but the next time you open the connection, P:\ppart will populate the field.
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HL7 Communications Manager
A number of changes have been made to how Communications Manager interfaces with Lytec MD:
A new segment, STF, has been added immediately after the PID segment. This segment is used to transmit referring provider information for Practice Partner, such as providers, staff, system users, and referring agents.
The Clean HL7 Tables button on the Application Settings window will now clean all but the latest triggers for patients and appointments. No longer will it clear the entire table.
Information for Race and Ethnicity will be transmitted via Communications Manager.
Changes have been made to the wording in Communications Messenger to enable you to see more quickly that it is processing and checking for new triggers. Communications Messenger will now show you the progress that it is making in checking for any incoming messages, as shown below.
Automatic Provider Mapping is available for new users who want to map their providers between Lytec MD and Practice Partner or other system. When new users initialize Communications Manager, they can select Automatic Provider Mapping and Send Providers to automatically populate Practice Partner with provider information entered in Lytec MD. In addition, existing users may use this feature, provided their data is set up with a one-to-one relationship in their existing mapping.
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Several libraries of data will be sent between Lytec and the Practice Partner EMR. These include Providers, Facilities, Procedure Codes, and Diagnosis Codes. The user can select on the Connection Edit window which libraries to send.
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In addition, the user can specify the location of the synchronization libraries on the Configure Protocol window.
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With LytecMD 2011, the user may not choose to place their Practice Partner software in a location other than P:\ppart. If you choose a different path, you must set the PP Server Location field in the Edit Connection window of Communications Manager to the path that you selected. It will default to P:\ppart if you do not manually enter the correct path. You may use the Browse button to locate the correct server drive and folder.
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Revenue Management Click Reduction
Several changes have been made to the functionality and workflow of Revenue Management to reduce the number of times that the user must click to achieve the desired result. Among these changes are:
Claims will be auto-checked so that the user does not need to click Check Claims. There is a new option on the Lytec tab in Revenue Management Preferences called Auto Check Claims. Selecting this option will enable the program to auto check the claims when the user selects Process > Claims.
Claim edit checks and IG edit checks have been combined into one step and executed when you select Claims from the Process menu. Errors are displayed on the Claims Preview report, as well as under each individual claim.
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One click removal of all claims marked with a red X, eliminating the need to click
Remove Claim many times. An icon appears next to the Remove Claim button on the Claim Preview window. Clicking this icon will remove all claims marked with a red X.
Addition of a Failed Claim report that will be displayed when the Send button is selected from the Claim Preview window. This report will display all claims that were removed, eliminating the need to preview this report separately.
Claims that fail any edit and are removed from the transmission file will be written back to Lytec.
Remove the OK button displayed after clicking Send from the Claim file saved message. Remove the Transmission has been received button that displayed after the file was sent/received.
Revenue Management 5010 ERA Changes
Changes have been made to Revenue Management processing to handle the upcoming switch to 5010 ANSI. Among these are the following:
Updates to the 5010 RelayHealth IG. These updates include:
For the 835 IG, the TRN02 element has increased size to a maximum of 50 characters.
The N407 element (Country Subdivision Code) in Loop 1000A AND Loop 1000B has been added to the 835 IG. It is situational and has a maximum length of 3 characters. It is required when the address is not in the United States of America, including its territories, or Canada, and the country in N404 has administrative subdivisions such as but not limited to states, provinces, cantons, etc.
Several new elements for Loop 1000A (Payer Identification) in the 835 IG that are not active yet but must be added. In this way, if they are received, the ERA will not be discarded. These are the following:
POS# ID Min/Max Usage Req
Values
PER Payer Technical Contact Information
1300 >1 R
PER01 Contact Function Code
ID 2--2 R BL
PER02 Payer Technical Contact Name
AN 1--60 S
PER03 Communication # Qualifier
ID 2--2 S EM, TE, UR
PER04 Payer Contact Communication #
AN 1-256 S
PER05 Communication Number Qualifier 2
ID 2--2 S EM, EX, FX,
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TE, UR
PER06 Payer Technical Contact Communication #
AN 1--256 S
PER07 Communication Number Qualifier 3
ID 2--2 S EM, EX, FX, UR
PER08 Payer Contact Communication #
AN 1--256 S
PER09 Contact Inquiry Reference
AN 1--20 N/U
PER Payer WEB Site
1300 1 S
PER01 Contact Function Code
ID 2--2 R
PER02 Name AN 1--60 N/U
PER03 Communication # Qualifier
ID 2--2 R
PER04 Payer Contact Communication #
AN 1-256 R
PER05 Not Used
There are new RDM (Remittance Delivery Method) elements being added to Loop 1000B. These will be ignored in posting but need to be defined in the IG. These are the following:
POS# ID Min/Max Usage Req
Values
RDM Remittance Delivery Method
1400 1 S
RDM01 Report Transmission Code
ID 1--2 BM, EM, FT, OL
RDM02 Name AN 1--60
RDM03 Communication Number
AN 1--256
RDM04 Not Used N/U
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There is a new DTM (Coverage Expiration Date) element for 5010. This segment explains that coverage was denied because the patient's coverage has expired. The new values are below:
POS# ID Min/Max Usage Req
Loop Repeat
Values
DTM Coverage Expiration Date
0500 1 S
DTM01 Date/Time Qualifier
ID 3--3 R 050
DTM02 Date* DT 8--8 R CCYYMMDD
DTM03 N/U
*This is the date on which the patient's coverage expired.
There are new Claim Received Date Elements (DTM) in Loop 2100. These have been added to the IG so that they are recognized if they are received. They are not used in posting a remit, however. Here are the new values:
POS# ID Min/Max Usage Req
Loop Repeat
Values
DTM Claim Received Date
0500 1 S
DTM01 Date/Time Qualifier
ID 3--3 R 050
DTM02 Date* DT 8--8 R CCYYMMDD
DTM03 N/U
*This is the date that the claim was received by the payer.
The number of repeats for the REF Service Identification Element in Loop 2110 has been increased to 8 for 5010. The 4010 required only 7.
There is a new element for 5010 added to the IG in Loop 2110 (Service Payment Information): REF Healthcare Policy Identification. Here is a table of the values:
POS # ID Min/Max Usage Req
Loop Repeat
Values
REF HealthCare Policy Identification
1000 5 S
REF01 Reference Identification Qualifier
ED 2--3 R 0K
REF02 Healthcare Policy Identification
AN 1--50 R
Updates to reports:
Claim Preview Report now includes:
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any suffix after the patient's name (Segment NM107 in Loop 2100).
the Coverage Expiration Date for an expired policy (DTM Coverage Expiration Date in Loop 2100).
the Claim Received Date, which shows the date the claim was received by the payer (DTM Claim Received Date in Loop 2100).
Claim Details Report now includes:
any suffix after the patient's name (Segment NM107 in Loop 2100).
the Claim Received Date, which shows the date the claim was received by the payer (DTM Claim Received Date in Loop 2100).
the specific amounts of a claim (REF Healthcare Policy Identification in Loop 2110).
Remittance posting includes Coverage Expiration Date in Loop 2100.
25 Changes to the 5010 Eligibility IG.
Element Location Modification
ISA11 (Interchange Control Standards ID)
Interchange Control Header Was previously hardcoded to U, but is now blank.
ISA12 (Interchange Control Version Number)
Interchange Control Header Replaced 00401 with 00501 for use with 5010.
GS08 (Version/Release/Industry Identifier Code)
Function Group Header Updated from 004010X092 to 005010X279
ST03 (Implementation Convention Reference)
Transaction Set Header This is a new segment added after ST02 and hardcoded to 00510X279.
NM112 (Name Last or Organization Name)
Loop 2100A This is a new element for 5010.
NM112 (Name Last or Organization Name)
Loop 2100B This is a new element for 5010.
REF04 (Reference Identifier) Loop 2100B This is a new element for 5010
NM107 (Name Suffix) Loop 2100C The insured person's name Suffix has been made available as a data element.
NM112 (Name Last or Organization Name)
Loop 2100C This is a new element for 5010.
REF04 (Reference Identifier) Loop 2100C This is a new element for 5010.
N407 (Country Subdivision Code)
Loop 2100C This is a new element for 5010.
DMG10 (Code List Qualifier Code)
Loop 2100C This is a new element for 5010.
DMG11 (Industry Code) Loop 2100C This is a new element for 5010.
DTP01 (Date/Time Qualifier) Loop 2100C This has changed from 472 to
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291.
EQ01 (Service Type Code) Loop 2110C New codes have been added. In addition, there is a new data element that takes the value from the appointment. If that value is null, it takes the value from practice preferences. If that value is null, 30 (Health Benefit Plan Coverage) is hardcoded. The latter is current functionality.
NM107 (Name Suffix) Loop 2100D The patient name suffix is added.
NM112 (Name Last or Organization Name)
Loop 2100D This is a new element for 5010.
REF04 (Reference Identifier) Loop 2100D This is a new element for 5010.
N407 (Country Subdivision Code)
Loop 2100D This is a new element for 5010.
DMG10 (Code List Qualifier Code)
Loop 2100D This is a new element for 5010.
DMG11 (Industry Code) Loop 2100D This is a new element for 5010.
EQ01 (Service Type Code) Loop 2110D New codes have been added. In addition, there is a new data element that takes the value from the appointment. If that value is null, it takes the value from practice preferences. If that value is null, 30 (Health Benefit Plan Coverage) is hardcoded. The latter is current functionality.
REF04 (Reference Identifier) Loop 2110D This is a new element in 5010.
The following PER segments have been deleted from Loop 2100B:
ID Min/Max Usage Req
Values
PER Information Receiver Contact Information
3 S
PER01 Contact Function Code
ID 2--2 R IC
PER02 Name AN 1--60 S
PER03 Communication Number Qualifier
ID 2--2 S ED, EM, FX, TE
PER04 Communication Number
AN 1--80 S
PER05 Communication Number
ID 2--2 S ED, EM, EX, FX, TE
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Qualifier
PER06 Communication Number
AN 1--80 S AAABBBCCCC
PER07 Communication Number Qualifier
ID 2--2 S ED, EM, EX, FX, TE
PER08 Communication Number
AN 1--80 S AAABBBCCCC
PER09 Contact Inquiry Reference
AN 1--20 N/U
Revenue Management Configuration and Setup Changes
Several changes have been made to Revenue Management to simplify the setup and
configuration process. Among them are the following:
Eliminated the Alias table for ERA processing. The user will not need to choose the practice or payor information for ERA processing. Instead, information from the ERA file itself is used to process the ERA file. The Pay To field from Loop 1000B (practice or provider) and the Payer Name field from Loop 1000A Segment N102 (payer information) directly match the information sent out on the claim and will be used, eliminating these steps.
Allowing the user to edit the Receiver table directly, bypassing the wizard. Certain sections of the table remain locked, however.
Allow the user to log in to Revenue Management automatically from Medisoft.
Simplify the setup of ERA. Assign Posting codes will be populated by default with the appropriate payment codes that reference carrier-specific codes in Medisoft. In addition, there is a set of default ERA posting defaults in the Remit Posting Code window in Revenue Management. If Use Insurance Posting Codes is checked and there are no carrier-specific codes, these new Default Posting Codes will be sent.
Navigating in Lytec
Lytec 2010 and later has an improved user interface that uses ribbon technology. Ribbons are a new type of Microsoft user interface (introduced with Office 2007) and streamline typical user actions by combining a command bar and a tab bar. This new combination creates a tab menu command bar located at the top of the application window.
After clicking the Lytec icon on your desktop, Lytec opens with the initial, limited ribbon menu featuring the Lytec button and the Help tab menu. The Help tab menu illustrates the
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combination of a tab bar and a command bar and displays commands horizontally instead of vertically.
Clicking the Lytec button displays key commands including Open Practice, New Practice, Backup and Restore Database, Migrate Legacy Databases, Register Program, Close Practice, and Exit. Backup and Restore Database is only available when a practice is not open and is not available when a practice is open. Close Practice is only available on the menu after a practice is open.
TIP: Double-clicking the Lytec button will also close the application.
When a practice is created, opened, or restored, the Lytec ribbon menu expands and displays all available options.
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To select a tab and display the available options, simply click the tab. As you move the mouse pointer over the available commands on the tab, the command is highlighted. Click to select the command. For instance, to open the Providers window, click the Lists tab and click Providers.
Menus also appear on tabs and are denoted by an arrow next to the command name. Click to display options on the menu. For instance, to open the Charges and Payments window, click Billing. Click Charges and Payments and select Charges and Payments.
The Lytec main window with the expanded ribbons interface illustrates key similarities and differences between Lytec 2010, 2011, and previous versions.
The ribbons interface features a title bar (Lytec 2011) with Minimize, Maximize, and Exit buttons. The title bar also displays the logged in user.
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The interface also uses a toolbar for quick access to key functions. Moving the mouse pointer over a button on the toolbar, reveals the name of the command. For more information on toolbar buttons, see the topic Toolbar.
You can also use keyboard shortcuts to access commands on the tab menus or on the toolbar. Press the ALT or F10 key to reveal the popup shortcuts. Then press the keyboard shortcut to launch a window or open a submenu (from the submenu, press another keyboard shortcut button to launch a window). For instance to open the Scheduling tab and view the Wait List, click and release the ALT key or F10 and then click the S key. Then click the W key. If you select the wrong tab (for instance the List tab instead of the Scheduling tab) press the ALT and this clears the shortcut keys for the tab menu. Press the ALT key again to display the shortcut keys for the tab menus and the toolbar.
Also click the TAB key and the CTRL key to display on a pop-up menu, open windows in the application and move between them using the arrow key.
Move between tabs on a window by clicking ALT and PAGE UP or PAGE DOWN
Remove a shortcut from the toolbar by right clicking the shortcut on the toolbar and selecting Remove from Quick Access Toolbar. For instance, to remove AR Work List, right-click the shortcut on the toolbar and then select Remove from Quick Access Toolbar.
You can also add commands from the tabbed menus by right-clicking the command and selecting Add to Quick Access Toolbar. For instance, if you click Lists, click Patient, and right-click Hold Codes, you can add this command to the toolbar by selecting Add to Quick Access Toolbar.
Restores default buttons that were deleted from the toolbar by clicking Tools, clicking Screen Display, and selecting Reset Quick Access Toolbar. Select this option to restore initial Lytec toolbar buttons.
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The toolbar also contains the Customize Quick Access Toolbar button . Click this button to change move the location of the ribbon or hide it. Select the Minimize the Ribbon command to increase workspace by only showing the full ribbon tabbed menus when you click the tabbed menu.
You can also select the Show Below the Ribbon command to move the toolbar below the tabbed menu.
You can quickly minimize, maximize, restore, and close windows.
Minimize Button Click the button at the top right corner of the window and the window will become a small icon at the bottom of the display.
Restore Button This button will restore the window to its original state.
Maximize Button This button will make the window fill the program display area.
Close Button This button will close the window.
Lists Tab
When you first launch Lytec and open a practice, the Lists tab menu is selected.
Patient Lists Group - Patient Drop-Down Menu
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Element/Command Definition/Function
Patients Launches the Patient Edit window for the last patient accessed unless the program option is selected to open to the entire Patient List. If the program option is selected, the list will open, however, the last patient accessed will be highlighted.
Ctrl + P
Merge Patients Launches the Merge Patient utility, which will allow you to merge two patient records.
Hold Codes Launches the Hold Code Edit/Entry window.
Notes Reminder Launches the Notes Reminders Edit/Entry window.
Patient Codes Launches the Patient Codes Edit/Entry window.
Patient Types Launches the Patient Types Edit/Entry window.
Default Patients Launches the Default Patient window, which mirrors the patient entry window and is used to specify which values will be defaulted when a new patient is created.
List Family Members Opens the List Family Members window, which allows the user to see all members of a single family.
EDI Notes Launches the select patient window and highlights the last patient who was accessed. When a patient is selected, it will open the EDI Notes screen for that patient. This is used to attach extra information to the claims submitted for the patient.
Patient Notes Launches the Find Patient window and highlights the last patient who was accessed and when a patient is selected, it will open the patient notes window for that patient.
Delete Inactive Patients Opens the Delete Inactive Patients window, which allows users to purge inactive patients from the data.
Archive Inactive Patients Opens the Archive Inactive Patients window, which allows users to archive inactive patients. Archiving allows for later retrieval.
Unarchive Inactive Patients Opens the Unarchive Patients window, which allows users to retrieve archived patients.
Delete Archived Patients Opens the Delete Archived Patients window, which allows users to delete archived patients.
Common Lists Group
Element/Command Definition/Function
Provider Launches the Provider Edit/Entry window.
Ctrl + K
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Referring Physicians Launches the Referring Physicians Edit/Entry window.
Transaction Code Launches the Transaction Code Edit/Entry window.
Ctrl + E
Diagnosis Code Launches the Diagnosis Code Edit/Entry window.
Ctrl + L
Insurance Companies Launches the Insurance Company Edit/Entry window.
Ctrl + I
Guarantors Launches the Guarantor Edit/Entry window.
Ctrl + G
Standard Lists Group - Standard Lists Drop-Down Menu
Element/Command Definition/Function
Practice Opens the Practice Information window where practice address information is stored.
EDI Receivers Launches the EDI Receivers Edit/Entry window.
Appointment Reason Codes Launches the Appointment Reason Codes Edit/Entry window.
Billing Status Codes Launches the Billing Status Codes Edit/Entry window.
Addresses Launches the Addresses Edit/Entry window.
A/R Management Status Launches the A/R Management Status Edit/Entry window.
A/R Management Tasks Launches the A/R Management Tasks Edit/Entry window.
Locations Launches the Locations Edit/Entry window.
Fee Schedule Types Launches the Fee Schedule Types Edit/Entry window.
Fee Schedules Launches the Fee Schedules Edit/Entry window.
Facilities Launches the Facilities Edit/Entry window.
Linked Transactions Launches the Linked Transaction Lines Edit/Entry window.
Laboratories Launches the Laboratories Edit/Entry window.
Place of Service Launches the Places of Service Edit/Entry window.
Insurance Categories Launches the Insurance Category Edit/Entry window.
Encoder Pro Group
Element/Command Definition/Function
Encoder Pro Opens the Encoder Pro window.
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Edit Tab
Clipboard Group
Element/Command Definition/Function
Undo If a record is being edited in any way, accessing this menu item will undo the last change that was made to the record.
Ctrl + Z
Cut Cuts the currently highlighted value and places it on the clipboard as long as the highlighted value is editable.
Ctrl + X
Copy Copies the currently highlighted value and placed it on the clipboard.
Ctrl + C
Paste Pastes the value currently residing in the clipboard into the field that currently has focus (as long as the value is valid for that field).
Ctrl + V
Select All Selects all records in the currently active set.
Search Group
Element/Command Definition/Function
Find Searches the selected data for a value.
Replace Replaces all values with a specified value within a specific record.
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Records Clipboard Group
Element/Command Definition/Function
Copy Record Copies the currently selected record and places it on the clipboard.
Cut Record Cuts the currently selected record and places it on the clipboard.
Past Record Pastes the record in the clipboard.
Scheduling Tab
Appointments and Tasks Group
Element/Command Definition/Function
Wait List Launches the Wait List window used to place people on a Wait List for an appointment.
Recall List Launches the Recall List that shows all appointments with a status of recall. This list is used to schedule their recall appointments.
Task List Launches the Task List specific to the current day's tasks.
Journal Launches the Journal which is used for free-form notes related to the appointments.
Schedule Appointments Launches the Appointment Scheduler to today's date and the default resource single day view.
Ctrl + S
Delete Appointments Opens the Delete Appointments window, which allows users to purge appointments from the data.
Delete Archived Appointments
Opens the Delete Appointments window, which allows users to delete appointments which have been archived.
Archive Appointments Opens the Archive Appointments window, which allows users to archive appointments. Archiving allows for later retrieval.
Unarchive Appointments Opens the Unarchive Appointments window, which allows users to retrieve appointments which have been
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archived.
Display Components Group
Element/Command Definition/Function
Calendar If selected while within the Appointment Scheduler and the calendar is visible, it will remove the calendar from view. If accessed while the toolbar is not visible, it will allow the user to view and access the Calendar.
Appointment Detail If selected while within the Appointment Scheduler and the Appointment Detail panel is visible, it will remove the Appointment Detail panel from view. If accessed while the Appointment Detail panel is not visible, it will allow the user to view and access the Appointment Detail panel.
Billing Tab
Billing and Collections Group - Charges and Payments Drop-Down Menu
Element/Command Definition/Function
Charges and Payments Launches the Charges and Payments window to the last patient accessed. If the program option is selected to show the patient list on entry, then the user would be presented with the list of patients with the last selected patient highlighted.
Ctrl + B
Generate Finance Charges Launches the Generate Finance Charges window used to charge interest to patients with overdue accounts.
Delete Paid Billings Opens the Delete Paid Billings window which allows users to purge paid billings from the data.
Archive Paid Billings Opens the Archive Paid Billings window which allows users to archive paid billings. Archiving allows for later retrieval.
Unarchive Billings Opens the Unarchive Billings window which allows users to retrieve billings which have been archived.
Delete Archived Billings Opens the Delete Archived Billings window which allows users to delete billings which have been archived.
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Billing and Collections Group
Element/Command Definition/Function
Pending Transactions Launches the Pending Transactions window used for processing transactions that are brought into Lytec from the Communication Manager.
Ctrl + 0 (Zero)
A/R Management Tool Launches the Filter A/R Management Tool window so the user can filter the collection (A/R Management) tasks. Once the filters are selected, the AR Management window will open allowing the user to proceed through the patient/insurance collection process.
A/R Work List Automatically launches the AR management window with a filter for the currently logged in user. Allows the user to proceed through the patient/insurance collection process.
A/R Management Notes Launches the Find Patient window and highlights the last patient who was accessed. When a patient is selected, the screen will display all the notes that have been placed on the patient file through the AR Management tool.
View Eligibility Results Launches the Eligibility Verification screen, which will display all the results of the Eligibility checks done in the practice.
Statement Messages Launches the Statement Messages window, which allows the users to configure custom messages for inclusion on patient statements including global messages, dunning messages, etc.
Billing and Collections Group - Statement Processing drop-down list
Element/Command Definition/Function
Transmit File Launches a Windows search panel to the last place it was previously opened. From here you will be able to select a statement form to transmit.
eApprove Files Launches the BillFlash web site in your default browser, opening to the eApprove Files page on which you can approve files that have been uploaded.
eView Statements Launches the BillFlash web site in your default browser, opening to the eView Statements page on which you can view statement files that have been uploaded.
eView Reports Launches the BillFlash web site in your default browser, opening to the eView Reports page on which you can open reports on files that have been uploaded.
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Enroll Enroll Launches the BillFlash web site in your default browser, opening to the Enroll page on which you can enroll with BillFlash.
BillFlash Account Launches the BillFlash web site in your default browser, opening to your Account page on which you can view or make changes to your account.
Billing and Collections Group - Revenue Management drop-down list
Element/Command Definition/Function
Revenue Management Launches the Revenue Management utility used for submitting electronic claims.
Revenue Management Reports
Launches Revenue Management Reports utility used for generating reports based on electronic claim data
Billing and Collections Printing Group - Print Insurance Claims Drop-Down Menu
Element/Command Definition/Function
Print Insurance Claims Launches a Windows search panel to the last place it was previously opened. Additionally, the last file that was accessed from this window is highlighted in subsequent launches of the window. From here the user will select an lci file used to print paper insurance claims or generate a text file. Once users select the file they would like to use, they will be brought through the paper claim process.
Reprint Insurance Claims Launches the Reprint Insurance Claims window, which will initiate the process of reprinting claims that were printed on a specific date.
Print Insurance Labels Launches the Print Insurance Labels window used to print labels for the insurance carriers to which the user will be sending paper claims.
Print Insurance Traces Launches a windows search panel to the last place it was previously opened. Additionally, the last file that was accessed from this window is highlighted in subsequent launches of the window. From here the user will select an lci or lns file used to print insurance tracers or generate a text file. Once users select the file they would like to use, they will be brought through the print insurance tracer process.
Print EDI Notes Launches a windows search panel to the last place it was previously opened. Additionally, the last file that was accessed from this window is highlighted in subsequent launches of the window. From here the user will select an lcn file used to print an EDI note. Once the user selects the file they would like to use, they will be brought through print EDI note process.
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Billing and Collections Printing Group - Print Statements drop-down menu
Element/Command Definition/Function
Print Statements Launches a Windows search panel to the last place it was previously opened. Additionally, the last file that was accessed from this window is highlighted in subsequent launches of the window. From here the user will select an lcs file used to print patient statements or generate a text file. Once users select the file they would like to use, they will be brought through the print patient statement process.
Ctrl + W
Reprint Statements Launches a window that allows you to select a date for which you would like to reprint statements. All statements sent on that date would then be reprinted.
Print Billing Cycle Statements Launches a Windows search panel to the last place it was previously opened. Additionally, the last file that was accessed from this window is highlighted in subsequent launches of the window. From here the user will select an lcs file used to print patient statements or generate a text file. Once users select the file they would like to use, they will be brought through the print patient statement process. The difference between this and the Print Statements option is that the Billing Cycle Statements will only print one per month for any patient/guarantor, allowing the office to send statements more regularly than once a month.
Collection Letters Launches a windows search panel to the last place it was previously opened. Additionally, the last file that was accessed from this window is highlighted in subsequent launches of the window. From here the user will select an lcc file used to print patient collection letters or generate a text file. Once users select the file they would like to use, they will be brought through the print collection letter process.
Billing and Collections Printing Group
Element/Command Definition/Function
Open Print Jobs Launches the Open Print Jobs window, which allows you to see what you are printing from Lytec, and cancel any desired jobs.
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Payments Tab
Payments Group
Element/Command Definition/Function
Apply Patient Payment Launches the Apply Patient Payment window used for entering and applying a patient payment to the charges in a patient account.
Apply Insurance Payment Launches the Apply Insurance Payment window used for entering EOBs from a single insurance carrier for multiple patients.
Small Balance Write Off Launches the Small Balance Write-off window used to write off patient balances that the office no longer wishes to collect.
Insurance Ledger Launches the Insurance Ledger window used to review all transactions posted to a specific insurance carrier.
Patient Ledger Launches the Patient Ledger window used to review a patient, guarantor, or family account.
Payments Group - Apply Manage Care Payment Drop-Down Menu
Element/Command Definition/Function
Manage Care Payments Launches the Managed Care window used to collect payments from managed care (capitated) plans that are not applied to specific charges.
Delete Manage Care Payments
Opens the Delete Managed Care Payments window, which allows users to delete managed care payments.
Quicken - Quickbooks Group
Element/Command Definition/Function
Quicken Allows Lytec users to export a QIF file from Lytec for use in posting payments into Quicken.
QuickBooks Allows Lytec users to export a IIF file from Lytec for use in posting payments into Quick Books.
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Reports Tab
Quick Reports Group
Element/Command Definition/Function
Day Sheet Launches the Day Sheet report to the data filters screen.
Transaction Journal Launches the Transaction Journal report to the data filters screen.
Practice Analysis Launches the Practice Analysis report to the data filters screen.
Reports Group- Summary Reports drop-down list
Element/Command Definition/Function
Monthly Summary Launches the Monthly Summary report to the data filters screen.
Yearly Summary Launches the Yearly Summary report to the data filters screen.
Sales Tax Report Launches the Sales Tax report to the data filters screen.
Refund Report Launches the Refund report to the data filters screen.
A/R Management Summary Launches the A/R Management Summary report to the data filters screen.
Reports Group - Analysis Reports drop-down list
Element/Command Definition/Function
Procedure Code Analysis Detail
Launches the Procedure Code Analysis - Detail report to the data filters screen.
Procedure Code Analysis Summary
Launches the Procedure Code Analysis - Summary report to the data filters screen.
Diagnosis Code Analysis Detail
Launches the Diagnosis Code Analysis - Detail report to the data filters screen.
Diagnosis Code Analysis Summary
Launches the Diagnosis Code Analysis - Summary report to the data filters screen.
Referring Physician Analysis Launches the Referring Physician Analysis report to the
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data filters screen.
Appointment Eligibility Analysis - Detail
Launches the Appointment Eligibility Analysis – Detail report to the data filters screen
Appointment Eligibility Analysis - Summary
Launches the Appointment Eligibility Analysis – Summary report to the data filters screen
Electronic Claims Analysis - Detail
Launches the Electronic Claims Analysis - Detail report to the data filters screen
Electronic Claims Analysis - Summary
Launches the Electronic Claims Analysis - Summary report to the data filters screen
Reports Group - Patient drop-down list
Element/Command Definition/Function
Wait List Launches the Wait List report to the data filters screen.
Patient Ledger Launches the Patient Ledger report to the data filters screen.
Patient Balances Launches the Patient Balance report to the data filters screen.
Patient Procedure Report Launches the Patients by Procedure report to the data filters screen.
Patient Diagnosis Report Launches the Patients by Diagnosis report to the data filters screen.
Patient Statistics Launches the Patient Statistics report to the data filters screen.
Patient By Hold Code Launches the Patients by Hold Code report to the data filters screen.
Prepayment Activity Launches the Prepayment Activity report to the data filters screen.
Patient Payment Annual Detail
Launches the Patient Payment Annual Detail (Tax) report to the data filters screen.
Reports Group - Audit Trail drop-down list
Element/Command Definition/Function
Audit Trail Launches the Audit Trail report to the data filters screen.
Billing Reconciliation To Appointments
Launches the Billing Reconciliation to Appointments report to the data filters screen.
Login History Launches the Login History report to the data filters screen.
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Reports Group - Billings drop-down list
Element/Command Definition/Function
Waiting Claims Launches the Waiting Claims report to the data filters screen.
Pending Claims Launches the Pending Claims report to the data filters screen.
Statement Pre-Run Launches the Statement Pre-Run report to the data filters screen.
Billing History Launches the Billing History report to the data filters screen.
Item Billing History Launches the Item Billing History report to the data filters screen.
Reports Group - Family Reports drop-down list
Element/Command Definition/Function
Responsible Party Launches the Family Responsible Party report to the data filters screen.
Dependent Launches the Family Dependent report to the data filters screen.
Reports Group - List Reports drop-down list
Element/Command Definition/Function
Patients
Launches the Patient List report to the data filters screen.
Archived Patients
Launches the Archived Patients List report to the data filters screen.
Inactive Patients
Launches the Inactive Patients List report to the data filters screen.
Guarantors
Launches the Guarantor List report to the data filters screen.
Providers
Launches the Provider List report to the data filters screen.
Insurance Companies Launches the Insurance Company List report to the data filters screen.
Transaction Codes
Launches the Transaction Code List report to the data filters screen.
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Diagnosis Codes
Launches the Diagnosis Code List report to the data filters screen.
Hold Codes
Launches the Hold Code List report to the data filters screen.
Notes Reminder
Launches the Notes Reminders List report to the data filters screen.
Facilities
Launches the Facilities List report to the data filters screen.
Referring Physicians
Launches the Referring Physicians List report to the data filters screen.
Addresses
Launches the Address List report to the data filters screen.
Laboratories
Launches the Laboratories List report to the data filters screen.
Place of Service
Launches the Place of Service List report to the data filters screen.
Patient Codes
Launches the Patient Codes List report to the data filters screen.
Patient Types
Launches the Patient Type List report to the data filters screen.
Billing Status Code Launches the Billing Status Codes List report to the data filters screen.
Insurance Categories
Launches the Insurance Category List report to the data filters screen.
Appointment Reason Codes
Launches the Appointment Reason Code List report to the data filters screen.
Locations
Launches the Location List report to the data filters screen.
EDI Receivers
Launches the EDI Receiver List report to the data filters screen.
Fee Schedule Types
Launches the Fee Schedule Type List report to the data filters screen.
Fee Schedules Launches the Fee Schedule List report to the data filters screen.
A/R Management Status
Launches the A/R Management Status List report to the data filters screen.
A/R Management Tasks
Launches the A/R Management Tasks List report to the data filters screen.
User Security
Launches the user Security List report to the data filters screen.
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Reports Group - Inventory Reports drop-down list
Element/Command Definition/Function
Inventory Sales Launches the Inventory Sales report to the data filters screen.
Inventory Re-Order Launches the Inventory Reorder report to the data filters screen.
Reports Group - Aging Reports drop-down list
Element/Command Definition/Function
Patient Aging
Launches the Patient Aging report to the data filters screen.
Insurance Aging
Launches the Insurance Aging report to the data filters screen.
Service Aging Launches the Service Aging report to the data filters screen.
Credit Balance Aging
Launches the Credit Balance report to the data filters screen.
AR Totals Aging
Launches the AR Totals report to the data filters screen.
Reports Group - Labels drop-down list
Element/Command Definition/Function
Patient Labels
Launches the Patient Labels report to the data filters screen.
Insurance Companies Labels
Launches the Insurance Company Labels report to the data filters screen.
Facility Labels
Launches the Facility Labels report to the data filters screen.
Referring Physician Labels
Launches the Referring Physician Labels report to the data filters screen.
Address Labels
Launches the Address Labels report to the data filters screen.
Reports Group - Custom Reports drop-down list
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Element/Command Definition/Function
Create Custom Reports
Launches the Custom Report Designer in order to create a new report.
Edit Custom Report
Launches the Custom Report Designer in order to edit an existing report.
Print Custom Report
Allows you to print any of the custom reports created or edited by the user.
Reports Group - Insurance Reports drop-down list
Element/Command Definition/Function
Charge Analysis Launches the Insurance Charge Analysis report to the data filters screen.
Payment Analysis
Launches the Insurance Payment Analysis report to the data filters screen.
Reimbursement Analysis
Launches the Insurance Reimbursement Analysis report to the data filters screen.
Policy Report
Launches the Insurance Policy Report to the data filters screen.
Manage Care Analysis
Launches the Managed Care Analysis report to the data filters screen.
Transaction Code Analysis
Launches the Transaction Code Analysis report to the data filters screen.
Insurance Lag Report
Launches the Insurance Lag Report to the data filters screen.
Authorization Referral List
Launches the Authorization/Referral List report to the data filters screen.
Authorization Referral Detail Launches the Authorization/Referral Detail report to the data filters screen.
Reports Group - Advanced Reporting drop-down list
Element/Command Definition/Function
Launch
Launches the Advanced Reporting module.
Schedule
Launches the Task Scheduler in order to schedule a report as part of the Advanced Reporting module.
Administrate
Allows users to select which Advanced Reports would be available within Lytec.
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Bundle Report
Launches the Bundle Import process for importing customized Advanced Reports.
Reports Group - Graphs drop-down list
Element/Command Definition/Function
Charges By Transaction Code
Allows the user to print a graph report called Charges by Transaction Code.
Charges By Diagnosis Code Allows the user to print a graph report called Charges by Diagnosis.
Charges By Provider
Allows the user to print a graph report called Charges by Provider.
Reports Setup Group - Print Options drop-down menu
Element/Command Definition/Function
Label Options
Opens a window labeled Print Labels Options, which allows the user to configure the label type, margins, fonts, and label specifications for the labels that are printed from within Lytec.
Graphic Categories
Launches the Graphics Categories window, which allows the users to create categories for transaction and diagnosis codes in order to better group the transactions together on the graphs printed from within Lytec.
Print Setup
Opens a window that allows the user to configure the default printer that will be utilized by the reports, claims, and statements printed from within Lytec. This window is labeled Print Setup.
Predefined Reports
Opens a window labeled Print Report Options which allows the user to configure various font settings and margins for the reports printed out of Lytec.
Tools Tab
Data Control Group
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Element/Command Definition/Function
Backup Data Initiates the backup creation process to the screen where the backup type is specified.
Restore Data Brings up a backup reminder window that gives the user the option to backup data now. Once the backup is complete, or if the user chooses not to backup, the currently open practice will close, and the restore process is initiated beginning with the screen where the restore type is specified.
Rebuild Data Files Opens the Rebuild Data Files window, which is used to rebuild structures, recalculate balances, and shrink the size of the data. This is part of the database maintenance process.
View Backup Launches the View Backup window.
Convert Images Converts the images stored in Lytec from the previous, proprietary format to a standard jpg format in order for inclusion on reports.
Data Control Group - Import Drop-Down Menu
Element/Command Definition/Function
Procedure Code Launches a Windows Open File window labeled Import Procedure Codes that opens to the last location accessed from that window that is looking for Procedure Code Files (.pcf). If one of those files are accessed and opened, the procedure code import process will be invoked. This is used to import codes purchased from Lytec.
Diagnosis Code Launches a Windows Open File window labeled Import Diagnosis Codes that opens to the last location accessed from that window that is looking for Diagnosis Code Files (.dcf). If one of those files are accessed and opened, the diagnosis code import process will be invoked. This is used to import codes purchased from Lytec.
Patient Launches a Windows Open File window labeled Import File that opens to the last location accessed from that window that is looking for text files in a comma delimited format. If one of those files are accessed and opened, the import patient process will be invoked. This is used to import patients that were exported by Lytec into a comma delimited text file.
Guarantor Launches a Windows Open File window labeled Import File that opens to the last location accessed from that window that is looking for text files in a comma delimited format. If one of those files are accessed and opened, the import guarantor process will be invoked. This is
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used to import exported that were exported by Lytec into a comma delimited text file.
Insurance Launches a Windows Open File window labeled Import File that opens to the last location accessed from that window that is looking for text files in a comma delimited format. If one of those files are accessed and opened, the import insurance carrier process will be invoked. This is used to import insurance carriers that were exported by Lytec into a comma delimited text file.
Transaction Code File Launches a Windows Open File window labeled Import File that opens to the last location accessed from that window that is looking for text files in a comma delimited format. If one of those files are accessed and opened, the import Transaction Code process will be invoked. This is used to import transaction codes that were exported by Lytec into a comma delimited text file.
Diagnosis File Launches a Windows Open File window labeled Import File that opens to the last location accessed from that window that is looking for text files in a comma delimited format. If one of those files are accessed and opened, the import diagnosis process will be invoked. This is used to import diagnosis codes that were exported by Lytec into a comma delimited text file.
Address Launches a Windows Open File window labeled Import File that opens to the last location accessed from that window that is looking for text files in a comma delimited format. If one of those files are accessed and opened, the import address process will be invoked. This is used to import addresses that were exported by Lytec into a comma delimited text file.
Billing Header Launches a Windows Open File window labeled Import File that opens to the last location accessed from that window that is looking for text files in a comma delimited format. If one of those files are accessed and opened, the import billing header process will be invoked. This is used to import billing headers that were exported by Lytec into a comma delimited text file.
Billing Detail Launches a Windows Open File window labeled Import File that opens to the last location accessed from that window that is looking for text files in a comma delimited format. If one of those files are accessed and opened, the import billing header process will be invoked. This is used to import billing headers that were exported by Lytec into a comma delimited text file.
Transaction Launches a Windows Open File window labeled Import File that opens to the last location accessed from that window that is looking for text files in a comma delimited format. If one of those files are accessed and opened, the import transaction process will be invoked. This is used to import transactions that were exported by Lytec into a comma delimited text file.
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Data Control Group - Export Drop-Down Menu
Element/Command Definition/Function
Patient Invokes the export Patient process, which will create a comma delimited file containing the patient records that qualify under the filters selected.
Guarantor Invokes the export guarantor process, which will create a comma delimited file containing the guarantor records that qualify under the filters selected.
Insurance Invokes the export insurance process, which will create a comma delimited file containing the insurance carrier records that qualify under the filters selected.
Transaction Code File Invokes the export transaction code process, which will create a comma delimited file containing the transaction code records that qualify under the filters selected.
Diagnosis File Invokes the export diagnosis code process, which will create a comma delimited file containing the diagnosis code records that qualify under the filters selected.
Address Invokes the export address process, which will create a comma delimited file containing the address records that qualify under the filters selected.
Billing Header Invokes the export billing header process, which will create a comma delimited file containing the billing header records that qualify under the filters selected.
Billing Detail Invokes the export billing detail process, which will create a comma delimited file containing the billing detail records that qualify under the filters selected.
Transaction Invokes the export transaction process, which will create a comma delimited file containing the transaction records that qualify under the filters selected.
Electronic Prescribing Group
Element/Command Definition/Function
ePrescribing Launches a web browser to OnCallData's web site in order to process electronic prescriptions.
ePrescribing Settings Launches the Electronic Prescribing Settings window used to configure the settings necessary to transmit electronic prescriptions to OnCallData.
Task Scheduler Group - Task Scheduler Drop-Down Menu
Element/Command Definition/Function
Schedule Backup Launches the Task Scheduler to a state that will only
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allow you to add/view scheduled backup tasks.
Schedule Eligibility Launches the Task Scheduler to a state that will allow you to add/view scheduled eligibility verification tasks.
Schedule Rebuild Launches the Task Scheduler to a state that will allow you to add/view scheduled data rebuild tasks.
Scheduled Tasks Launches the Scheduled Tasks window which displays tasks that have been scheduled.
Display Components group - Screen Display drop-down menu
Element/Command Definition/Function
Cascade Windows Arranges the open Lytec windows in cascading format.
Tile Windows Tiles the open Lytec windows.
Arrange Icons Moves the title bars of open windows to the lower left portion of the Lytec screen.
Close All Windows Closes all open Lytec windows without closing the application.
Lock Screen If selected while the status bar is visible, it will remove the status bar from view. If accessed while the status bar is not visible, it will allow the user to view and access the bar.
Reset Quick Access Toolbar Restores default buttons that were deleted from the toolbar. Select this option to restore initial Lytec toolbar buttons.
Admin Tab
Security Group
Element/Command Definition/Function
Change Password Launches the Change Password window, which will allow the currently logged in user to change his/her password.
Audit Trail Launches the Audit Trail Settings window, which is used
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to configure which functions within Lytec will be monitored within the audit trail.
Preferences Opens the preferences window, which is used to specify practice specific settings in more area than is possible with the Practice Information window.
User Preferences Launches the User Preferences window, which is used to configure program settings specific to the user who is logged in to that instance of Lytec.
Users Security Profiles Launches the Users window, which is used to set up specific users in the current practice.
Server Logins Launches the manage logins window, which shows the Admin, DBA, Practice List, and Report passwords used to access the data via the SQL management suite.
User Types Launches the User Type list window where the different types of users would be specified. This allows users to configure security access permissions for a large number of users without requiring the administrator to setup each individual user. The administrator can set up groups and then assign the groups to individual users.
Administration Group
Element/Command Definition/Function
Communications Manager Launches the Communication Manager program used to setup the HL7 link between Lytec and various other interfaced products.
Administrative Dashboard Launches the Administrative Dashboard used by administrators to track the data within the practice as well as users currently logged in.
Custom Fields Launches the Custom Fields window, which allows users to set up custom data fields within the Patient, Provider, Insurance, Address, Billing, and Billing Detail lists.
Online Update Settings Allows the user to configure when online updates is invoked.
Help Tab
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Help Group
Element/Command Definition/Function
Help Topics Launches the Lytec Help file.
F1
Register Program Allows you to register Lytec, or view the currently entered registration information.
Knowledge Base Launches a web browser to the Lytec Knowledge Base.
About Launches a splash screen that shows the version of Lytec being run.
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Setting up the Program
Setting up the Program
Before you can use the Lytec program, you have to create a practice. You might only need to create one practice, but you can create multiple practices if necessary.
Creating a Practice
To create a practice in Lytec, click the Lytec button and select New Practice. The New Practice window opens.
Practice Name: Enter the name of your practice.
SYSTEM Password: Enter the SYSTEM user password for the practice.
Confirm Password: Reenter the SYSTEM user password for the practice.
Opening a Practice
To open a practice in Lytec, click the Lytec button and select Open Practice. The Practice List window opens.
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Open Practice: Click the Open Practice button to access the selected practice.
New Practice: Click the New Practice button to create a practice that does not appear in the list.
Browse: Click Browse to open an existing data that is not in the Practice List window.
Delete: Click the Delete button to remove the selected practice from the Practice List window. When you click Delete, you are not deleting the actual data files. You are just removing the name of the practice from the Practice List window and, therefore, from access in the program.
Rebuild Index: Click the Rebuild Index button to rebuild the database list index.
Add Tutorials: Click the Add Tutorials button to add the tutorial practice, Centertown Offices, to the Practice List window. When you add the tutorial practice to the Practice List window, this button will disappear. It reappears if you delete the tutorial practice from the Practice List window.
Customizing Your Program
There are various ways in which you can customize your program for more efficient use.
Patients Window Tab Order
You can customize the order in which fields are accessed in the Patients window by setting the tab order in the Default Patient or the Quick Add – Patients window. This way you can move directly to those fields that you usually populate (or that are required to save the record) and skip the others.
To make changes to the Patients window tab order, follow these steps:
1. Click Lists and click Patient. Select Default Patients. The Default Patient window opens.
2. Click the Tab Order button and select Set Tab Order.
3. Blue squares appear next to fields, showing the current tab order. Click the blue boxes in the same order that you want the cursor to move in the window. When done, click Tab Order and select Record Stop.
4. Select Save Tab Order or Save Tab Order As. Give the tab order an easily identifiable name. Click OK.
5. Select Load Tab Order in the Tab Order menu. Highlight the tab order template you want, click the Set Default button (if you want this layout every time you open the Patients window), and click OK. If you only want to use the tab order while you currently have the window open, don’t click Set Default.
6. You can also select the tab order in the Patients window by clicking the Patient button and selecting Load Tab Order.
Window Position and Size
Each lookup window is moveable and resizable and its position and size are remembered when you close the window. The next time you open the window, it will be in the same place and the same size as you left it.
F1 Look up Save Window Position and Size.
Edit Layout
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To display more of the information you need to see, you can modify, add, or remove fields shown in a lookup window or in Charges and Payments.
F1 Look up Lookup Window and Edit Layout.
Charges and Payments Layout
Governed by security permissions, you can change the layout of two grids in the Charges and Payments window. The Header grid is provided so you can display information that is not already showing in this window. You can also modify which columns are displayed and their position in the Detail Items grid.
F1 Look up Edit Layout.
Report Ranges
You can enter ranges for each report, save them, and then load them when you next select the report. For example, you may need to subtotal the Day Sheet by location every time you print that report. Since the option to Subtotal by location is not selected by default, you can select the option, save the range, and set it to be your user default. Then every time you go into the Day Sheet, the Subtotal by location option is automatically checked.
To access the report range options, click the Option button in any report, claim, or statement. You can load existing ranges, save the current ranges, and delete ranges.
F1 Look up Save Report Ranges.
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Setting up the Practice Once you have the program set up, the next step is to enter data into each of the different areas of the program, i.e., entering insurance company records in the Insurance Companies window, entering transaction codes in the Transaction Codes window, and so on. Here is a sequence for practice setup that should help you enter your practice information without moving back and forth between windows. You will set up elements (records) that are referred to in other records and grid entries.
1. Set up security
2. Set up preferences
3. Enter practice information on the Practice Information window, Practice Settings tab,
4. Set up EDI Receivers,
5. Enter insurance company records,
6. Enter facility records,
7. Enter practice information on the Practice Information window, Practice IDs tab,
8. Enter provider records,
9. Enter referring physician records,
10. Enter transaction codes,
11. Enter diagnosis codes,
12. Enter other address records,
13. Enter guarantor records,
14. Set up patient records.
Keeping in mind your practice structure and your filing needs will help you set up your practice. Also consider reviewing the Assigning Rules topic before completing grid entries on the Practice, Provider, Facility, and Referring Physician IDs tabs since these entries or rules determine what information is pulled/included in a print or electronic claim.
If you are a solo provider (file claims as an individual) then . . .
You can enter key elements like NPI, taxonomy, and tax ID/social security number, on the Practice level in the Practice IDs grid. Then you would need to create at least one record (can create more if you have a different requirements from various insurance carriers) on the Provider IDs grid in which you select the From Practice button for these data elements. Selecting From Practice will pull these values for claims from the Practice IDs grid.
Or when setting up your practice (assuming you do not need to send taxonomy in Loop 200A), you could on the Practice IDs grid select None for NPI, taxonomy, tax ID/social security number and enter a minimal amount of information of Practice IDs grid (still need at least one record). You would then create at least one record on the Provider IDs grid in which you specify your NPI, taxonomy, tax ID/social security number.
You set your claim filing status on the Providers window on the Provider IDs matrix by selecting the Individual button for the provider in your practice. If you are solo than this might be the only rule (grid entry) you would need to complete on this window. Most likely though, you will probably have at least one or more insurance carriers that require different information, and in that case you would create other grid entries that are specific to that insurance company and the information needed, for instance a legacy qualifier such as a medicare number. Each of the additional entries would need to be complete since the claims processing pulls all the information in an entry and an incomplete entry (for instance, no NPI number) would not be included in the claim, causing rejection. If you file electronic claims and you have one or more insurance companies that require taxonomy in 2000A than you will also need to complete at least one record on the practice level on the Practice IDs tab. The taxonomy field in the
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Providers IDs matrix pulls in 2310b (used for groups). Importantly, if the insurance carrier requires taxonomy in 2000A, you would also need to go to the Insurance Companies window, look up the carrier's record, and select the Send Practice Taxonomy in Loop 2000A box on the Information tab. If your carrier requires dual taxonomy (both loops), then you would also put it at the provider level. For more information on taxonomy, look up Taxonomy.
If you have a facility attached to your practice, you would create that record on the Facility window. If your practice has referring physicians, then you would create those records on the Referring Physicians window.
You create/edit facilities in the Facilities window accessed by clicking Lists and clicking Standard Lists. Select Facilities. If you have enumerated a separate NPI number for your facility and need to send facility billing information in Loop 2420D or pull data for box 32 of the CMS 1500 form, you can specify the type of facility and qualifier (77- service location, FA - Facility, etc.) along with including a separate facility NPI number and if this information is sent on the claim by selecting the Send Facility on Claim check box and do not include any other data.
For more information, see the topic Facility Information.
Create/edit referring physicians in the Referring Physicians window accessed by clicking Lists and clicking Referring Physicians. In this record, you can link the facility to a particular insurance company/category, if needed, and include other billing details such as the referring physician's NPI, taxonomy, and other legacy IDs.
For more information, see the topic Referring Physician Information.
If you are a group (file claims as a group) then . . .
If you are a group practice, then you will complete at least one grid entry on the Practice IDs grid for the practice. You will also create at least one grid entry on the Provider IDs grid for each provider. If you have a provider that in some instances bills using his/her own NPI number, for a specific insurance company, you can create an extra grid entry for this provider, in which you specify the insurance company and select to pull the provider's NPI number from the Provider IDs grid. Depending on your carrier's taxonomy requirements, you will most likely enter taxonomy on the Provider level. The taxonomy field on the practice level on the Practice IDs grid pulls in 2000A (solo practices, not group practices) whereas the taxonomy field on the provider level pulls in 2310B. If your carrier requires dual taxonomy (both loops), then you would also put it at the practice level and go to the Insurance Companies window, look up the carrier's record, and select the Send Practice Taxonomy in Loop 2000A box on the Information tab. For more information on taxonomy, look up Taxonomy.
You set your claim filing status on the Providers window on the Provider IDs matrix by selecting the Group button for each provider in your practice. You will probably have at one or more insurance carriers that require different information, and in that case you would create other grid entries that are specific to that insurance company and the information needed, for instance a legacy qualifier such as a medicare number. Each of the additional entries would need to be complete since the claims processing pulls all the information in an entry and an incomplete entry (for instance, no NPI number) would not be included in the claim, causing rejection.
If you have a facility attached to your practice, you would create that record on the Facility window. If your practice has referring physicians, then you would create those records on the Referring Physicians window.
You create/edit facilities in the Facilities window accessed by clicking Lists and clicking Standard Lists. Select Facilities. If you have enumerated a separate NPI number for your facility and need to send facility billing information in Loop 2420D or pull data for box 32 of the CMS 1500 form, you can specify the type of facility and qualifier (77- service location, FA - Facility, etc.) along with including a separate facility NPI number and if this information is sent on the claim by selecting the Send Facility on Claim check box and do not include any other data.
For more information, see the topic Facility Information.
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Create/edit referring physicians in the Referring Physicians window accessed by clicking Lists and clicking Referring Physicians. In this record, you can link the facility to a particular insurance company/category, if needed, and include other billing details such as the referring physician's NPI, taxonomy, and other legacy IDs.
For more information, see the topic Referring Physician Information.
If you are a billing service or if your pay to address is different than your service address
If you are a billing service or have a different billing address from the pay to address, you will need to complete the Practice Information window, Practice Pay To tab in addition to the other tabs in the Practice Information window. The pay to address is populated in Loop 2010AB from information entered on this tab. Fields on this tab are also used for sending electronic claims and in reports (designed through the Custom Report writer).
NPI Setup Considerations for Solo Provider
If you are a solo provider (file claims as an individual) with the same pay to as your billing address (the Pay To tab is blank), you can enter your NPI information on the Practice IDs grid. In this case, you would select on the Providers IDs grid the From Practice button instead of selecting the National Provider ID button and entering an NPI number.
If you are a solo provider with different billing information and pay to information (the Pay To tab is complete), you can enter your NPI information on the Provider IDs grid. In this case, you would select on the Providers IDs grid the National Provider ID button and enter your NPI number. Entering the NPI number on the practice level is required in this case to pull your NPI number in Loop 2010AB. If you left it only on the practice level, the NPI number would not pull for this loop.
If you are a solo provider that has insurance carriers that require mixed NPI numbers (some require individual while some require a group) you would enter your group NPI number on the Practice IDs grid. You would then create an entry on the Provider IDs grid in which you would enter your individual NPI number on Provider IDs grid and apply it to all insurance companies, an insurance category, or a carrier (you could create several records if needed to address other issues such as legacy numbers, taxonomy, etc.). For those carriers that require the group NPI you would create at least one other separate entry on the Providers IDs grid (might need more depending on other issues such as legacy numbers, taxonomy, etc.) for that carrier or that insurance class in which you select the From Practice button instead of selecting the National Provider ID button and entering an NPI number.
NPI Setup Considerations for Groups
If you file claims as a group, you can enter your NPI information on the Practice IDs grid. In this case, you would select on the Providers IDs grid the From Practice button instead of selecting the National Provider ID button and entering an NPI number.
If you have insurance carriers that require mixed NPI numbers (some require individual NPI numbers while some require a group) you would enter your group NPI number on the Practice IDs grid. You would then create entries on the Provider IDs grid in which you would enter your the specific provider’s individual NPI number on Provider IDs grid and apply it to a specific insurance company or an insurance category (you could create several records if needed to address other issues such as legacy numbers, taxonomy, etc.). For those carriers that require the group NPI you would create at least one other separate entry on the Providers IDs grid (might need more depending on other issues such as legacy numbers, taxonomy, etc.) for that carrier or that insurance class in which you select the From Practice button instead of selecting the National Provider ID button and entering an NPI number.
Assigning Rules
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Lytec claim processing for both print and electronic claims depends on a series of flexible rules that you define on the various ID grids in the application. When setting up or updating your practice data, you will create a series of grid entries (rules) on the Practice IDs and Provider IDs grid. You may also use the Facility IDs and Referring Physician IDs grids depending on your practice structure. These grid entries that you complete contain your basic practice information such group or individual NPI, taxonomy, tax IDs, claim filing status (group or individual) and connect this information to the insurance carriers that your practice accepts and the doctors in your practice as a series of rules.
You begin by creating general entries for each provider on the Provider IDs grid and at least one entry on the Practice IDs grid level.
NOTE: the setup for solo providers offers more flexibility. For more information, see Practice Information
In these general entries you enter information that would apply the most generic situation. Then you would create other grid entries that apply to a specific insurance carrier, insurance category, facility, provider etc.
TIP: when creating or editing IDs grid entries, do not create matching wild card entries (all selected for insurance company and insurance category) since the rules engine would not know which row to select. If you had different legacy numbers, for instance in each entry, the system might not select the correct row. In this case, modify one of the wild card rows and apply it to a specific insurance company or category.
When you create claims, the application gathers general data and then selects data from the IDs grids by analyzing the entries (rows) on the various IDs grids. The process of selecting the correct row involves first selecting a row that applies to the insurance carrier or provider. If more than one row is present on the various ID grids, the application matches the row on an IDs grid to the data gathered for the claim. The logic looks for a specific match on an IDs grid first before moving to a general match (All button); for instance the application searches for insurance carrier X before looking for a row that applies to all insurance carriers.
The logic continues matching the other various selections on the grids. For instance, if one or more entries are on the grid, the application would see which entries matches the facility on the claim. This pattern has a specific order and follows the left to right layout on the IDs grid. For instance, on the Practice IDs grid, the logic looks at provider code first, then insurance company, then facility, etc.
For instance, if you are setting up a group practice with three doctors, you would need to have at least one rule (grid entry) on the Practice IDs grid and one rule on the Providers IDs grid for each provider (three rules). You must include one entry for each provider on the Provider IDs grid since you define your claim filing status (individual or group) here. For this general rule on the Practice IDs grid, you could apply it to all providers, all insurance carriers, and all facilities (assuming you have no facilities associated with your practice or all facilities would use the same details.
In this entry, you could include your group NPI, taxonomy, and tax ID numbers. Then on the Providers ID grid, you would create one grid entry for each provider. Each of these initial entries would be general and could apply to all insurance carriers and facilities. You would also select Group for your claim type and could select From Practice to pull NPI, taxonomy, and Tax IDs from the Practice IDs grid. If one of the insurance carriers that your practice accepts requires a legacy identifier, you would create a second entry on the Practice IDs grid. By creating a second entry on this grid instead of the Provider IDs grid, you save time and effort since one specific entry could be applied to all the providers at the practice level instead of creating an entry for each provider on the provider level. In this second entry, you would select the insurance carrier and select all providers. Importantly, you would need to include your NPI, taxonomy, and Tax IDs since each grid entry needs to be complete. You would also select the legacy number your carrier requires. When the application gathers claim data it would select this row for the specific insurance company and pull the data for the claim.
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If one of the providers in your practice files claims as an individual with an insurance company the other providers do not use, you would need to create another rule on the Provider IDs grid for that provider. In this grid entry, you would specify the insurance company. You would also change your filing status to Individual and entry the provider's NPI number, not the group NPI number. You could also include the taxonomy and tax ID/social security number in this grid entry.
Setup Activities After Data Conversion
If you are converting data from an existing Lytec practice, then you will need to review/select your claim filing status (individual or group) for each provider in your practice.
To select your filing status
1. Click Lists and click Providers.
2. On the Provider Codes field, click the magnifying glass and select a provider.
3. Review the data on the Provider Information tab and update as necessary. Click the Provider IDs tab.
4. The conversion process will have created at least one entry for the provider. On the Provider IDs grid, select the first entry and click Edit. The Edit Provider IDs window opens.
5. If you file claims as an individual, make sure the Claim Type Individual button is selected.
6. If you file claims as a group, make sure the Claim Type Group button is selected.
7. Click OK.
Repeat steps 4-7 for any other entries in the grid. When complete, repeat steps 2-7 for any other providers in the practice.
To provide the highest level of data integrity and accuracy, the conversion process for Lytec provider/practice setup, does not delete information while creating grid entries that might still be needed, such as legacy information (Blue Cross provider numbers, Medicare provider numbers, etc.) but converts this data to a grid entry in Lytec. Before filing claims, you will also need to finalize your grid entries, making sure to remove unnecessary data such as out-of-date legacy numbers.
This activity is especially important for any data entered on Insurance IDs tab of the Providers window in previous versions of Lytec and also if you used the NPI Only check box on the Insurance Companies tab in Lytec (introduced in Lytec 2008 SP1). Since data was converted instead of deleted to provide a high level of data accuracy in Lytec, you will need to remove out-of-date legacy numbers from the new grid entries.
For instance, if you had an entry in the Insurance ID tab in Lytec 2009 for a Medicare provider number, assigned this value to an insurance company on the Provider ID field of the Identification tab (both no longer used), and then at a later date selected the NPI only check box on the Insurance Companies tab for this insurance carrier, this legacy number will be converted in Lytec 2011. Before filing a claim with this carrier, you would need to remove this from the grid entry in Lytec 2011. In this example, you would click Lists and click Providers. In the Provider Code field, click the magnifying glass and select the provider. Click the Provider IDs tab. When the data converted, the insurance carrier that had required the Medicare provider number will have a specific row on the Provider IDs grid. Select that row and click Edit. Then in the Legacy Identifier 1 field, select the None button. Click Save. You would repeat this process for any other legacy data that is out-of-date.
You will also need to examine each IDs grid (Practice, Provider, Referring Physician, and Facility) before completing print or electronic claims. This step is critical for success, especially
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when converting data, with multiple legacy numbers. For instance, if your practice in Lytec 2009 had a referring physician record that had entries in National Provider ID, Insurance Code 1, Insurance Code 2, Other ID, and Taxonomy Code on the Address window, the conversion process will create four entries in the Referring Physicians IDs grid. All of these entries would be generic (wild card) rows without any selection of an insurance company or insurance carrier. The system would create a row with NPI and taxonomy, and then three more rows that combine NPI and taxonomy with each of the legacy numbers. These gird entries, however, need modification since all four would be generic/ wild card rows in which all is selected for insurance company and insurance carrier.
Before filing claims, you would need to first examine the legacy numbers and see if all are still needed. Then, you would begin adding, deleting, or editing entries to match your claim filling needs. For instance, you might keep the generic/wild card row since this information is needed for most of the insurance carriers you file claims with. Then, you might select one of the other legacy wild card rows (the rows in which All insurance companies and all insurance categories are selected) and apply this rule to a specific insurance carrier or category. If needed, you could add a second legacy number if the carrier required it. You could delete the other entries or apply an insurance company or category to the entry.
If you do not review and modify you ID grid entries, you can potentially have problems when filing claims if you leave multiple wild card rows (all selected for insurance companies and insurance categories) since the rules engine would not know what rule to select. In this case, the rules engine might select the correct (most complete wild card row) row but could also pull one that contained the wrong legacy ID resulting in a claim rejection.
Security
Setting up security protects the data from unauthorized access and use. If you want to create security in the program, set up each staff member as a user in the system. Each user has a security profile that indicates his or her access to features in the program.
To set up users in the program, click Admin and select Users/Security Profiles.
Use the buttons on the side to add a new user, to edit the selected user, to delete the selected user, or to set the security profile for the selected user.
F1 Look up Users/Security Profiles and Security Profile.
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User Types
If you want multiple users to have the same security profile, set up user types. A user type creates a template of what users can and cannot access. This feature becomes important if you have groups of employees who need the same security profile. You can create a user type, set its security profile, and then assign it to the appropriate users. This prevents you from having to go into the Security Profile window and set up each user separately. Click Admin and click User Types.
F1 Look up User Types.
User Preferences
With the User Preferences window, you can enter specific settings for the user currently logged into the system. Click Admin and click User Preferences.
F1 Look up User Preferences.
Preferences
Use the Preferences window to set functional settings in the program. Click Admin and click Preferences.
General: This tab lets you indicate how you want to generate patient chart numbers. You can also set how you want to use the ENTER key and how to generate the next superbill number.
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Charges and Payments: This tab controls multiple options for the Charges and Payments window.
Aging: This tab controls how insurance and patient balances age.
Aging Buckets: This tab lets you indicate how many days you want each aging bucket to last. For example, say you want to have aging periods of 0-35 days, 36 -70 days, 71-105, 106-140, and > than 141. You can make the adjustment in the Aging Buckets tab, and it will be reflected in all the areas where aging appears.
Reports: This tab lets you indicate how you want to preview your reports and whether to print report header pages.
Year-to-Date: This tab includes options for setting default filter values for three reports that capture Month-to-Date and Year-to-Date data.
Billing Cycle: This tab lets you set how you want the program to calculate exclusion dates in the billing cycle. These dates are loaded in the Exclude tab when printing statements.
Passwords: This tab controls the use and application of program passwords.
Patient Package: The Preferences window, Patient Package tab lets you create a group of custom reports that can be printed when a patient comes in for an appointment. To see the Patient Package tab, scroll to the right using the arrows next to the tabs. To set up a patient report package, follow these steps:
1. Click Admin and click Preferences. The Preferences window opens.
2. Click the right arrow at the end of the tab list twice and click the Patient Package tab.
3. Click the Add button. The Open window should open to your Custom Reports directory.
4. Select the report form you want to add to the package and click Open. The report will be added to the list.
5. Repeat steps 3 and 4 to add more reports to the package. You can select up to 10 reports.
6. When finished adding reports, click OK to save your changes. You can then print the patient package for each patient in the Day view of the appointment grid.
Image Formats: Use the options on this tab to specify the format in which images will be stored in your practice database. You can also indicate the amount of compression, and hence, the size of the files as they are stored. We recommend that you select CMP as this format allows the greatest amount of compression to keep your database smaller; however, if you store your images in this format, you will NOT be able to use them as part of custom reports. If you use images in custom reports, select either jpg, gif, or tif.
BillFlash: Allows you to set several options for what prints on your statements when you use BillFlash to prepare, print, and send them.
F1 Look up Preferences.
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Entering and Editing Practice Information
Setup Scenarios
If you are a solo provider, you can use two different methods to set up your practice.
For instance, you can enter key elements like NPI, taxonomy, and tax ID/social security number, on the Practice level in the Practice IDs grid. Then you would need to create at least one record (can create more if you have a different requirements from various insurance carriers) on the Provider IDs grid in which select the From Practice button for these data elements. Selecting From Practice will pull these values for claims from the Practice IDs grid.
Or when setting up your practice (assuming you do not need to send taxonomy in Loop 200A), you could on the Practice IDs grid select None for NPI, taxonomy, tax ID/social security number and enter a minimal amount of information of Practice IDs grid (still need at least one record). You would then create at least one record on the Provider IDs grid in which you specify your NPI, taxonomy, tax ID/social security number.
If you are a group practice, then you will complete at least one grid entry on the Practice IDs grid for the practice. You will also create at least one grid entry on the Provider IDs grid for each provider. If you have a provider that in some instances bills using his/her own NPI number, for a specific insurance company, you can create an extra grid entry for this provider, in which you specify the insurance company and select to pull the provider's NPI number from the Provider IDs grid.
Billing Service or Different Pay To Address
If your pay to address is different from your service address, you will also need to complete the Practice Pay To tab. You will also complete this tab if you are a billing service.
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Entering Practice Information
1. Click Lists and then click Standard Lists. Select Practice. Click Practice Settings. On the Practice panel, enter the contact information for practice including practice name, address, telephone number, etc.
2. On the Claims panel, you will select your practice type and entity type. These selections are usually based on your business's legal organization. From Practice Type, select Individual or Group Practice. From Entity Type, select Person or Non-Person.
3. On the Reporting panel, you will enter/select banking, tax, and practice information. On the Bank Account field, enter the practice’s bank account number. This will enable the bank account number to print on the bank deposit sheet. TIP: Print bank deposit sheets using the Day Sheet or the Transaction Journal to show check and cash payments.
4. On the Sales Tax Rate field enter the sales tax rate currently applicable to your practice. TIP: If you have the taxable option checked in the transaction code’s Defaults tab or in the More Detail window, the system will automatically calculate the sales tax from the rate in this field.
5. On the New Rate Effective Date field, enter the date on which the sales tax rate became effective. This field is necessary if your sales tax rate changes and you enter the old tax rate in the next field. On the Old Tax Rate field, if your sales tax rate changes, enter the old sales tax in this field.
6. From the Practice Type list, select the best descriptor for your practice. This selection is available for custom reporting. You will need to add the Practice Type field to a custom report for the data to pull on the report.
7. From the Practice Category list, select either Medical or Chiropractic, depending on which category is applicable to your practice. NOTE: When you choose Chiropractic, three more fields become available: Use AutoDoc box, a browse field, and the Clear button. If you use AutoDoc in conjunction with Lytec, click Use AutoDoc. Click the magnifying glass button to the right of the bottom field to choose the folder in which the patient demographic information will be deposited. When you have multiple practices and use AutoDoc for more than one of them, all patient demographic information will only go to the one folder you select here. Click the Clear button to take the selected folder out of the field.
Entering a Practice IDs Grid Entry
Use the Practice IDs tab and Practice IDs grid to enter or edit key data elements associated with your practice (tax ID/social security number, NPI, taxonomy, legacy numbers, etc). You will set up at least one entry (rule) on the Practice IDs grid and associate this information to all providers, insurance carriers or insurance categories, and all facilities or a particular provider or carrier, and an insurance category or any combination of these elements. For more information on entering data on the IDs grid, see the topic, Assigning Rules.
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This grid contains two elements. The first displays all current entries (rules). The second element, the New/Edit Practice ID window, is used to edit or create entries. The grid displays insurance company, insurance category, facility, NPI, Taxonomy, tax ID/ social security number and legacy data.
TIP: when creating or editing IDs grid entries, do not create matching wild card entries (all selected for insurance company and insurance category) since the rules engine would not know which row to select. If you had different legacy numbers, for instance in each entry, the system might not select the correct row. In this case, modify one of the wild card rows and apply it to a specific insurance company or category.
1. Click Practice IDs tab.
2. Click the New button to create an new grid entry. --OR-- To edit an entry, select the record on the grid and click Edit.
3. Select either the All or Provider button. Select the All button to apply the rule to all providers associated with the practice. To apply the rule to a specific provider, select the Provider button and click the magnifying glass to select the specific provider.
4. Select the All, Insurance Company, or Insurance Category button. Select the All button to apply the rule to all insurance companies associated with the practice. To apply the rule to a specific insurance company, select the Insurance Company button and click the magnifying glass to select the insurance company. To apply the rule to a specific insurance category, select the Insurance Category button and click the magnifying glass to select the insurance category.
5. Select either the All or Facility button. Select the All button to apply the rule to all facilities associated with the practice. To apply the rule to a specific facility, select the Facility button and click the magnifying glass to select the specific provider.
6. Select either the None or National Provider ID button. Select the None button to not associate an NPI number with the rule. Select the National Provider ID button and enter an NPI number to associate that NPI number with rule. TIP: if your practice has a group NPI number, enter it here. Then, if providers in your office need to file claims as individuals, you can create a rule for that provider using the provider's individual NPI number that you enter on the Provider IDs grid.
7. Select either None or Taxonomy. Select the None button to not associate a taxonomy number with the rule. Select the Taxonomy button and enter a taxonomy number to associate that taxonomy
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number with rule. If your carrier requires this taxonomy number on a claim, you will also need to select the Send Practice Taxonomy in Loop 2000A box on the Information tab of the Insurance Companies window.
8. Select the None, Tax Identifier, or Social Security Number button. Select the None button to not associate a tax ID or social security number with the rule. Select the Tax Identifier button and enter the tax ID number to associate with the rule. Select the Social Security Number button and enter the social security number to associate with the rule.
9. If needed, enter up to two legacy numbers and qualifiers to associate with the rule using the Legacy Identifier 1 and 2 fields. Use these fields to customize your rule to meet filing requirements with an insurance carrier(s). For each entry select either None or Legacy Identifier. Select the None button to not associate a legacy number with the rule. To associate a legacy number with the rule (for instance a Medicare Provider Number), select the Legacy Identifier button, select an ID qualifier, and enter the legacy number to associate with the rule.
Entering and Editing Practice Information for a Billing Service
This tab is used when entering billing service information or if your pay to address is different from your service address.
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1. Click Lists and then click Standard Lists. Select Practice. Click Practice Pay-To.
2. Enter the pay to information in the Name, Address, City, State, etc. fields. Note: the Extra 1 and Extra 2 fields are only used if a carrier requires extra data on a claim. It can hold up to 40 characters.
3. Click OK.
EDI Receivers
You define EDI receivers and their parameters for transmitting information to a clearinghouse or payer for electronic claims on the EDI Receivers window. When using Lytec to send electronic claims, you will set up your clearinghouse or direct payer in Lytec and also in Revenue Management. The settings in Lytec on the EDI Receivers window are used for setting rules for electronic claims generation. The actual transmission of claims is driven by Revenue Management. When you set up a receiver in Lytec, the Revenue Management feature will use these settings for creating a receiver. You may need to enter or select more settings in Revenue Management to send claims. Once an EDI receiver is set up, Revenue Management will synchronize the EDI settings in Lytec. If you make changes on these tabs in Lytec, the changes transmit to Revenue Management, and changes made there are also transferred to Lyec.
When setting up Lytec for the first time, you can set up a receiver using the least amount of information, for instance, entering the receiver name only on the Name field on the Address tab. With this information in place, you can set up your claims generation rules on the Practice, Provider, Referring Provider, Facility, and Insurance Companies tab. Then, in Revenue
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Management, you can finalize setting up your EDI module (necessary before sending claims). You can also completely set up your EDI receiver in Lytec and then finalize the setup in Revenue Management.
To Complete a Basic Setup for an EDI Receiver
1. Click Lists and select Standard Lists. Select EDI Receivers. The EDI Receivers window opens.
2. Click the Address tab. In the EDI Receiver field, enter a code for a new EDI receiver or leave the field blank and let the program create a unique code based on the Name field.
3. In the Name field, enter a name for the receiver.
4. Option: complete other EDI setup activities in Revenue Management. When this task is complete, the setup data from Revenue Management populates to the EDI Receivers window. --OR-- Enter setup information on the other EDI tabs referring to the electronic claims documentation for setup instructions.
5. Click Save.
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Entering and Editing Insurance Company Information
Setup Scenarios
Each insurance carrier requires a record in the database. This record consists of two parts: general contact information and claims-specific information. Use the Information tab for general contact data. Claim-specific data also goes on this tab along with the Claims tab. Many of the fields on the Claims tab are used for electronic claims only.
Entering Data on the Information Tab
1. Click Lists and click Insurance Companies. The Insurance Companies window opens.
2. Click New.
3. Click the Information tab and enter the company's contact information in fields such as Name, Address 1, Address 2, City, State, ZIP Code, Telephone, Fax, and Email.
4. From the Type list, select an insurance descriptor from the following options: Blue Cross-Physician, Blue Shield, Champus, Commercial, Medicaid Physician, Medicare, Medicare with Crossover, Worker’s Compensation, HMO, PPO. Options: If you have a fee schedule to associate with the insurance company, select the Fee Schedule magnifying glass and select a fee schedule type.
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If your practice accepts assignments directly from the payor, click the Accept assignment check box. If you want to associate the insurance company with any or all of the insurance categories that you have created, click the Insurance Category 1, 2, or 3 magnifying glass and select an insurance category. Companies can have multiple categories. Other Billing Situations: Select the Send Ordering Provider in Loop 2420E if you submit claims with ordering provider information. Select the Send Practice Taxonomy in Loop 2000A if you file electronic claims and your carrier requires your practice's taxonomy number in Loop 2000A. Contact your carrier for taxonomy requirements.
NOTE: the EDI Special Processing Agreement box is only used for Tricare (Champus) claims only.
The Claims tab is mostly used for electronic claims.
1. Click the Claims tab.
2. In the Primary Receiver panel on the EDI Receiver list, click the magnifying glass and select an EDI receiver you use when sending electronic claims for primary insurances. If you do not enter an EDI receiver in the EDI Receiver when Primary field, electronic claims will not be created or sent for this insurance company.
3. In the Payer ID field enter the payer ID for the insurance company. Refer to the enrollment information you received from the clearinghouse and look up the commercial identification number/ submitter identification numbers assigned to the insurance company by the clearinghouse. Option: For the RelayHealth clearinghouse, click the Payer ID magnifying glass to look this up using the pre-loaded database, which contains many payer IDs.
4. If you use the eligibility verification service and want to verify eligibility with this insurance carrier, in the Eligibility Payer ID field, enter the payer ID (for some carriers, the eligibility payer ID is different from the payer ID). Refer to the enrollment information you received from the clearinghouse and look up the commercial identification number/ submitter identification numbers assigned to the insurance company by the clearinghouse. Option: For the RelayHealth clearinghouse, click the Payer ID magnifying glass to look this up using the pre-loaded database, which contains many payer IDs.
5. Option: The National Plan ID field is not yet mandated. If you have received an ID number, enter it in this field.
6. If you file secondary claims with the insurance company, select/enter values on the Secondary Receiver panel for the EDI Receiver, Payer ID, Eligibility Payer ID, and National Plan ID fields. If you do not enter an EDI receiver in this section of the window, electronic claims will not be created or sent for this insurance company for secondary claims.
7. If you submit electronic claims for commercial insurance companies, enter the commercial identification number and the submitter identification numbers assigned to the insurance company by the clearinghouse in the Payer ID field (NOTE: this Payer ID field consists of two boxes).
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8. Your insurance carrier may specify a maximum number of transactions per claim. If the company does have a maximum threshold, click the up or down arrows on the Max Transactions Per Claim field to set a value. If you leave this field blank, the max transactions per claim defaults to 50.
9. The Payee ID field is only used for electronic claims for Illinois Medicaid. Check the enrollment information you received from the payor for the payee ID and enter this value in this field.
10. The Submitter ID field is only used for electronic claims. Enter the submitter ID assigned by the clearninghouse/payer. Refer to the enrollment information you received from the clearinghouse/payer and look up the submitter identification number assigned.
11. Group Name: Enter the provider’s group name.
12. Click Save.
Entering and Editing Facility Information
Setup Scenarios
If you have a facility attached/affiliated with your practice, you will need to create a record for it. There are two components to the record: contact/demographic data entered on the Information tab and billing-specific information entered on the Facility IDs tab.
If you have enumerated a separate NPI number for your facility and need to send facility billing information in Loop 2420D or pull data for box 32 of the CMS 1500 form, you can specify the type of facility and qualifier (77- service location, FA - Facility, etc.) along with including a separate facility NPI number and if this information is sent on the claim by selecting the Send Facility on Claim check box.
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Entering Contact Information
1. Click Lists and then click Standard Lists. Select Facilities. The Facilities window opens. Click Information.
2. Enter contact data associated with the facility including a name, address, telephone number, etc.
Entering Information on the Facility IDs grid
Use the Facility IDs tab and Facility IDs grid to enter or edit key data elements associated with a facility (NPI number, taxonomy number, CLIA number, legacy numbers, etc.). If your practice is/associated with a facility, you will set up at least one entry (rule) on the Facility IDs grid and associate this information to all or a specific insurance carrier or an insurance category.
For more information on entering data on the IDs grid, see the topic, Assigning Rules on page 65..
When creating or editing a facility IDs record, you will first create/modify a rule based on a combination of all or of a specific insurance company or insurance category. When processing claims, the rules engine uses this information to select the correct entry on the grid.
The second part of creating or editing a facility ID record is to select if facility data will appear on a claim along with selecting a qualifier for the facility and associating other data elements to pull for a claim including: a combination of none or a specific NPI, taxonomy number, CLIA number, and legacy data (if you need to send information in Loop 2420D or box 32 of the CMS 1500 form). After the rules engine identifies the correct row on the grid, this data is used in processing (either print or electronic) the claim.
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TIP: when creating or editing IDs grid entries, do not create matching wild card entries (all selected for insurance company and insurance category) since the rules engine would not know which row to select. If you had different legacy numbers, for instance in each entry, the system might not select the correct row. In this case, modify one of the wild card rows and apply it to a specific insurance company or category.
1. Click the Facility IDs tab. This window contains two elements. The first displays all current entries (rules). The second element, the New/Edit Facility IDs window, is used to edit or create entries. The grid displays insurance company, insurance category, NPI, Taxonomy, CLIA, and legacy data.
2. Click the New button to create an new grid entry. --OR-- To edit an entry, select the record on the grid and click Edit.
3. Select either All, Insurance Company, or Insurance Category. Select the All button to apply the rule to all insurance companies associated with the facility. To apply the rule to a specific insurance company, select the Insurance Company button and click the magnifying glass to select the insurance company. To apply the rule to a specific insurance category, select the Insurance Category button and click the magnifying glass to select the insurance category.
4. To include facility information on a print or electronic claim (box 32 CMS 1500 form and Loop 2420D), select the Send Facility on Claim box and the select an ID Qualifier. Leave the box blank (unchecked) to not include facility information on a claim.
5. Select either None or National Provider ID. Select the None button to not associate an NPI number with the rule. Select the National Provider ID button and enter an NPI number to associate the facility NPI number with rule.
6. Select either None or Taxonomy. Select the None button to not associate a taxonomy number with the rule. Select the Taxonomy button and enter a taxonomy number to associate that taxonomy number with rule.
7. Select either None or CLIA. Select the None button to not associate a CLIA number with the rule. Select the CLIA button and enter a facility CLIA number to associate with rule.
8. If needed enter up to two legacy numbers and qualifiers to associate with the rule using the Legacy Identifier 1 and 2 fields. Use these fields to customize your rule to meet filing requirements with an insurance carrier(s). For each entry select either None or Legacy Identifier. Select the None button to not associate a legacy number with the rule.
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To associate a legacy number with the rule, select the Legacy Identifier button, select an ID qualifier, and enter the legacy number to associate with the rule.
Entering and Editing Provider Information
Setup Scenarios
If you are a solo provider, you can use two different methods to set up your practice.
For instance, you can enter key elements like NPI, taxonomy, and tax ID/social security number, on the Practice level in the Practice IDs grid. Then you would need to create at least one record (can create more if you have a different requirements from various insurance carriers) on the Provider IDs grid in which select the From Practice button for these data elements. Selecting From Practice will pull these values for claims from the Practice IDs grid.
Or when setting up your practice (assuming you do not need to send taxonomy in Loop 200A), you could on the Practice IDs grid select None for NPI, taxonomy, tax ID/social security number and enter a minimal amount of information of Practice IDs grid (still need at least one record). You would then create at least one record on the Provider IDs grid in which you specify your NPI, taxonomy, tax ID/social security number.
If you are a group practice, then you will create at least one grid entry on the Provider IDs grid for each provider. You will also complete at least one grid entry on the Practice IDs grid for the practice. If you have a provider that in some instances bills using his/her own NPI number, for a specific insurance company, you can create an extra grid entry for this provider, in which you specify the insurance company and select to pull the provider's NPI number from the Provider IDs grid.
Entering Provider Information
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1. Click Lists and click Providers. Click Provider Information.
2. Click New. In the Provider panel enter demographic information for the provider such as last name, first name, title, etc.
3. In the Reference panel enter business related information such as the provider's social security number, tax ID, state license number, DEA number, and UPIN. Options:
4. In the Claim panel, select the Hospice Employed box if the provider is an employee of a hospice.
5. Select the Medicare Participating Provider box if the provider is considered a Medicare participating provider. A Medicare participating provider agrees to accept assignment on all Medicare claims for covered services and supplies. This field is generally used with electronic claims.
6. Select the Allow Eligibility Verification box to allow eligibility verification for this provider's patients. A patient is assigned to this provider either in the Associations tab of the patient's record or the patient's appointment.
7. Select the Signature on File box to indicate that the provider's signature is on file.
8. From the Default Location Code list select a default location code for the provider. If the practice has more than one location, you can generate reports based on each location. NOTE: The program does not require a default location code be used in the Providers window or in Charges and Payments. If any report displays or subtotals location information and no location has been specified for a given billing number, the location that displays in the report is called "Unassigned." If you go back to the billing number later and assign a location that was not previously assigned, the reports will then reflect these updated changes.
Entering Provider IDs Grid Entries
Use the Provider IDs tab and Provider IDs grid to enter or edit key data elements associated with a provider (tax ID/social security number, NPI, taxonomy, legacy numbers, etc). You will set up at least one entry (rule) on the Provider IDs grid for each provider in your practice and associate this information to all insurance carriers or insurance categories and all facilities or a particular insurance carrier or an insurance category or any combination of these elements. When creating or editing a provider IDs record, you will first create/modify a rule based on a combination of all or of a specific insurance company or insurance category and facility. When processing claims, the rules engine uses this information to select the correct entry on the grid.
After the rules engine identifies the correct row on the grid, this data is used in processing (either print or electronic) the claim.
For more information on entering data on the IDs grid, see the topic, Assigning Rules on page 65.
TIP: when creating or editing IDs grid entries, do not create matching wild card entries (all selected for insurance company and insurance category) since the rules engine would not know which row to select. If you had different legacy numbers, for instance in each entry, the system might not select the correct row. In this case, modify one of the wild card rows and apply it to a specific insurance company or category.
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1. Click Provider IDs. This grid contains two elements. The first displays all current entries (rules). The second element, the New/Edit Provider ID window, is used to edit or create entries. The grid displays insurance company, insurance category, facility, NPI, Taxonomy, tax ID/ social security number, mammography certificate numbers, CLIA numbers, care plan oversight numbers, and legacy data.
2. Click the New button to create an new grid entry. --OR-- To edit an entry, select the record on the grid and click Edit.
3. Select either All, Insurance Company, or Insurance Category. Select the All button to apply the rule to all insurance companies associated with the provider. To apply the rule to a specific insurance company, select the Insurance Company button and click the magnifying glass to select the insurance company. To apply the rule to a specific insurance category, select the Insurance Category button and click the magnifying glass to select the insurance category.
4. Select either All or Facility. Select the All button to apply the rule to all facilities associated with the provider (select this option if there are no facilities associated with the provider. To apply the rule to a specific facility, select the Facility button and click the magnifying glass to select the specific provider.
5. Select either Claim Type Individual or Claim Type Group. Select the Individual button if the provider is a solo practitioner or files claims as an individual. Select the Group button if the provider is a member of a group practice or files claims as a group.
6. Select either From Practice or National Provider ID. Select the From Practice button to pull NPI number from the Practice IDs grid. TIP: If you do not want to send an NPI number on a claim, select From Practice and then on the Practice IDs window, create a matching entry for the provider in which you select None for the NPI option. Select the National Provider ID button and enter an NPI number to associate that NPI number with the rule.
7. Select either From Practice or Taxonomy. TIP: If you do not want to send a taxonomy number on a claim, select From Practice and then on the Practice IDs window, create a matching entry for the provider in which you select None for the Taxonomy option. Select the From Practice button to pull the taxonomy number from the Practice IDs grid.
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Select the Taxonomy button and enter a taxonomy number to associate that taxonomy number with the rule.
8. Select From Practice, Tax Identifier, or Social Security Number. Select the From Practice button to pull the tax ID/social security number from the Practice ID grid. Select the Tax Identifier button and enter the tax ID number to associate with the rule. Select the Social Security Number button and enter the social security number to associate with the rule. Other Options:
9. If you file mammography claims select the Mammography Cert button and enter the certificate number to associate with the rule. Select the None button to not associate a mammography certificate number with the rule.
10. If you file laboratory claims using a CLIA number select the CLIA button and enter the CLIA number to associate with the rule. Select the None button to not associate a CLIA number with the rule.
11. If your carrier requires a care plan oversight number, select the Care Plan Oversight button, select an ID qualifier, and enter the care plan oversight number to associate with the rule. Select the None button to not associate a care plan oversight number with the rule.
12. If needed enter up to three legacy and qualifiers to associate with the rule using the Legacy Identifier 1, 2, and 3 fields. Use these fields to customize your rule to meet filing requirements with an insurance carrier(s). For each entry select either None or Legacy Identifier. Select the None button to not associate a legacy number with the rule. To associate a legacy number with the rule (for instance a Medicare Provider Number), select the Legacy Identifier button, select an ID qualifier, and enter the legacy number to associate with the rule.
Entering and Editing Referring Physician Information
Setup Scenarios
If you have referring physicians affiliated with your practice, you will need to create a record for each referring physician. In this record, you can link the facility to a particular insurance company/category, if needed, and include other billing details such as the referring physician's NPI, taxonomy, and other legacy IDs.
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Entering Contact Information
1. Click Lists and click Referring Physicians.
2. Click Information. On the Information tab, enter demographic information for the referring physician, such as last name, first name, title, etc.
Entering Information on the Referring Physicians IDs Grid
Use the Referring Physician IDs tab and grid to enter or edit key data elements associated with a referring physician (NPI, taxonomy, legacy numbers, etc). You will set up at least one entry (rule) on the Referring Physician IDs grid for each referring physician that works with your practice and associate this information to all insurance carriers or insurance categories or a particular insurance carrier or an insurance category.
When creating or editing a referring physician IDs record, you will first create/modify a rule based on a combination of all or of a specific insurance company or insurance category. When processing claims, the rules engine uses this information to select the correct entry on the grid.
After the rules engine identifies the correct row on the grid, this data is used in processing (either print or electronic) the claim.
The second part of creating or editing a referring physician record is associating data to pull for a claim including selecting whether the referring physician's entity type (person or non-person), along with a combination of a specific NPI, Taxonomy, and legacy data. For these values, you can either include a value or select None to not include a value.
TIP: when creating or editing IDs grid entries, do not create matching wild card entries (all selected for insurance company and insurance category) since the rules engine would not know which row to select. If you had different legacy numbers, for instance in each entry, the system might not select the correct row. In this case, modify one of the wild card rows and apply it to a specific insurance company or category.
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1. Click Referring Physician IDs tab. This grid contains two elements. The first displays all current entries (rules). The second element, the New/Edit Referring Physician IDs window, is used to edit or create entries. The grid displays insurance company, insurance category, NPI, Taxonomy, and legacy data.
2. Click the New button to create an new grid entry. --OR-- To edit an entry, select the record on the grid and click Edit.
3. Select either All, Insurance Company, or Insurance Category. Select the All button to apply the rule to all insurance companies associated with the referring physician. To apply the rule to a specific insurance company, select the Insurance Company button and click the magnifying glass to select the insurance company. To apply the rule to a specific insurance category, select the Insurance Category button and click the magnifying glass to select the insurance category.
4. Select either Person or Non-Person. Select the Person button if the referring physician is a person and not an organization. Select the Non-Person button if the referring physician is an organization.
5. Select either None or National Provider ID. Select the None button to not include a referring physician's NPI with the rule. Select the National Provider ID button and enter an NPI number to associate that NPI number with the rule.
6. Select either None or Taxonomy. Select the None button to not include a taxonomy number with the rule. Select the Taxonomy button and enter a taxonomy number to associate that taxonomy number with the rule.
7. If needed enter up to two legacy numbers and qualifiers to associate with the rule using the Legacy Identifier 1 and 2 fields. Use these fields to customize your rule to meet filing requirements with an insurance carrier(s). For each entry select either None or Legacy Identifier. Select the None button to not associate a legacy number with the rule. To associate a legacy number with the rule (for instance a Medicare Provider Number), select the Legacy Identifier button, select an ID qualifier, and enter the legacy number to associate with the rule.
Transaction Codes
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Transaction codes are all the different types of financial codes that you enter in the system: CPT codes, payment codes, credit and debit adjustment codes, etc. To enter transaction codes, click Lists and click Transaction Codes.
Description Tab
Transaction Code: Enter a short identifier code. For procedure codes, this is usually the CPT code. For other transaction codes, enter a code that you will be able to identify easily.
Inactive: If you want to mark the transaction code as unavailable for use throughout the program, click Inactive.
NOTE: If you mark a transaction code inactive and then try to use it in various parts of the program, such as Charges and Payments or Insert Appointments, you will get a warning indicating the transaction code is inactive. However, you will still be able to save the charge, appointment, etc.
Description: Enter a brief but clear description in the Description field to identify the code. What you enter in this field prints on patient statements as the code’s description.
Type: Each option in the Type field has an affect on the Insurance Portion or Patient Portion available in the Charges and Payments window. Select the appropriate type.
Payment Type: This field is only available when the transaction code type is Patient Payment.
Unique Type of Service: This field is available as a reference field to enter your own type of service.
Standard Cost: This field is used when generating a Managed Care Analysis report. Enter the dollar amount in labor and supplies that it costs for the doctor to perform the procedure.
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Purchased Service Cost: Use this field to report the direct cost of purchased services like outside laboratory fees.
This is a Lab Procedure which Requires a CLIA Number where Applicable: Click this check box to make the CLIA number appear on an insurance claim when the transaction code is used.
NOTE: The Billing Information tab of the Billing Options window must have a laboratory record selected in the Laboratory field for the CLIA number to appear. The selected laboratory must also have the CLIA number entered in the CLIA Number field of its record in the Laboratories window.
Defaults Tab
Place of Service and Type of Service: Enter the place of service and the type of service for the transaction code in their respective fields. The online Help files have both a place of service list and a type of service list available as a reference guide. Look up Place of Service Codes and Type of Service Codes.
CPT Code and Charge: Enter the CPT code and the charge amount that should appear on insurance claims when this transaction code is entered.
NOTE: When you modify one of the default fields, the program will display a message telling you that the defaults have changed. If you want to make the same changes in the fee schedules assigned to the CPT code, you will need to open the Fee Schedules tab and click the Set to Defaults button. The Place of Service, Type of Service, CPT Code, and Charge entered in the Defaults tab will overwrite what is currently in those fields in the Fee Schedules tab.
Taxable: Click this check box if sales tax needs to be calculated for the transaction code. When you check this option, sales tax will be automatically calculated based on the Sales Tax Rate field in the Practice Settings window.
Print on Claims: Click this check box to default a check in the Print check box in the Charges and Payments window. A check in the Print check box indicates the charge will appear on an insurance form.
Charge Patient Only: Click this check box to transfer the entire charge amount to the patient portion. This check box is for procedures for which insurance companies will not pay.
F1 Look up Defaults Tab - Transaction Codes.
Appointments Tab
Appointment Colors: Transaction codes can be used to color code the Appointment grid. This feature helps you identify which procedure will be performed for a patient during an upcoming appointment. Select colors in the Text Color and the Background Color fields to use the color-coded transaction codes in the Appointment grid.
Appointment Length: Enter a default appointment length in hours and/or minutes. When you enter this procedure code in an appointment, the appointment length will default to what you enter here.
Auto Recall: Use this section to schedule recall appointments automatically. If you enable this feature, the program schedules a recall appointment when this transaction code is used in Charges and Payments.
F1 Look up Appointments Tab - Transaction Codes.
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Inventory Tab
If you have inventory items that you sell to your patients, such as vitamins, you can set up an inventory tracking system for each item. This feature assists you in keeping track of how many units you have of each item. It also assists you in keeping track of the number of units you sell and how much revenue you generate from them. Information can only be entered into this tab if you choose Inventory as the Transaction Type on the Description tab.
F1 Look up Inventory Tab.
Fee Schedules Tab
Open the Fee Schedules tab to assign CPT codes, charges, allowed amounts, write-offs, etc., to transaction codes.
If you have multiple locations set up with unique locality and carrier numbers, you will have a fee schedule listed for each location. You can enter individual fee schedule information for the transaction code when it is performed at different locations.
If there is a locality number or a carrier number in the fee schedule, you must enter the appropriate location when entering charges in Charges and Payments to apply the fee schedule correctly.
CPT: When you create a new transaction code, the CPT column is empty. To pull the default CPT code from the Defaults tab into this field, click the Set to Defaults button. The default Place of Service, Type of Service, CPT Code, and Charge will populate the applicable fields in each fee schedule.
Facility: The Facility column displays the allowed amount expected from the insurance company if the procedure is performed in a facility, as designated by the insurance company. Indicate whether the place of service is a facility or non-facility in the Places of Service window. When entering the transaction code in Charges and Payments, the Expected column will display this amount if the place of service for the transaction has Facility checked in its record.
Set to Defaults: Click this button to pull the default CPT code from the Defaults tab into this field. The default Place of Service, Type of Service, CPT Code, and Charge will populate the applicable fields in each fee schedule.
New Row: Click this button to add a new fee schedule to the transaction code’s record.
Delete Row: Click this button to delete the selected fee schedule from the transaction code’s record. When you delete a fee schedule from the record, you are not deleting it completely from the practice. It just will not apply to this transaction code.
Diagnosis Codes
To enter diagnosis codes, click Lists and click Diagnosis Codes.
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Diagnosis Code: Enter a short identifier code. This is usually the ICD-9 code.
Description: Enter a brief but clear description in the Description field to identify the code.
ICD-9 Code: Enter the ICD-9 code in the IDC-9 Code field (even if it is the same as that used in the Diagnosis Code field). This code prints in box 21 of the insurance claim form.
F1 Look up Diagnosis Codes.
Entering an Attorney, Employer, or Other Addresses
Use the Addresses window to enter information for attorneys, employers, and other entities. To set up address records, click Lists and click Standard Lists. Select Addresses. The Addresses window opens.
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1. To set up address records, click Lists and click Standard Lists. Select Addresses. The Addresses window opens.
2. In the Address Code field enter, a code for a new address record, or leave the field blank and let the program create a unique code based on the Full Title field. Option: to edit an existing record, click the Address Code magnifying glass and select an existing address record.
3. From the Type list, select either Attorney,Employer, or Other. A facility record is entered on the Facility window (Lists, Standard Lists, Facilities). A referring physician record is entered on the Referring Physicians window (Lists, Referring Physicians). For more information, see Facility Information and Referring Physician Information.
4. Enter other demographic data such as last name, first name, telephone number, etc.
5. Click Save.
Guarantors
A guarantor is a responsible party and/or insured party who is not a patient in the practice. To enter guarantor records, click Lists and click Guarantors.
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Enter the guarantor’s demographic data in the fields in the window.
Entity Type: Choose Person or Non-Person to indicate the guarantor’s entity type. For example, if the guarantor is a company name, choose Non-Person. If the guarantor is an individual, choose Person. This field is usually used for worker’s compensation claims.
F1 Look up Guarantors.
Patients
To create patient records, click Lists and click Patient. Select Patients.
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The Patients window contains much of the information that appears on the insurance form as well as other information used throughout the program. This section gives pointers on setting up a patient record, but does not cover every field that exists in the Patients window.
F1 Look up Patients.
Responsible Party
The responsible party is generally the person who will be billed for the patient’s portion of the charges on a statement. If a patient is not responsible for his or her own financial obligations, one of the first things you should do is assign the patient a responsible party. To specify a patient’s responsible party, click the Responsible Party button. Your options for the responsible party are as follows: Self (the patient), Another Patient, or Guarantor. If you choose another patient or a guarantor as the responsible party, the program will ask you if you want to use the responsible party’s demographic and insurance information in the patient’s record.
F1 Look up Responsible Party.
Patient Information Tab
Patient Chart: Enter a short identifier code. If you want to let the program create a unique code based on the Last Name field, leave the field blank and make sure the Generate from name field is clicked in the Preferences window available from the Settings menu.
New Patient Date: When you add a new patient, the system date will automatically appear in the New Patient Date field. If you converted your data, the patient’s earliest date of service will automatically appear in the New Patient Date field. When you enter a date of service that is earlier than the current new patient date, the program will automatically update the date.
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You can turn this feature on or off in the Charges and Payments tab of the Preferences window.
The patient’s balance and appointment information displays at the bottom of the window. You can turn off the display by clicking Do Not Perform Account Balance Calculation to the right.
F1 Look up Patient Information Tab.
Insurance Tabs
Insurance Code: Enter the patient’s insurance company in the Insurance Code field.
Type: Click the down arrow to the right of the Type field to select the appropriate insurance type. The insurance type for Medicare companies is Nongroup.
Insured ID: Enter the patient’s insured ID number.
Insured: If the insured person is not listed or is incorrect in the Insured section, click the Set Insured button to select the patient, another patient, or a guarantor as the insured person. Then click the down arrow to the right of the Relation to Insured field to select the appropriate relationship.
Authorization: Click the magnifying glass icon to access the Find Authorization/Referral window. This window lets you edit and delete existing authorizations, as well as create new ones.
Bill Insurance Automatically – Primary Insurance Tab: Click this option on the Primary Insurance tab to make a check mark appear for the patient’s new billings in the Bill To section of the Charges and Payments window. The check mark appears next to the primary insurance company’s name.
Bill Automatically after Primary – Secondary Insurance Tab: Click this option on the Secondary Insurance tab to bill the secondary insurance after you have applied an insurance payment. For this feature to work correctly, you must use a payment code with the code type Insurance Payment to apply the payment. After you have processed an insurance payment, a check mark appears next to the secondary insurance company’s name in the Bill To section of the Charges and Payments window.
Bill Automatically after Primary – Tertiary Insurance Tab: Click this option on the Tertiary Insurance tab to bill the tertiary insurance after you have applied an insurance payment. For this feature to work correctly, you must use a payment code with the code type Insurance Payment to apply the payment. After you have processed an insurance payment, a check mark appears next to the tertiary insurance company’s name in the Bill To section of the Charges and Payments window.
Accept Assignment: Click this check box to accept assignment for the patient.
F1 Look up Insurance Tabs - Patients.
Associations Tab
Provider: Click the magnifying glass icon to search for a provider. You can also type the provider’s code directly in the field.
Facility, Referring Physician, Referring Patient, and Attorney: Click the magnifying glass icon to search for a record. You can also type the record’s code directly in the field.
Supervising Physician and Outside Primary Care Provider: These fields access records in the Referring Physicians window. Click the magnifying glass icon to access the lookup
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window. You can also type the provider’s code directly in the field. You should set up these records in the Referring Physicians window.
Date Last Seen PCP: Enter the date that the patient was last seen by the primary care provider.
F1 Look up Associations Tab.
Claim Information Tab
The Claim Information tab contains information necessary for filling out insurance claims.
Type: Specify a symptom type. Choose between Illness or LMP (Last Menstrual Period).
Date: In the field beneath Type, enter the date of the last symptom.
Similar Symptom: Click this box if the patient has experienced similar symptoms before. Enter the date of the similar symptom in the Date field beneath the check box.
Status: Click the down arrow to the right of the Status field to select the patient’s status from the drop-down list. If you select Death as the status, the Date of Death field will become available. Enter the date of death in that field.
Lab Charges: If applicable, click the Lab Charges box and enter the amount of the charges in the Amount field.
Signature on File / Assign Payments: Click this box to indicate the patient’s signature is on file for the assignment of payment.
Patient Signature Source: Click this option if the source of the patient's signature is on file.
Release of Information Authorized: Click this box to signify that a release of the patient’s information has been authorized. Enter the date the release was authorized in the Date field below.
More Information
Click the More Information button to access more fields that are applicable to filling out an insurance claim form.
More Information 1 Tab
Date of Last X-Ray: Enter the date of the patient's last X-ray.
Consultation Dates: Enter the date ranges of the patient's consultation dates.
Total Disability: Enter the date ranges of the patient's total disability.
Partial Disability: Enter the date ranges of the patient's partial disability.
Hospitalization: Enter the date ranges of the patient's hospitalization.
Assumed: Relinquished Care: These fields are provided for providers who share post-operative care. Enter the date the provider assumed care for this patient in the first field. Enter the date the provider relinquished care of the patient in the second.
Prescription Date: This field is required for hearing and vision claims. Enter the prescription date. This field is used for electronic claims sent in the ANSI format.
Date of Last Visit: Enter the date of the patient's last visit. This updates automatically when you enter charges in Charges and Payments.
Months Treated: Enter the number of months the patient has been treated.
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Date of Manifestation: This field is only used for electronic claims. Refer to your direct module checklist and manual for a value to enter in this field.
Init Treated Date: Enter the date on which the patient was initially treated.
First Contact Date: Enter the date on which you had first contact with the patient.
EPSDT: Click this option to indicate that Medicaid EPSDT applies to the patient. The EPSDT indicator refers to Medicaid provisions for well-child care.
Family Planning: Click this option to indicate that Medicaid family planning applies to this patient. This indicator refers to Medicaid provisions for family planning.
Levels of Subluxation: For chiropractor practices, enter the levels of subluxation for the patient.
Ambulatory Surgery Required: Click this option to indicate that the patient required ambulatory surgery.
Third-Party Liability: Click this option to indicate when a third party is liable for coverage of the patient's condition.
Special Program Code: Select one of the codes from the drop-down.
Birth Weight: The Birth Weight field is for newborns. Enter the delivery weight.
Weight Units: The Weight Units field is to specify the unit of measurement used in the Birth Weight field. Enter GR for grams or LB for pounds.
Return to Work - Use this section of the window to specify when the patient can return to work.
Type: Specify the patient status of being able to return to work. Select one of the following from the drop-down list: Conditional, Limited, N/A, or No Return.
Date: Enter the date when the patient returned or can return to work.
Last Worked: If applicable, enter the last date the patient worked. This field is for worker’s compensation claims.
Accident - Use these options to enter and specify the patient's accident information.
Type: Specify the type of accident. Choose from Auto, Other, or leave it blank.
Date: Enter the date of the accident.
State: Enter the two-letter state abbreviation where the accident occurred.
Employment Related: Click this option if the accident is employment related.
Emergency: Click this option if the accident was an emergency.
Condition Codes: Enter up to 12 Condition Codes for the patient. These fields identify any conditions that may affect the processing of the claim. Condition codes are used on the professional claim.
More Information 2 Tab
Original Reference #: Use this field for Medicaid claims. This field is the claim reference number from the original EOB. It might also be referred to as a ―Transaction Control Number.‖
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Resubmission Number: Use this field for Medicaid claims. This number is a two-digit code that indicates the reason for the claim being submitted. It can vary from carrier to carrier and is not required by all Medicaid intermediaries.
Service Authorization Exception: This field is applicable for some Medicaid claims.
Referral Number: This field is only used for electronic claims. Refer to your direct module checklist and manual for a value to enter in this field.
Reference ID Qualifier: This field is required for some EDI claims.
Nature of Condition: This field is typically used by chiropractic practices. Click the down arrow to the right of the field to select one of the options.
Complication Indicator: This field is available only when you select Acute Manifestation in the Nature of Condition field. Click the down arrow to the right of the field to select an option.
Condition Description 1 and 2: Use up to 80 characters to enter a description of the patient's condition.
Findings and Referral Items: These fields are typically used for EPSDT and only in some states.
Conditional Codes: These fields are only used for electronic claims. Refer to your direct module checklist and manual for values to enter in these fields.
Therapy Type: This field is typically used for podiatry. Click the down arrow to the right of the field to select an option in the drop-down list.
Systematic Condition: This field is typically used for podiatry. Enter a three-character code signifying the condition that justifies the necessity of foot care.
Class Finding: This field is typically used for podiatry. Enter the class findings for routine foot care in this field.
Pregnant: If applicable, check this field and then enter the Estimated Date of Birth.
External Cause of Accident: Use this field to record a code that indicates there was some physical entity that contributed to the accident. For example, there are codes for tripping over objects, falling out of bed, falling downstairs, etc. These codes are in the ―E-code‖ section in your ICD9-CM book. Enter the ―E-code‖ in the External Cause of Accident field without the decimal or the last digit will be truncated.
IDE Number: This number is required when there is an investigational device exemption on the claim. An IDE Number is assigned by the FDA.
Homebound: Click this check box if the patient is homebound. This field may be used when sending electronic claims using the ANSI format.
Entity Type: Choose Person or Non-Person to indicate the patient’s entity type. For example, if the patient is a company, choose Non-Person. If the patient is an individual, choose Person. This field is usually used for worker’s compensation claims.
Insurance Type Code: This field is only used for electronic claims. Refer to your direct module checklist and manual for a value to enter in this field.
Demonstration Code: This field is only used for electronic claims. Refer to your direct module checklist and manual for a value to enter in this field.
Timely Filing Indicator: This field is only used for electronic claims. Refer to your direct module checklist and manual for a value to select in this field.
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F1 Look up More Claim Information.
Champus Information
Click the Champus Information button to enter military claim information for the patient.
F1 Look up Champus Information.
Diagnosis / Reminders Tab
Click the magnifying glass icon in the numbered fields of the Permanent Diagnosis Codes section to assign up to twelve permanent diagnoses for the patient. Permanent diagnoses are helpful when you have patients who come in often with the same diagnoses.
Hold Codes: Click the magnifying glass icon in the numbered fields of the Hold Codes section to assign up to five hold codes to the patient. Hold codes are pop-up reminder messages that you can create in the Hold Codes window.
Notes Reminder Code: Click the magnifying glass icon to assign a notes reminder code to the patient. The notes reminder code indicates whether a patient has patient notes on file.
Images Reminder Code: Click the magnifying glass to assign a patient images reminder code to the patient. This code indicates the patient has images saved to his/her record.
A/R Mgmt Status: Click the magnifying glass icon in the A/R Mgmt field to assign an A/R management status code to the patient. This code indicates the A/R mgmt status of the patient’s account.
F1 Look up A/R Management Status.
Contacts Tab
This tab is provided to keep track of additional information that will help in contacting the patient. You can also use this tab to enter emergency contact information for the patient.
F1 Look up Contacts Tab - Patients.
Appointments Tab
This tab shows all the patient’s future and/or past appointments.
F1 Look up Appointments Tab - Patients.
Patient Images
The Patients window Patient Images tab displays the images that you have saved for the selected patient. This tab is for display only. To scan, import, export, print, or edit an image, click the Patients button and select Images.
F1 Look up Patient Images Tab - Patients.
Custom Fields Tab
NOTE: The Customs Fields tab will not appear unless you go to the Custom Fields option in the Settings menu and set up custom fields in the Patients tab.
To enter information in the custom fields, open the Custom Fields tab of the Patients window.
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Entering Transactions Entering Charges and Payments are two of the most important tasks performed in Lytec. These transactions are the basis for the rest of the accounting activities that you perform, such as billing claims and statements and printing financial reports. You will enter transactions in the Charges and Payments window as well as enter insurance payments in the Insurance Payment wizard and patient payments in the Patient Payment wizard.
Entering Charges and Payments
The Charges and Payments window is where you enter charges in the system. You can also enter payments for a line item or for a billing. To open the Charges and Payments window, click Billing and click Charges and Payments. Select Charges and Payments.
Open Item Transaction Entry
Lytec uses an open item transaction entry method that groups a set of related transactions into a single billing number. The billing number determines what charges will be billed together on an insurance claim. You can access existing billings and create new ones in the Charges and Payments window.
Creating a Billing
To create a billing, follow these steps:
1. Click Billing and click Charges and Payments. Select Charges and Payments. The Charges and Payments window opens.
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2. In the Patient Chart field, click the magnifying glass icon to select the patient for whom you want to enter charges and press ENTER.
3. The cursor will go down to the Billing field and a billing number will automatically appear in the field. The billing number that appears is the next available billing number in the practice. The first billing that you create will be 1, the second will be 2, and so on.
4. Click the New/Open button to begin entering charges in the Detail Items section.
5. In the Date From column, enter the date of service for the procedure performed. When you select the field, a down arrow appears to the right of the field. Click that down arrow and a calendar appears from which you can choose a date. You can also type the date directly in the field.
6. The provider code that appears in the Provider column is the provider you entered in the Associations tab of the patient’s record. Click the field and then click the magnifying glass icon or press F3 to search for a different provider, if necessary.
7. Enter a diagnosis code and a transaction code in the Diagnosis and TX Code columns, respectively. Also, enter up to two modifiers in the M1 and M2 columns and a place of service in the POS column, if necessary.
8. Enter the charge amount in the Amount column and the number of units used in the Units column. The Extended column multiples the values in the Amount and Units columns and cannot be edited.
9. If you want to enter another charge for the billing, press ENTER and a new transaction line will be created. When you are finished entering all the transactions for the billing, click Save or press F2 to save the billing.
Charges and Payments Window Buttons
Billing Button
The Billing button contains features that affect the entire billing. For example, if you were to select Delete from the Billing button, you would delete the entire billing.
F1 Look up Billing Button – Charges and Payments.
Detail Button
The Detail button contains features that affect the selected detail item. For example, if you were to select Delete from the Detail button, you would only delete the selected detail item.
F1 Look up Detail Button – Charges and Payments.
Print Button
Click Print to print insurance claims and statements directly from a billing number. Print primary, secondary, or tertiary insurance claims as well as walkout and full statements.
F1 Look up Print Button – Charges and Payments.
New Button
Click New to create a billing.
Save Button
Click Save to store the information for the billing.
Close Button
Click Close to exit the window.
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Window Reset
If you have resized or repositioned this window, click Window Reset to reset the window to its default size and position.
Apply Insurance Payments
The Apply Insurance Payment window is where you enter bulk insurance payments and then apply them to multiple patient billings. This window is useful when an insurance company consolidates several billings for a patient or for several patients into one payment.
Using the Apply Insurance Payment window
To enter bulk insurance payments in the Apply Insurance Payment window, click Payments and click Apply Insurance Payment.
Follow these steps to enter an insurance payment:
1. Enter the date for which you are entering the payment in the Payment date field. To enter this date, you can either click the down arrow and select the date from the calendar that appears or type the date directly in the field.
2. Enter a reference number for the payment in the Reference field. Usually, this is the check number for the payment.
3. Enter the amount of the check you received from the insurance company in the Check Amount field.
4. Enter the amount of the total charge backs that you are going to apply in the Total charge backs field. A charge back is an amount that the insurance company deducts from the current payment amount when that company overpaid on a previous check. Unless you have a charge back to apply, be sure you leave this field at $0.00. If you enter an amount in this field, the wizard will force you to apply the amount in the field as a charge back.
5. The Total payments field adds the amount in the Total Charge Backs field to the amount in the Check amount field. The Total payments field cannot be edited.
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6. Click the Show zero and negative balance billings box if you want to show all patient billings when applying the payment, even those with zero and negative balances.
7. Enter the appropriate codes in the Codes section that you are going to use when applying the payment. Once you have applied and posted a complete payment, the Apply Insurance Payment window will automatically enter the codes you used in this section.
8. Click the magnifying glass icon to search for the appropriate primary, secondary, and tertiary insurance payment codes in the Primary payment, Secondary payment, and Tertiary payment fields, respectively. The payment codes you enter in these fields all need to have Insurance Payment as their transaction code type.
9. Click the magnifying glass icon to search for the appropriate partial primary, partial secondary, and partial tertiary insurance payment codes in the Partial primary payment, Partial secondary payment, and Partial tertiary payment fields, respectively. Depending on which partial payment codes that you enter in these fields, the transaction code types need to be Partial Primary Insurance Payment, Partial Secondary Insurance Payment, or Partial Tertiary Insurance Payment. Only use a partial payment if you think the insurance company in question will send further payments for a procedure.
10. Click the magnifying glass icon to search for the appropriate write-off code in the Write Off 1 and Write Off 2 fields. The write-off codes you enter in these fields have to have Insurance Adjustment as their transaction code type.
11. If necessary, click the magnifying glass icon to search for the appropriate charge back code in the Charge back field. The charge back code you enter in this field needs to have Insurance Charge Back as its transaction code type.
12. Once you have the Codes section filled out, click Next to go to the second window of the Apply Insurance Payment wizard. When the Apply Insurance Payment window appears, it automatically calculates, selects, and displays the insurance carrier responsible for the payment. When making this initial calculation, the application uses the patient’s data to automatically calculate which insurance is responsible for the payment (if the primary has paid, then the secondary would be responsible, etc.) and display this insurance carrier in the Insurance list along with bolding the carrier along the top for quick recognition. If needed, you can select a different insurance carrier from the Insurance lookup. When determining the responsible insurance carrier, the application checks the whole system for any insurance payments (transaction code of IP) including zero dollar payments) made to date and uses this data to display the correct carrier. For instance, if an insurance payment or a zero dollar insurance payment for John Smith’s primary carrier is entered in the system, when you open the Apply Insurance Payments window, John Smith’s secondary carrier (assuming he has one) would be automatically selected. NOTE: for the automatic selection of the appropriate carrier with this feature, you need to enter a zero payment for a carrier if the carrier is not responsible or does not pay; otherwise the application would not default to the next responsible carrier—it needs the record of a payment or a zero payment to move the responsibility to the next carrier.
13. If there are charge-backs to apply, the program requires you to work through them before applying payments. To apply a charge-back, click the magnifying glass to select the correct Patient and Billing. Enter the correct amount in the Charge
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Back column. Click Next to proceed to the next window where you can apply insurance payments.
14. This window lets you apply insurance payments either to the entire billing balance or as a line item payment. It also lets you indicate if the payment is a full or partial payment.
15. The two fields in the top right corner of the window, Amount and Unapplied, will tell you the total payment amount and the amount that remains unapplied.
16. Click the magnifying glass icon in the Patient field to search for the patient for whom you want to apply an insurance payment.
17. The Insurance field automatically calculates, selects, and displays the insurance carrier responsible for the payment. However, if you need to change the insurance company, click the magnifying glass icon in the field to search for the insurance from which you received the payment.
18. Once the patient and insurance fields have information in them, the billings available for applying insurance payments will appear in the lower section of the window. The Ins1, Ins2, and Ins3 area shows the insurance companies assigned to the patient. When you scroll through the patient’s billings, the insurance company currently responsible for that billing will be highlighted.
19. The To apply payments at a billing level section of the window lets you apply a payment for an entire billing to the entire billing. Click the Apply column and enter the payment amount for the entire billing. If it is a partial payment, click the box in the Part column. If there is a write-off, enter the amount in the Write Off 1 column. If there is a second write-off, enter the amount in the Write Off 2 column. The Balance column calculates the billing balance according to what you entered in the Apply, Write Off 1, and Write Off 2 columns.
20. The To apply payments at an item level section of the window lets you apply a payment amount for each transaction in the billing. This type of payment entry is necessary if you want to process the Insurance Reimbursement Analysis report. The TX Code column shows the transaction code to which you are applying a payment. The Units column shows how many units are assigned to that transaction line.
21. Click the Apply column for the appropriate line item and enter the payment amount for that transaction. If it is a partial payment, click the box in the Part. column. If there is a write-off, enter the amount in the Write Off 1 column. If there is a second write-off, enter the amount in the Write Off 2 column. The Expected column pulls the facility or non-facility amount from the fee schedule.
The Balance column calculates the line item balance according to what you entered in the Apply, Write Off 1, and Write Off 2 columns.
22. Once you are done entering the payment amount appropriate for that patient, click Next to go on to the next patient.
23. Repeat steps 15-21 until the amount in the Unapplied field is $0.00. Once you are done applying the entire insurance payment, click Post. If you have applied the entire check, the payments and write-offs you entered will be posted to their respective billings. If you have not applied the entire check, a message will appear that says, ―An unapplied amount remains. Payment batch does not match balance.‖ Once you click OK in this message, it will take you back to the payment application window. You have to apply the remaining amount in the Unapplied field before you can post the check.
Apply Patient Payments
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The Apply Patient Payment window is where you enter patient payments and apply them to several charges and/or billings. This window is useful when a patient sends a check that covers charges on several billings.
Follow these steps to apply a patient payment:
1. Click Payments and click Apply Patient Payment. The Apply Patient Payments wizard opens. If the payment you are applying is from a patient, choose Patient and click the magnifying glass icon to select the appropriate patient.
2. If the payment you are applying is from a guarantor, choose Guarantor and click the magnifying glass icon to select the appropriate guarantor.
3. Click the Include all family members to show all the patients who have the selected patient or guarantor as their responsible party.
4. Enter the date for which you are entering the payment in the Payment date field. To enter this date, you can either click the down arrow and select the date from the calendar that appears or type the date directly in the field.
5. Enter a reference number for the payment in the Reference field. Usually, this is the check number for the payment.
6. Enter the total payment amount that you received from the patient or guarantor in the Payment Amount field.
7. Click the Show zero and negative balance billings box if you want to show all patient billings when applying the payment, even those with zero and negative balances.
8. In the Codes section, enter the payment and write-off codes to use when applying the payment. Once you have applied and posted a complete payment, the Apply Patient Payment window will automatically enter the codes you used in this section.
9. Click the magnifying glass icon to search for the appropriate code in the Patient Payment field. The payment code that you enter in this field needs to have Patient Payment as its transaction code type.
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10. Click the magnifying glass icon to search for the appropriate write-off code in the Write Off field. The write-off code that you enter in this field needs to have Adjustment - Credit as its transaction code type.
11. Click the magnifying glass icon to search for the appropriate code in the Sales Tax Payment field. The payment code that you enter in this field needs to have Sales Tax Payment as its transaction code type.
12. Once you have the Codes section filled out, click Next to go to the second Apply Patient Payment window.
13. The two fields in the top right corner of the window, Amount and Unapplied, will tell you the total payment amount and the amount that remains unapplied.
14. The To apply payments at a billing level section of the window lets you apply a payment for an entire billing to the entire billing. Click the Apply column and enter the payment amount for the entire billing. If there is a write-off, enter the amount in the Write Off column. The Balance column calculates the billing balance according to what you entered in the Apply and the Write Off columns.
15. The To apply payments at an item level section of the window lets you apply a payment amount for each transaction in the billing. Click the Apply column for the appropriate line item and enter the payment amount for that transaction. If there is a write-off, enter the amount in the Write Off column. The Balance column calculates the line item balance according to what you entered in the Apply and the Write Off columns.
16. Once you are done applying the entire payment, click the Post button. If you have applied the entire check, the payments and write-offs you entered will be posted to their respective billings. If you have not applied the entire check, a message will appear that says, ―An unapplied amount remains. Payment batch does not match balance.‖ Once you click OK in this message, the program will take you back to the payment application window. You must apply the remaining amount in the Unapplied field before you can post the check.
Prepayments
When a patient pays a copay or pays for a series of visits, you can set up that payment as a prepayment and then apply money from it as you enter each charge. You can also print the Prepayment Activity report to view all the prepayments entered for each patient.
NOTE: You can use any patient payment code to enter prepayments, but we recommend that you set up a prepayment code that you only use for prepayments.
You enter prepayments on a patient level and then apply them in Charges and Payments or the Patient Payment Wizard.
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Entering Prepayments
To enter a prepayment for a patient, follow these steps:
1. Click Lists and click Patient. Select Patients.
2. In the Patient Chart field, enter the patient for whom you are setting up prepayments.
3. Click the Patient button and select Prepayment. The Set Up Prepayment window opens.
4. Click the Add button. The Add New Prepayment window opens.
5. Enter the prepayment amount, date entered, payment transaction code, and a reference (if applicable).
6. Click OK. Once you are back on Set Up Prepayment, click Save to save the prepayment to the database.
7. Click Close to exit the window.
Applying Prepayments in the Apply Patient Payment Wizard
After you enter a prepayment, you need to apply it to a charge.
To apply a prepayment in the Apply Patient Payment wizard, follow these steps:
1. Click Payments and click Apply Patient Payment.
2. In the From section, choose the patient for whom you want to apply the prepayment.
3. The Prepayment section should show the patient's current prepayment balance. Click Next.
4. Before you can apply the prepayment, you have to select the prepayment and designate how much money you want to apply. Click Select Prepay. The Select Prepay window opens.
5. This window displays all the available prepayments for the patient. Leave a check in the Apply column for any prepayments you want to apply money from.
6. After you have selected the prepayment(s) you want to use, enter the amount you want to apply in the second Apply column. You can enter the entire prepayment balance, or you can enter partial amounts. If you have selected more than one prepayment, enter the amount you want to apply from each prepayment. Click OK.
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7. Back on the Apply Patient Payment wizard, notice that the Prepay Amount field reflects the amount you selected in the previous step. From here, you apply prepayments like you apply regular payments in the Apply Patient Payment wizard.
8. Enter an amount in the Prepay field in the top section to apply the prepayment to an entire billing or enter an amount in the Prepay field in the bottom section to apply the prepayment to specific line items.
9. You have to apply the entire amount in the Prepay Amount field before you can post. Once you are finished applying the prepayment, click Post. You should be back on the first Patient Payment wizard window. You can choose another patient and continue applying payments/prepayments or close the window.
Applying Prepayments to a Billing in Charges and Payments
There are two ways to apply a prepayment in Charges and Payments: to a billing and to a detail item. This section tells you how to apply a prepayment to a billing in Charges and Payments.
1. Click Billing and click Charges and Payments. Select Charges and Payments.
2. In the Patient Chart field, enter the patient for whom you want to apply the prepayment.
3. In the Billing field, select the billing for which you want to apply the prepayment.
4. Click the Billing button and select Apply Prepay. The Apply Bill Prepay window opens.
5. Change the date entered in the Apply Date if necessary.
6. Enter the amount you want to apply in the Apply column.
7. If you just want to apply from the oldest prepayment in the list, click Apply from Oldest.
8. Click OK to apply the payment. The program then creates a prepayment line item in the Detail Item section. Click Save to save the changes.
Applying Prepayments to a Detail Item in Charges and Payments
To apply a prepayment to a line item in Charges and Payments, follow these steps:
1. Click Billing and click Charges and Payments. Select Charges and Payments.
2. In the Patient Chart field, enter the patient for whom you want to apply the prepayment.
3. In the Billing field, select the billing for which you want to apply the prepayment.
4. In the Detail Items section, select the line item for which you want to apply the prepayment.
5. Click the Detail button and select Apply Prepay. The Apply Item Prepay window opens.
6. Change the date entered in the Apply Date if necessary.
7. Enter the amount you want to apply in the Apply column.
8. If you just want to apply from the oldest prepayment in the list, click Apply from Oldest.
9. Click OK to apply the payment. The program then creates a prepayment line item in the Pay Item window like if you applied a regular payment.
10. Click Save to save the billing.
Printing a Prepayment Receipt
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A prepayment receipt can now be printed from the Enter Copay as Prepayment window. This window can be accessed from the Appointment button on the Scheduler window or from the Patient button on the Patients window. To print a prepayment receipt, follow these steps:
1. From the Enter Copay as Prepayment window, click the Print button.
2. Select Print from the drop down menu.
3. A message appears asking if you want to save the prepayment record. Click Yes. The Print window appears.
4. Select your desired printer and print settings. Click OK when you are ready to print the receipt.
Pending Transactions
Transactions imported into Lytec from an EMR service through Communications Manager are held as Pending Transactions until they can be processed by a Lytec user. F1 Look up Communications Manager Overview
To open the Pending Transactions window, click Charges and Payments and click Pending Transactions. --OR--
Click the Pending Transactions icon in the Charges and Payments window.
The Pending Transactions window offers many of the same functions as the Charges and Payments window with a few exceptions that are documented below. If there are no pending transactions, this window will act like a normal Charges and Payments window. F1 Look up Working with Pending Transactions
Items in the Pending Transactions window include:
Pending Transactions arrows: Clicking the arrows will move you to the first, previous, next, or last pending transaction group. Pending Transactions icon: Clicking the Pending Transaction icon will open a Lookup window with all the available pending transactions. Detail Items: The grid displays the information imported from the EMR transaction file. Save: Click Save to save the transaction to the billing and remove it from the pending transaction list. You are not able to save a pending transaction if there are any errors.
Pending Transaction Errors
Before a pending transaction can be saved in Lytec, it must be free of errors. This means that information in the EMR file must match records held in Lytec.
Basic information about the transaction—Patient Chart, Provider, Facility, etc.—is checked for errors when the pending transaction record is first opened in Lytec. You must resolve the error before continuing to work with the pending transaction.
Before saving a transaction or exiting the Pending Transactions window, the program checks for errors in the Detail Items grid. If there is an error, a Lytec message describing the type of error appears. You must correct the error before the Pending Transaction can be saved.
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Billing Claims and Statements
Billing Claims and Statements
After you have entered transactions in the Charges and Payments window, you should be ready to bill insurance claims and patient statements.
Billing Insurance Claims
There are two different ways you can bill insurance claims through Lytec. You can print them on paper or send them electronically.
Technical Criteria for Processing Insurance Claims
Billings that meet these two criteria will print an insurance claim.
1. In the Charges and Payments window, there must be a check next to the insurance company’s name in the Bill To section. Any time you print a claim and click yes to the message asking you if the claims printed correctly, the check is automatically removed. To reprint such a claim in a batch, click the box next to the insurance company’s name in the Bill To section of Charges and Payments.
2. The billing you want to print must have an assigned insurance company in the Billing Options window. You can see the assigned insurance company from the Charges and Payments window by selecting Bill Options from the Billing button.
Paper Claims
There are two areas from which you can print insurance claims in Lytec. You can select Print Insurance Claims from the Billing menu or click Print in the Charges and Payments window.
Through the Billing Tab
Click Billing and click Print Insurance Claims. Select Print Insurance Claims. The Select Custom Form window opens.
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Use the Select Custom Form window to select the appropriate form, for instance CMS 1500-Standard. If you cannot see the forms in the Select Custom Form window, you may have to navigate to the default location (Custom Reports folder) of the forms. The program will remember where the forms are stored once you have navigated to the Lytec directory and selected a form.
Select the form file you want to use and click Open.
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Options Tab
Print Claim Types: Click the drop down arrow to select the types of insurance you want to print claims for.
Diagnoses Per Page: Enter a number to specify how many diagnosis codes will appear on each page of an insurance claim.
Include Payments: Click this box to show the payments applied to the charges on the insurance claim.
Include Tab
The information you enter in the Include tab tells the program which insurance claims you want to print. For example, if you want to print insurance claims for billing numbers 13-20 only, enter 13 in the first Billing Numbers range and 20 in the second. If you want to print all available insurance claims, leave all the ranges blank.
Exclude Tab
The information you enter in the Exclude tab tells the program which insurance claims you do not want to print. For example, if you do not want to print statements for patients who are assigned a certain patient code, put that code in the first and second Patient Code ranges. If you want to print all available insurance claims, leave all the ranges blank.
F1 Look up Print Insurance Claims.
Through Charges and Payments
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When you print insurance claims through Charges and Payments, you print the claim for the selected billing only.
F1 Look up Print Button - Charges and Payments.
Electronic Claims
Note: Before you can send claims electronically, you have to complete registration/enrollment activities with a clearinghouse (RelayHealth if you are using Revenue Management Advanced) and/or an insurance company.
Electronic claims send your insurance claims online either directly to the insurance company or to a clearinghouse that then sends the claims to the insurance company. Lytec currently offers modules that send to a clearinghouse and modules that send directly to insurance companies via the Revenue Management feature. This solution is offered in two forms: Revenue Management Advanced and Revenue Management Direct.
Revenue Management Advanced uses the RelayHealth clearinghouse for electronic claims processing and eligibility verification. With Lytec, there is no cost for this software option though there are clearinghouse charges. For more information on pricing, contact your local value added reseller or Lytec sales at 800-333-4747.
Revenue Management Direct provides pre-configured connectivity to the most popular direct payers and also supports adding connections to other payers or clearinghouses. This solution is available as an annual subscription with additional fees per direct connection. For more information on pricing, contact your local value added reseller or Lytec sales at 800-333-4747.
With either option, Revenue Management provides a flexible tool that lets you manage your claims processing environment and, if necessary, make changes without completely replacing your EDI software.
Revenue Management differs from other EDI solutions by virtue of its design; it is an integrated component of Lytec which means that the company that produces your practice management solution also produces your EDI solution—a complete revenue management solution that seamlessly updates claim status and date sent while also providing ERA (electronic remittance advice) posting and eligibility verification.
Revenue Management provides value and robust support by supporting claims submissions for many types of providers and facilities including physicians, therapists, surgery centers, rural health, imaging centers, DME providers, dialysis centers, etc. You can send Part B claims to virtually any payer via the RelayHealth clearinghouse or direct connections. It even supports Part A along with ERA and eligibility verification.
Revenue Management seamlessly fits your established workflow. After you enter records and charges and create claims, the Revenue Management feature retrieves the claim data that you plan on submitting from the Medisoft database and creates an electronic claim file and transmits the files to the payers. You can also receive and view reports and complete ERA activities such as posting primary, secondary, or tertiary payments along with updating claim status for crossover claims.
An important feature of Revenue Management is the claim tracking and history. The feature supports sending and receiving claim status transactions, which gives you insight into your claim processing payment timeline. Revenue Management also saves claim information including when it was edited or sent and acknowledgments/payments received.
You can also quickly view and print reports associated with the claim and, if needed, quickly send a claim status inquiry.
Before sending claims with the Revenue Management feature, make sure all patient/guarantor information (patient demographic information and insurance carrier information) is correct and that current charges are entered in the Charges and Payments window.
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The insurance company associated with the patient’s billing must have a Payer ID and an EDI Receiver (Claims tab, Insurance Companies window) assigned to it.
Also for a billing to move to Revenue Management make sure:
Charges and Payments window Bill To panel Bill column is selected for the insurance carrier.
Charges and Payments window Details Items grid Print box is selected for the billing line item.
Charges and Payments window Billing Button Billing Options Primary, Secondary, Tertiary Insurance tabs Print Billing to Paper Only is not selected.
To send claims, click Billing and click Revenue Management. Select Revenue Management. The Revenue Management main window opens and displays claims for EDI Receivers in the practice.
NOTE: To run electronic claims reports, click Billing and click Revenue Management. Select Revenue Management Reports.
After the Revenue Management feature launches, you can click Check Claims and select an EDI Receiver to analyze your claim files for errors using several claim edit processes. This feature is offered on a subscription basis.
After the claim error checking process runs, error-free claims appear on the grid with the Send box selected and Passed appears in the Edit Status column. If a claim failed the claim check process, the Send box is not selected and Error appears in the Edit Status column. You can view the errors now and fix them in Lytec later or before sending claims. You can also run an error report to capture the current errors.
NOTE: this feature is not required to send claims using the Revenue Management feature.
Before claims are sent, the Revenue Management feature creates a claim file. If you do not use the error checking feature, you will need to review your claims on the grid and select the Send box for those claims you want to send. Even if you use the error checking feature, you can manually select the Send box to transmit claims that were not marked. Select Send and select Claims. Select the EDI receiver.
The Revenue Management feature processes the available claim information and creates a preview report.
The claim preview report also checks claims for HIPAA errors (errors that typically cause rejections).
Any HIPAA are marked on the report with a red X. Before transmitting the file, you can remove the claims with errors.
Click the Send button to send your claims files. Revenue Manager then selects the correct communications tool for contacting the payer and transmitting the file.
While connected and transmitting the claim files, the utility also downloads reports. Once the claim file is sent, Revenue Management automatically updates the billing in Lytec.
Billing Statements
In Lytec you can either print statements on paper or send them electronically. You are also able to view a Statement Pre-Run Report before you print or send electronically a batch of statements.
Paper Statements
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Like printing insurance claims, there are two areas from which you can print patient statements in Lytec. You can select Print Statements from the Billing menu, or you can click the Print button in the Charges and Payments window.
Through the Billing Tab Menu
Click Billing and click Print Statements. Select Print Statements and the Select Custom Form window will appear.
Use the Select Custom Form window to select the appropriate form. If you cannot see the forms in the Select Custom Form window, you may have to navigate to the default location of the forms using the Look In field. The program will remember where the forms are stored once you have navigated to the correct directory and selected a form.
Click the form file you want to use and click the Open button.
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Options Tab
Statement Date: Enter the date that you want to appear on the statements. You can either enter the date directly in the field or click the down arrow to the right of the field to access a calendar.
Statement Messages: Click the drop down arrow to select the type of message that appears in the Notes section on the bottom of the statements. You can enter what you want to appear for both the Standard and the Dunning messages in the Statement Messages window available from the Settings menu.
Sort Patients By: Click the drop down arrow to select the order in which you want the statements to print. The available options are as follows: Address, Chart, City, Name, Social Security Number, State, or Zip Code.
Combine Family Members: Click this check box to combine all the family members’ billings on one statement.
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Balance Forward Format: Click this check box to print statements in a balance forward format. All non-current transactions are grouped as a previous balance amount on the statement.
Print Items That Have Not Been Printed On A Statement: Click this check box to ensure that all transactions not previously printed on a statement print in the detail section. You cannot select this option unless you select Balance Forward Format above.
Combine Split Payments: Click this check box to combine payments applied to multiple charges when they have the same reference number. You can enter a reference number in the Reference field in the Apply Insurance Payment, Apply Patient Payment, or Pay Item windows. It is usually the check number.
Print Date Insured Billed: Click this check box to include insurance billing dates on the statements.
Subtotal by Billing: Click this check box to subtotal each billing before the statement goes on to the next one.
Indent Payments & Adjustments: Select this check box to specify whether an adjustments or payment is indented which improves the readability of the statement by indenting all transactions related to a given charge.
NOTE: Depending on item detail length, some items might be truncated/abbreviated. Before printing a statement or multiple statements, consider previewing the statement to make sure this feature does not impact overall clarity of the elements and the appearance of the statement.
Minimum Patient Balance: Enter an amount to print statements for those patients who have a patient portion of that amount or greater.
Include Paid Billings: Click the down arrow to select how you want paid billings included on the printed statements. The available options are as follows: Current Month Only, Exclude Paid Billings, and Include All Billings.
Include Statement Balances: Click the down arrow to select how you want to include credit balance statements. The available options are as follows: Include Credit Balance Statements, Exclude Credit Balance Statements, and Only Include Credit Balance Statements.
Minimum Aging Balance: Enter an amount to set the minimum aging balance for which you want to print statements. If you enter an amount in this field, statements will not print unless they have an aging balance that is the same or greater.
Aging Older Than: Click the down arrow to select the aging period for which you want to print statements.
Include Charges Only: Click this check box to exclude payments from the printed statements.
Charge Details Only: This option is automatically selected when you select the charge-based patient statement format, Charge Details Only. This format displays data as one line item per charge and lists insurance payment, guarantor payment and adjustment amounts for items applied to each charge, as well as the balance for each charge. You can add this field to other custom reports; for more information on adding this field to other reports, see the topic, Graphics-Based Custom Form Setup. To use this format, in the Charges and Payments window, open a billing and click Print and select Walkout Statement or Full Statement. Open the Custom Reports folder and select Charge Details Only Click Open. Make other data selections as needed. Click Print or click Preview.
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Print After Insurance Payment Only: Click this check box to print billings for which you have received and applied an insurance payment on the statements. If you do not check this box, statements will print regardless of whether you have received and applied an insurance payment.
Print Items Selected in A/R Management Queue: Click this check box to force the items to print that you marked as needing patient statements in the Billing button of the A/R Work List. These statements will print regardless of the other options and ranges you choose.
Include Tab
The information you enter in the Include tab tells the system what statements you want to print. For example, if you want to print statements for all billings created in March of 2003, enter 03/01/2003 in the first Billing Created Dates range and 03/31/2003 in the second. If you want to print all available statements, leave all the ranges blank.
Exclude Tab
The information you enter in the Exclude tab tells the system what statements you do not want to print. For example, if you do not want to print statements for patients who are assigned a certain patient code, put that code in the first and second Patient Code ranges. If you want to print all available statements, leave all the ranges blank.
Through Charges and Payments
When you print patient statements through Charges and Payments, you print either a walkout statement or a full statement. A walkout statement only prints transactions for the selected billing.
F1 Look up Print Button - Charges and Payments.
Electronic Statements
Before you can send statements electronically, you have to enroll with BillFlash. To enroll, select Billing and then Statement Processing. Select Enroll and follow the enrollment wizard at the BillFlash web site. When you close the BillFlash website, Lytec will create an EDI Receiver record for BillFlash and file your new user name and password. After you have enrolled, you can begin sending electronic statements.
Transmitting an Electronic Statement File to BillFlash
1. To transmit an electronic statement file, click Billing and click Statement Processing. Select Transmit Statement. On the Select Transmit Statement Form window, navigate to the forms available (usually in the Custom Reports folder) and select a form. Click Open. This form will be highlighted automatically the next time you open this window.
2. On the Transmit Statement window, select your options. These options are the same as on the Print Statement window.
3. Click Transmit. The file is created and uploaded to BillFlash. The BillFlash eApprove Files page opens.
NOTE: uploaded files will be saved locally to C;\Documents and Settings\All Users\Application Data\Lytec\2011(or current release)\Custom Reports\BillFlash.
4. Use the eApprove Files page to review the files that were uploaded and then select Approve to approve them.
5. On the Confirm Approval page, click Approve File.
6. Close the BillFlash web page and click Yes on the Did the statement upload correctly and has been approved? message.
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Statement Pre-Run Report
The Statement Pre-Run Report displays information about a batch of statements before you actually print it. It displays a chart number, responsible party, patient responsible amount, insurance responsible amount, charge amount, payment amount, balance, and number of pages for each statement. It also totals all the amounts and the number of statements in the batch.
To run the Statement Pre-Run Report, click Reports and click Billing. Select Statement Pre-Run. Just like when you print statements, the Select Custom Form window opens.
Choose the report format you want to use and click Open. The Print Statements window opens.
You should fill out the Print Statements window like you would when you print statements. The program needs to know which statements you want batched together before it can tell you specific information about the batch.
When you are finished filling out the options and ranges, click Print if you want to print the report directly to the printer or Preview if you want to display the report on screen. The report then prints or displays accordingly.
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Managing Overdue Balances
Managing Overdue Balances
This chapter covers the A/R (Accounts Receivable) Management module in Lytec. The A/R Management module helps you manage your delinquent accounts. You can put overdue billings into the A/R Management module and then track your office's efforts to retrieve payment.
NOTE: This feature was previously called the Collections module.
There are three main parts of using the A/R Management module:
Putting billings in A/R Management
Assigning billings to an agent
Performing A/R Management activities
Put Billings in A/R Management
To put a billing in A/R Management, click Billing and select A/R Management Tool.
NOTE: You must have security permissions to access the A/R Management Tool. To give or remove permissions to the A/R Management Tool, make changes to the user’s Security Profile.
The Filter A/R Management Tool window opens, in which you can determine the billings you want to appear in the A/R Management Tool. The values you enter in the filters limit the billings that you can assign to an agent.
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Once you enter values and click OK, the A/R Management Tool opens with the selected billings. You must then assign these billings to an agent.
F1 Look up Filter A/R Management Tool.
Assign Billings to an Agent
After you filter the billings you want to appear in A/R Management, the A/R Management Tool opens. In this window you can assign each billing to an agent.
If both the patient and insurance have responsibility for a billing, that billing appears twice in the list. One entry will be patient responsible and the other will be insurance responsible.
Assign
You can assign billings with the two options available from the Assign button: Assign Selected or Batch Assign. Use Assign Selected to highlight the appropriate billings and to make the assignments yourself. Use Batch Assign to enter values into ranges and let the program make the assignments.
F1 Look up Steps to Assigning a Billing to an Agent, Assign Selected, and Batch Assign.
Charges and Payments
Highlight a billing and click Charges and Payments to open that billing in Charges and Payments.
Detail
Highlight a billing and click Detail to access the A/R Management detail for that billing. You can see responsible entity information, patient information, and billing information, enter notes, mark the billing as needing a statement, insurance claim, or collection letter, and so on.
F1 Look up A/R Management Detail.
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Click Print to print the A/R Management Tool List.
F1 Look up Print A/R Management Tool List.
Window Reset
Click Window Reset to reset the window size and position to the program defaults.
Close
Click Close to exit the window.
F1 Look up A/R Management Tool.
A/R Management Activities
Once you have assigned billings to an agent, that agent can go into his/her A/R Work List and perform A/R Management activities. This is the window where most agents will perform their A/R Management activities. To access the work list, click Billing and click A/R Work List.
NOTE: You can only change agents in this window if you have security rights to the A/R Management Tool.
Tasks
In this button you can assign a new task to a billing, change a task’s due date, remove a billing from A/R Management, and pay off zero-balance billings. If a user has security rights to the A/R Management Tool, he/she can also reassign selected billings or perform a batch reassignment.
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F1 Look up Tasks Button.
Billing
This button has different options available depending on what type of party is responsible for the selected billing. If the billing is patient responsible, you can mark the billing as needing a statement in this button. If the billing is insurance responsible, you can mark the billing as needing an insurance claim.
You can also indicate that you want the billing to go out in a collection letter.
F1 Look up Billing Button - A/R Management.
Charges/Payments
Highlight a billing and click Charges and Payments to open that billing in Charges and Payments.
Detail
Highlight a billing and click the Detail button to access the detail for that billing. You can see responsible entity information, patient information, and billing information, enter notes, mark the billing as needing a statement, insurance claim, or collection letter, and so on.
F1 Look up A/R Management Detail.
Print List
Click Print List to print the A/R Work List.
F1 Look up Print A/R Work List.
Window Reset
Click Window Reset to reset the window size and position to the program defaults.
Close
Click Close to exit the window.
F1 Look up A/R Work List.
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Checking Eligibility The Eligibility Verification feature lets you check a patient's insurance coverage online. Contact the Lytec sales department at 800-333-4747 for information on pricing. You must have broadband internet service to make eligibility verification inquiries.
The Revenue Management feature conducts eligibility verification.
Eligibility Verification Setup
To set up Lytec for eligibility requests, you must make sure the Tax ID is entered on the Practice Information window, Practice IDs grid. You must also enter information in the Providers, Insurance Companies, and Patients windows.
Practice Information: Click Lists and click Standard Lists. Select Practice. Click the Practice IDs tab. On the Practice IDs grid, make sure there is an entry on the grid with the Practice Tax ID populated.
Providers: Click Lists and click Providers. Open the Providers window and pull up the provider whose patients you want to verify. Make sure the following fields are populated:
Provider Information Tab: Select the Allow Eligibility Verification box.
Provider IDs Tab: On the Provider IDs grid, make sure there is an entry on the grid with the Practice Tax ID populated.
Insurance Companies: Click Lists and click Insurance Companies. Pull up the insurance for which you want to verify coverage. Make sure the following field is populated:
Claims tab: Click the magnifying glass in the Payer ID field to search for the payer associated with this insurance company. The Payer ID Lookup window opens. If you select the payer and the Eligibility Payer ID field is blank, then the clearinghouse to which Lytec sends verification requests does not support that payer at this time for eligibility requests.
NOTE: Some carriers require Group NPI numbers instead of Individual NPI numbers for individual practitioners. If one of your carriers requires a Group NPI number, you will need to set up an separate entry on the Provider IDs grid for handling this type of dual NPI environment. For more information, look up Setting up Mixed NPI Numbers for Eligibility.
Patients: Click Lists and click Patient. Select Patients. Pull up the patient for whom you want to verify coverage. When the patient is the guarantor, make sure the following fields are populated:
Patient Information tab: Last Name, First Name, Date of Birth, and Gender fields
Primary, Secondary, and/or Insurance tabs: Insurance Code and Insured ID Number fields
Associations tab: Provider field.
When the patient is a dependent, these additional fields must be populated:
Patient Information Tab: Last Name, First Name, Date of Birth, and Gender fields
Primary, Secondary, and/or Insurance Tabs: Relation to Insured and Insured (click the Set Insured button to populate) fields
Ways to Verify Eligibility
There are multiple places in the program from which you can make eligibility verification requests: the Eligibility Verification Results screen, the Patients window, the appointment grid, and the Eligibility Verification Scheduled Tasks window. The type of eligibility inquiry you make, either real-time or scheduled, depends on the window from which you are making the request.
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Eligibility Verification Results: If you access this window by clicking Billing and clicking View Eligibility Results, the list will automatically show the last inquiry made for each patient. You can also set it to show all inquiries. To make a real-time eligibility inquiry from the Eligibility Verification Results screen, highlight the desired patient and click Verify.
Patients: To make a real-time eligibility inquiry for a specific patient, click the Patient button and select Eligibility Verification. The Eligibility Verification Results screen opens for the patient. You just click the Verify button to make the inquiry.
Appointment Grid: To make a real-time eligibility inquiry for a specific patient from the appointment grid, right-click the patient's appointment and select Eligibility Verification. The Eligibility Verification Results screen opens for the patient. You just click the Verify button to make the inquiry.
Eligibility Verification Scheduled Tasks: You can use the Scheduled Tasks feature to schedule a daily time to send a batch of eligibility inquiries. To schedule the batch, click Tools and click Task Scheduler. Select Schedule Eligibility. The task will automatically make inquiries for patients scheduled in the appointment grid up to a week in advance.
Look up the following step-by-step instructions to help you learn how to use the eligibility verification features:
Making a Real-Time Eligibility Inquiry from Appointments
Making a Real-Time Eligibility Inquiry from Patients
Scheduling Eligibility Verification Inquiries
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Scheduling Tasks The Lytec Scheduled Tasks feature uses the Windows Task Scheduler to schedule a time to make backups, to run both Lytec and Advanced Reporting reports, to make eligibility inquiries, and to rebuild the data files. You can only schedule tasks to which you have permissions. For example, if your user login does not have permissions to print insurance claims, you cannot schedule a time to print insurance claims.
For the scheduled task to run, you do not need to have Lytec open. However, the following events must occur:
The computer on which you scheduled the task must be turned on.
The Windows user who scheduled the task must be logged into the same computer.
The computer can be in the Lock Screen mode, but the correct user must be logged in.
Once a scheduled task begins, the program opens an instance of Lytec that does not count against the number of practice licenses. So a scheduled task can run in the background while you work in another instance of Lytec.
You can view the Scheduled Tasks history through the Audit Report. If a problem occurs when running a scheduled task, you can review the Audit Report and the Windows Task Scheduler program. To view the Audit Report, click Reports and click Audit Trail.
You can view the Lytec tasks in the Windows Task Scheduler of the Windows Control Panel. Different operating systems may have different options, but to open the Windows Task Scheduler in Windows XP Professional SP 2, go to the Windows Start button, select Settings, and select Control Panel. Then select Scheduled Tasks in the Control Panel. You can see all the tasks scheduled through Lytec. Double-click a task to see its properties. If, for some reason, you cannot delete a task in Lytec, you can delete it here.
If any errors occur during a scheduled task, Lytec stops the procedure until the user resolves the problem. For example, when printing claims, statements, and the Day Sheet, Lytec asks if the reports have printed correctly. When you schedule those reports, the program waits until you have answered the question to complete the task.
Scheduling a Backup
If you have previously made a backup on a particular day, the scheduled backup will not run. To schedule a backup, follow these steps:
1. Click Tools and click Task Scheduler. Select Schedule Backup. The Scheduled Tasks window opens.
2. Click Add to create a new scheduled backup. The Backup Wizard opens.
3. Look up ―Backing up data to a new backup file‖ or ―Backing up data to an existing backup file‖ for instructions on using the Backup Wizard to back up data to a new or existing backup file.
4. Once you are through the steps of the Backup Wizard, the Schedule Task window opens.
5. In the Task section, enter a description, a starting date, an ending date, and a time at which to run the backup.
6. In the Repeat Occurrence section, choose how frequently you want the automatic backup to repeat.
7. The Repeat Options section changes according to the option you choose in Repeat Occurrence. Choose when you want the automatic backup to repeat.
8. The Backup Settings tab shows the SQL script the program uses to run the backup but needs no input from you.
9. Click OK to schedule the backup.
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10. The scheduled task is saved to Lytec as well as to the Windows Task Scheduler.
Scheduling a Lytec Report
To schedule a Lytec report, follow these steps:
1. Click Reports and select the report you want to schedule.
2. Click the Options button and select Schedule Report. The Scheduled Tasks window opens.
3. Click Add to create a new scheduled report. The Schedule Task window opens.
4. In the Task section, enter a description, a starting date, an ending date, and a time at which to run the report.
5. In the Repeat Occurrence section, choose how frequently you want the automatic backup to repeat.
6. The Repeat Options section changes according to the option you choose in Repeat Occurrence. Choose when you want the automatic backup to repeat.
7. Click the Print Settings tab.
8. Specify if you want to preview or print the report. If you are printing the report, specify if you want to use the Windows default printer or another printer.
9. Specify if you want to use the default set of ranges or a set of ranges you have saved.
10. Click OK to schedule the report.
11. The scheduled task is saved to Lytec as well as to the Windows Task Scheduler.
Scheduling an Advanced Reporting Report
Before you can schedule a report in Task Scheduler, you must set a report range and create a scheduled report in Advanced Reporting.
F1 Look up Creating a Report Range and Creating a Scheduled Report in the Advanced Reporting help file.
To schedule an Advanced Reporting Report, follow these steps:
1. Click Reports and click Advanced Reporting. Select Schedule. The Scheduled Tasks window opens.
2. In the Scheduled Tasks window, click Add to schedule a new Advanced Reporting report. The Schedule Task window opens.
3. In the Task section of the Schedule Task window, enter a description, a starting date, an ending date, and a time at which to run the report.
4. In the Repeat Occurrence section, choose how frequently you want to produce the report.
5. The Repeat Options section changes according to the option you choose in Repeat Occurrence. Choose when you want to produce the report.
6. Click the Print Settings tab.
7. In the Report field, click the Select button to choose the report you want to schedule.
8. The scheduled task is saved to Lytec as well as to the Windows Task Scheduler.
Scheduling an Eligibility Verification Inquiry
To schedule an eligibility verification inquiry, follow these steps:
1. Click Tools and click Task Scheduler. Select Schedule Eligibility. The Scheduled Tasks window opens.
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2. Click Add. The Scheduled Task window opens.
3. Enter a description, starting and ending date, and a time at which to run the eligibility inquiry. You can only choose to repeat the eligibility inquiry on a daily basis.
4. Click the Eligibility Schedule Options tab.
5. Enter the number of days prior to the appointment date for which you want to verify patient eligibility. If you only want to verify eligibility for that day's appointments, enter 0. If you want to verify eligibility for that and the next day's appointments, enter 1, and so on.
6. Enter how frequently you want the program to verify eligibility for the same patient.
7. Put a check next to the insurance(s) for which you want to verify eligibility.
8. Click OK to schedule the eligibility verification inquiry.
9. The scheduled task is saved to Lytec as well as to the Windows Task Scheduler.
Scheduling a Data Rebuild
Scheduling a data rebuild lets you make sure the data files are rebuilt periodically.
NOTE: When you run a data rebuild manually, the program prompts you to make a backup. When the program runs a scheduled data rebuild, it does not prompt you to make a backup as that would require user input.
To schedule a data rebuild, follow these steps:
1. Click Tools and click Task Scheduler. Select Schedule Rebuild. The Scheduled Tasks window opens.
2. Click Add to create a new scheduled data rebuild. The Rebuild Data Files window opens.
3. Click the functions you want the program to perform, such as Reset Patient Balances, and then click the data files you want the program to rebuild. You can also click Select All and every function and data file will be selected.
4. Once you are finished selecting the rebuild options, click OK. The Schedule Task window opens.
5. In the Task section, enter a description, a starting date, an ending date, and a time at which to run the data rebuild.
6. In the Repeat Occurrence section, choose how frequently you want the scheduled data rebuild to repeat.
7. The Repeat Options section changes according to the option you choose in Repeat Occurrence. Choose when you want the scheduled data rebuild to repeat.
8. The Task Options tab shows the rebuild options you selected but needs no input from you.
9. Click OK to schedule the data rebuild.
10. The scheduled task is saved to Lytec as well as to the Windows Task Scheduler.
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Scheduling Appointments Launch the appointment scheduling feature in Lytec by clicking Scheduling and clicking Schedule Appointments. The scheduling feature is composed of three windows: Calendar window, Appointment grid, and Appointment Details grid.
Calendar
By default, the calendar will appear when you open the appointment grid. The Calendar window remains displayed if the main appointment window is minimized. You can move and resize the Calendar. Double-clicking the window returns it to the default location and size. You can also double-click the main appointment window to maximize its size in the available space. If you want to remove the calendar from the screen, go to the View menu and select Calendar. If you want to see the calendar, repeat the steps. This option is only available when you have the appointment grid open.
The calendar gives you the opportunity to quickly move from one day to the next in the appointment grid. Click the date you want to view on the calendar and the appointment grid will automatically move to that date. You can also use the D, W, M, and Y buttons by the date to move either forward or backward through the calendar. D moves the calendar a day, W moves it a week, M moves it a month, and Y moves it a year.
The calendar initially comes up on the right-hand side of the screen and displays the current month plus a few months in the future. However, you can view either more or fewer months by moving your mouse over the calendar border until you get a double edged arrow, holding down the left mouse button, and moving the border out or in. You can also move the calendar around the screen by holding down your left mouse button on the header, moving the calendar where you want it to go, and releasing the mouse button.
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Wait List
The Wait List is a list of people waiting for appointments to be scheduled when there are not any available at a specific date or time.
To access the list, click Scheduling and click Wait List.
You can add patients to the wait list, edit entries already existing, delete entries, or schedule appointments from the Wait List window.
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Any information added in the Edit Wait List or Insert Wait List windows will not be included in the patient record. For example, if you enter a work phone number here, it will not show up in the Patients window.
To schedule an appointment from the Wait List, click the Schedule button (the Appointment grid is also opened). When an appointment is scheduled from the Wait List, all the information contained in the record is transferred to the Schedule Wait List window, the appointment is set, and the status is automatically changed to Pending. The entry is removed from the Wait List.
F1 Look up Wait List.
Entering an Appointment
To enter an appointment, follow these steps:
1. Click Scheduling and click Schedule Appointments. The Appointment grid opens.
2. Go to the date on which you want to schedule an appointment.
3. Once you have selected the correct date, click the time slot for which you want to schedule an appointment. Then either double-click the time slot or click the Appointment button and select Insert to bring up the Insert Appointment window.
4. Click the magnifying glass icon in the Patient Chart field to search for the patient for whom you want to enter an appointment. Once you enter a chart in that field, the Description, Home Phone, and Work Phone fields list the patient’s information. If you are scheduling an appointment for a patient whose record has not been created, enter that patient’s name in the Description field.
5. If applicable, enter a provider, a reason, and a procedure in the Provider, Reason, and Procedure fields.
6. If applicable, enter an authorization for the patient’s visit.
7. If they are not defaulted based on the reason or procedure, enter an appointment length in hours and minutes.
8. Click the up and down arrows in the Slot field to indicate which slot the appointment will fill. You will only be able to select a slot if you are entering an appointment at a time when there is at least one appointment already scheduled.
9. If they are not defaulted based on the reason or procedure, choose colors for the appointment’s text and background.
10. Click OK to save the appointment.
If you would like to see the patient’s future and/or past appointments, open the Appointments tab. Select the type of appointments you would like to see, future or past or both. The appointments will appear in the window.
The Patient Account Balance section at the bottom of the window contains patient account balances for each insurance carrier, for the patient, the co-pay amount, the next appointment, and the previous appointment.
The Do Not Perform Account Balance Calculation check box disables the balance calculation display. Once checked, the setting applies in every patient record and every Edit or Insert Appointment window. The Calculate Now button recalculates and displays the information.
Once you have edited or created a new appointment using the options on the General and Appointments tabs, you can save your changes, cancel changes, or save your changes and immediately move to the Charges and Payments window for entering a billing-- Lytec Professional and greater.
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Click OK - Charges and Payments to save the currently open chart number and then go to the Charges and Payments window. In the Charges and Payments window, the chart number from the Edit/Insert Appointment window is displayed with the next available billing number. This command is also available as right-click option on the Edit Appointment window or as a keyboard shortcut, CTRL + SHIFT + B. This button is only available if a valid chart number is selected on the Edit/Insert Appointment window.
Appointment Grid Views and Buttons
Appointment Grid Views
There are four views available in the Appointment grid: the Day view, the Week view, the Multiple Resource view, and the Template view. The first three are for viewing appointments by day, by week, and by multiple resources. The fourth is for entering templates into the Appointment grid. A template blocks out a period of time during which you schedule certain types of appointments.
To move between these views, click one of the icons in the bottom left hand corner of the Appointment grid.
Appointment Grid Buttons
Day View
When you click Scheduling and click Schedule Appointments, the Appointment grid defaults to the Day view. If you move to a different view, click this icon in the bottom left corner of the window to get back to the Day view.
Week View
Select the Week view to display all of the appointments for each day of the week selected on the calendar. Click the Week view icon in the bottom left corner of the window, and the Week view will appear.
This view shows the week’s appointments for the selected resource. The selected resource shows in the Title bar of the Appointment grid.
Multiple Resource View
Select the Multiple Resource view to see multiple resources concurrently. The Multiple Resource view defaults to the day selected in the Day view or the calendar. Click this icon in the bottom left corner of the window, and the Multiple Resource view will appear. This view shows the appointments scheduled for each resource in the selected Multiple Resource view.
Template View
Use this option to create templates for the Appointment grid. A template is a block of time set aside for certain types of appointments. For instance, if the doctor only wants to see new patients between 8 and 9 a.m, you could create a template for that time period that indicates it is set aside for new patients. Select this icon in the bottom left corner of the window, and the Template view will appear.
This view shows all the templates set up for the selected resource. The selected resource shows in the Title bar of the Appointment grid. In the example above, Appointments is the selected resource.
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After you have created/edited a template, you can assign the template to multiple resources. If your office has multiple templates, you do not need to create the same templates for multiple resources. Instead, you can use the controls on the Resource tab to assign a template to multiple resources.
F1 Edit Insert Template.
Appointment Detail View
The Appointment Detail window is a dockable window that appears in all three appointment views (day view, week view, and multi resource view) of the Appointment grid. The Appointment Detail displays detailed information for the record currently highlighted in the Appointment grid so that you can easily view the details of an appointment. The Appointment Detail window can be docked vertically or horizontally anywhere in the Appointment grid. The layout of the window is customizable and fields can be added or removed. The Appointment Detail window remains displayed if the main appointment window is minimized. You can move and resize it. Double-clicking the window returns it to the default location and size. You can also double-click the main appointment window to maximize its size in the available space.
NOTE: Changes to the layout of the Appointment Detail window do not affect the layout of the Appointment grid.
F1 Look up Appointment Detail Window.
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Appointment Grid Buttons
Appointment Button
The Appointment button is available from the Day view, the Week view, and the Multiple Resource view. Use it to perform various scheduling tasks. For example, you can use options in this button to insert, to delete, or to reschedule an appointment.
Status: Select this option to change the status of the highlighted appointment on the Appointment grid. A Status menu opens to the right.
Status Menu: Click a status to assign it to the appointment. Whenever you change an appointment’s status, the new status will show in the Status column of the Appointment grid.
Show: Select this option at the bottom of the Status menu to indicate which appointment statuses will appear in the Appointment grid. When you unselect a status, all appointments assigned to that status are removed from the grid; however, they are not deleted. If you reselect that status, those appointments will reappear.
Edit: Select this option to modify the selected appointment in the Appointment grid. The Edit Appointment window is the same as the Insert Appointment window.
Insert: Select this option to add a new appointment in the highlighted time slot.
Delete: Select this option to erase the selected appointment from the Appointment grid.
Repeating: Select this option to enter appointments that occur at the same time at regular intervals.
NOTE: If applicable, you can convert a repeating appointment into a template. In the Repeating Appointments window, select the repeating appointment and click the Convert button. After you convert a repeat appointment to a template, go to the Template view to modify its settings.
Insert Recall Appointment: Select this option to enter a recall appointment. All recall appointments for a particular day will appear on the bottom of the Appointment grid. To see a list of recall appointments, print the Appointments by Status report available from the Print button. You can choose to print only those appointments that have Recall as a status. You can also see a list of recall appointments by going to the Activities menu and selecting Recall List. The Recall List window shows both the past and future recall appointments.
Cross Schedule: Select this option to schedule an appointment across multiple resources. Say a patient comes to see a physical therapist and uses the treadmill machine as part of his therapy. You can use the Cross Schedule Appointment window to book his appointment with the therapist and exercise machine at the same time.
Reschedule: Select this option to reschedule the selected appointment for a different time. The Reschedule Appointment window is identical to the Cross Schedule window. When you reschedule a single appointment, the status of the current appointment changes to Rescheduled and the status of the new appointment is Pending.
If you want to reschedule multiple appointments on the Day view, use the right-click menu on the Appointment grid to copy and paste them to a new day or a new time. To select multiple appointments, click the first appointment, hold down the SHIFT key, and click the last appointment. If the appointments you want to copy are not consecutive, hold down the CTRL key and click each appointment you need.
Save View as Default: Select this option to save the current view as the default when you open the Appointment grid.
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Enter Copay as Prepayment: Select this option to enter a copay for a the patient assigned to the selected appointment.
Eligibility Verification: Select this option to check eligibility for the patient assigned to the selected appointment.
eView Button: Click this button to open the eView page of BillFlash's web site with this patient's data displaying. You must be enrolled in BillFlash for this option to work.
Resource Button
The Resource button is available in the Day, the Week, and the Template views. A resource is a person, place, or thing for which you schedule appointments, such as a provider, a machine, a room, a therapist, etc.
New Resource: Select this option to create a new resource for the Appointment grid. You can set the resource’s name, time, and increment properties.
Open Resource: Select this option when you want to open a resource different from the resource currently open in the Appointment grid. Whenever you open the Appointment grid, Appointments is the default resource.
Delete Resource: Select this option to erase an existing resource. The program will not let you delete the default resource, Appointments.
Resource Options: Select this option to change the selected resource’s name, time, and increment properties. It has the same options as the Create Resource window.
Print Button
The Print button is available in the Day, the Week, and the Multiple Resource views. It is where you print the schedule and superbills. You can also print appointment lists and custom appointment reports.
Schedule: Select this option to print the schedule currently displayed in the Appointment grid. The ranges for this option change depending on the view currently open.
Superbills: Select this option from the Day view to generate superbills or tracking slips. The provider can then make notes of the services performed on the superbill. You can also print superbills through the Custom Appointment Reports option or by right-clicking a specific appointment and selecting Print Superbill.
Appointments by Patient: Select this option to print a list of appointments grouped by patient.
Appointments by Date-Time: Select this option to print a list of appointments grouped by date and time.
Appointments by Status: Select this option to print a list of appointments grouped by status. For this report to work properly, you must assign statuses to appointments in the Appointment grid.
Appointments by Reason: Select this option to print a list of appointments grouped by reason. For this report to work, you must assign reasons to appointments.
Appointment Opportunities: Select this option to print a list of patients who have not been seen for a certain length of time for a certain reason, procedure, diagnosis, etc. For example, you could use this report to print a list of all those patients who have not been in to have a mammography in the last six months.
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Custom Appointment Reports: Select this option to print one of the available custom appointment reports.
Patient Package: In the Preferences window, Patient Package tab, you can set up a group of custom reports that can be printed when a patient comes in for an appointment. To print the patient package, select this option. The Print window opens, where you can select a printer and set other print options. Click OK to print the patient package.
Go To Button
Use the options in the Go To button to jump to certain dates in the Appointment grid. The Go To button on the Week view has different options available from the Go To button on the Day, the Multiple Resource, and the Template views.
Today, Previous Day, Next Day, Previous Week, Next Week, Previous Month, Next Month, Previous Year, or Next Year: Select one of these options to move the calendar accordingly.
Specific Day: Select this option to go to a particular day.
Custom View
This button is available from the Multiple Resource view only. Use it to create, to modify, and to delete custom views. You can also use it to select the custom view that you want to appear in the Multiple Resource view.
Template
This button is available from the Template view only. Use it to create, to modify, and to delete templates.
Templates are available to block off periods of time for specific types of appointments. You can enter appointments in templates in the Day, Week, and Multiple Resource views, but you cannot modify or create a template unless you are in the Template view.
If you want to copy a template from one day to another, click the template and press CTRL + C, move to the new day or time, select the beginning time period, and press CTRL + V. If the copied template is assigned to just particular days and you copy to a day not assigned, you will have to edit the template(s) to include the day you need.
To select multiple templates, click the first template, hold down the SHIFT key, and click the last template. If the templates you want to copy are not consecutive, hold down the CTRL key and click each template you need.
You can also create multiple time slots for each time interval for multiple booking of appointments.
Search
The Search button is available from the Day, Week, and Multiple Resource views. Use it to search for names and other information in the Appointment grid. When you click the Search button, the Find Appointment window appears with the Search Criteria tab activated.
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Search Criteria Tab
Use the Search Criteria tab to determine how you want to search.
Blank Slot in … increments: Enter a time period for which to search when searching an open time slot.
Find ALL valid matches, including multiple appointment slots: Click this box to search for valid matches, including multiple appointment slots, when searching for an empty appointment slot.
Find first match in any selected resource: Click this box to search for the first valid match in any of the selected resources. It will search through the first selected resource first and then go down through the list. If you do not check this box, then it will search for the first valid match that fits all of the selected resources.
Compare Appointment and Template Reason Codes: Click this box to match reason codes when cross-scheduling an appointment. You must enter a code in the Reason Code field and a description in the Description field in the Appointment tab for this option to be available.
Find time slot with matching Reason Codes: Choose this option if you only want to find empty appointment slots in a template that match the reason code in the Appointment tab.
Find any open time slot: Choose this option if you want to find empty appointment slots anywhere on the appointment grid.
Appointment: Choose this option to find appointments entered with a specific description. Enter the appropriate description in the field to the right of Appointment.
Chart: Choose this option to find appointments entered for a specific chart number. Enter the chart number in the field to the right of Chart.
Reason Code: Choose this option to find appointments based on reason codes. Enter or select the reason code in the field to the right of Reason Code.
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Home Phone: Choose this option to find appointments entered for patients with a specific home telephone number. Enter the telephone number in the field to the right of Home Phone.
Work Phone: Choose this option to find appointments entered for patients with a specific work telephone number. Enter the telephone number in the field to the right of Work Phone.
NOTE: Choose this option to find appointments that have specific words in the Note field. Enter the words for which you want to search.
Match Whole Phrase Only: If you want to search for appointments with a whole phrase, click the Match whole phrase only check box.
Appointment Tab
Use the Appointment tab to enter basic information about the appointment(s) for which you want to search.
Search Tab
Use the Search tab to indicate a time frame for your search.
Find
Click the Find button to start the search. A smaller Find window appears that lets you set the direction of the search, find the next available appointment, set the appointment, go back to the full Find Appointment window, or close the search.
F1 Look up Search Button – Schedule Appointments.
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Preparing Reports
Preparing Reports
Among other things, the reports available in the program help you track your finances, analyze your revenue, print patient information, and age both patient and insurance balances.
Before you begin printing any reports, you should set the printer options that are available from the Reports tab menu.
Printer Setup
To set your printer options, click Reports and click Print Options. Select Print Setup.
Printer
The printer listed in the Name field is the printer that is set as the default printer for your computer. The default printer is the one to which Lytec will automatically send documents when you print. If you want to change the default printer for the program, click the down arrow to the right of the Name field and select the correct one. To change the properties for the printer, click the Properties button.
Paper
To change the paper size, click the down arrow to the right of the Size field and select the correct size. The Paper Source field refers to the place in your printer from which the printer pulls paper when printing. Some printers have only one tray; others have multiple trays. To change the paper source, click the down arrow to the right of the Source field and select the correct source.
Orientation
Choose Portrait if you want to print horizontally. Choose Landscape if you want to print vertically.
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Printing Reports
NOTE: You can set default ranges for each report. Look up Save Report Ranges in the online Help files.
Once you have the correct printer options set up, you should be ready to print reports. There is a lot of valuable information in the program that you can access by printing reports.
Filtering a Report
When running a report, you have two methods for filtering data, which in turn determines what data appears on a report. The standard filtering method that is available on all reports generates data based on a To/From range. You select the starting and ending points and the system examines data between these parameters. For a more precise search, you can use Multi-select filtering to build precise search parameters by replacing key From/To ranges parameters on a report with your own filtering criteria by using the SHIFT key to select a beginning and ending ranges and the CTRL key to select multiple values not in consecutive order. Multi-select filtering does not replace standard filtering for every range on a report; some fields are only available in a standard To/From format. Even when selected, most reports on which Multi-select is available rely on a combination of standard To/From ranges and Multi-select filtering.
To use Multi-select filtering on a report, click the Change to: Multi-Select button. Fields that support this option will change from To/From ranges to a single Lookup field. To create your custom search criteria, click the magnifying glass icon at the end of a field; and in the Lookup window; hold down the SHIFT key and use the mouse to select beginning and ending ranges, and hold down the CTRL key to select multiple values not in consecutive order. Click OK and continue selecting other data for the report.
Depending on your reporting needs, you can set the default search filter to Multi-select for the report on which it is available. You can set this default option on the Preferences - Reports Tab by selecting the Set Report Ranges on Multi-select.
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F1 Multi-Select Filtering or Using Multi-Select Filtering.
Tracking Finances
You can use the Day Sheet, Transaction Journal, and the Monthly and Yearly Summary reports to track your finances on a daily, monthly, and yearly basis.
Day Sheet
Print a Day Sheet on a daily basis to maintain a permanent record of the transaction activity for the practice. (If the electronic records or data files are damaged, you can use a well-maintained set of Day Sheets to recreate the transaction activity.)
NOTE: Once a Day Sheet for a specific period has been printed and closed, the Day Sheet will not print for that period again (if the Close After Printing check box is selected). However, this information will print again in the Transaction Journal.
Click Reports and click Day Sheet.
Options Tab
Subtotal by provider: Click this check box to include an individual subtotal for each provider in the practice. When Subtotal by Provider is checked, the Subtotal by Location field becomes active.
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Subtotal by location: Click this check box to include a subtotal for each provider’s location.
Print Bank Deposit Sheet: Click this check box to print a bank deposit sheet for the practice with the Day Sheet.
Close after printing: Click this check box to close the transactions after you print the Day Sheet. If this box is checked, the transactions that print on the Day Sheet will not print on a Day Sheet again. However, they will print on the Transaction Journal. See page 62 for information on the Transaction Journal.
Include YTD and MTD: Select the Include YTD and MTD box to display month-to-date and year-to-date data for the current fiscal year. The system uses the month displayed in the Year-to-Date Starting list on this tab for determining the beginning of the financial year; you can modify this setting before running the report or set a default value on the Preferences Year-to-Date Tab for reporting. If you do not select a specific date range on the Ranges tab, the month-to-date value is based on the first day of the current month and the current day, while the year-to-date would include up to twelve months of data depending on when your financial year begins. If you do enter a narrower range of dates, the results of the report use these filter dates for the start and end dates for the month-to-date and year-to-date. This information is displayed on the report in a column for year-to-date data, month-to-date data, and also another column that captures data through today's date. These totals display for each of the sub-sections of the report. If you select this option, you can also then select to define if the system uses the Entry Date or Date of Service for running the report.
Year-to-Date Using
Entry Date: Select the Entry Date button to filter data based on the date the service was entered in Lytec for reporting. F1 See the topic Preferences Year-to-Date Tab.
Date of Service: Select the Date of Service button to filter based on the actual date the service was rendered for reporting. F1 See the topic Preferences Year-to-Date Tab.
Year-to-Date Starting
Month: From the list, select the month in which your financial year starts. The default value is January. If you select a fiscal month that occurs after the current calendar month, the report uses the month from the previous year as the fiscal year start date for filter date (for instance, if you run the report on September 1 but select a fiscal year starting in October, the data displayed range would start in October of the previous calendar year). F1 See the topic Preferences Year-to-Date Tab.
Sort By: The option you select in this section determine how the report sorts. Select Patient Chart, Patient Name, Billing Number, Billing Created Date, Service Date, or Entry Date/Time to sort the report by that field.
Reference: The options in this section are connected to the Reference field in the Apply Insurance Payments wizard, the Apply Patient Payments wizard, in the Managed Care Payments window, and in the Pay Item window. They are also connected to the Note field in the More Detail window of Charges and Payments. The Reference field is normally used for a check number for the payment to which it is connected, but you can use it however you want.
Do not print references: Click this option to exclude all references from the payment wizards on the Day Sheet.
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Print all references: Click this option to print all references from the Apply Insurance Payments wizard, the Apply Patient Payments wizard, the Managed Care Payments window, and the Note field in the More Detail window.
Only print lines with this reference: Click this option and then enter a specific reference in the field to the right to print only those transactions to which the specific reference is attached. This option is normally used to look at finance charges or to see all the payments that were applied from a certain check number.
Ranges Tab
The Ranges tab lets you filter the information that appears on the report. When you enter values in the ranges, it limits the information that prints on the report to those values. The more values you enter in the ranges, the less information will print on the report. If you want to print all the transactions available, leave all the ranges blank.
It is recommended that you leave the ranges blank and print a Day Sheet daily to keep an accurate record of the transactions or paper trail.
NOTE: Keep in mind that if you have Close after printing checked on the Options tab, then those transactions that have already been printed on a Day Sheet will not appear again, no matter what values you enter in the ranges.
Included in the Day Sheet
A Day Sheet includes transaction detail, charge summary, credit summary, accounting summary, and optional deposit sheet. The following lists the included items in each part:
Transaction Detail
Transactions: chart numbers, date of transaction, provider who performed the service, place of service, billing number, diagnosis code, and the amount
Totals: charges, debit adjustments, patient payments, insurance payments, credit adjustments, managed care charges, and managed care payments
Provider balance by location
Total provider balance
Report balance
Charge Summary
Charges: transaction charges, descriptions, amount, percent total, and count
Breakdown of amount produced per provider
Report totals
Credit Summary
Credit: transactions (payment codes used), descriptions, amounts, percent total, and count
Breakdown of credits received per provider
Report totals
Accounting Summary
Previous accounts receivable
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Totals: charges, credits, adjustments, and new accounts receivable
Bank Deposit Sheet (optional)
Payments received: date, reference, description, and amount
Totals: checks, cash, and deposit
Transaction Journal
This report prints a list of transactions for a specific period. You can also print a Bank Deposit Sheet with this report. Unlike the Day Sheet, a Transaction Journal can be printed for specific ranges as many times as needed.
Click Reports and click Transaction Journal. The Print Transaction Journal window will appear.
Options Tab
Subtotal by provider: Click this check box to include an individual subtotal for each provider in the practice. When Subtotal by Provider is checked, the Subtotal by Location field becomes active.
Subtotal by location: Click this check box to include a subtotal for each provider’s location.
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Print Bank Deposit Sheet: Click this check box to print a bank deposit sheet for the practice with the Transaction Journal.
Active: Click this option to print active transactions on the Transaction Journal
Archive: Click this option to print the archived transactions on the Transaction Journal.
Include YTD and MTD: Select the Include YTD and MTD box to display month-to-date and year-to-date data for the current fiscal year. The system uses the month displayed in the Year-to-Date Starting list on this tab for determining the beginning of the financial year; you can modify this setting before running the report or set a default value on the Preferences Year-to-Date Tab for reporting. If you do not select a specific date range on the Ranges tab, the month-to-date value is based on the first day of the current month and the current day while the year-to-date would include up to twelve months of data depending on when your financial year begins. If you do enter a narrower range of dates, the results of the report use these filter dates for the start and end dates for the month-to-date and year-to-date. This information is displayed on the report in a column for year-to-date data, month-to-date data, and also another column that captures data through today's date. These totals display for each of the sub-sections of the report. If you select this option, you can also then select to define if the system uses the Entry Date or Date of Service for running the report.
Year-to-Date Using
Entry Date: Select the Entry Date button to filter data based on the date the service was entered in Lytec for reporting. F1 See the topic Preferences Year-to-Date Tab.
Date of Service: Select the Date of Service button to filter based on the actual date the service was rendered for reporting. F1 See the topic Preferences Year-to-Date Tab.
Year-to-Date Starting
Month: From the list, select the month in which your financial year starts. The default value is January. If you select a fiscal month that occurs after the current calendar month, the report uses the month from the previous year as the fiscal year start date for filter date (for instance, if you run the report on September 1 but select a fiscal year starting in October, the data displayed range would start in October of the previous calendar year. F1 See the topic Preferences Year-to-Date Tab.
Sort By: Select an option in this section to determine how the report sorts. Choose Patient Chart, Patient Name, Billing Number, Billing Created Date, Service Date, Billing Status Code, or Entry Date/Time to sort the report by that field.
Reference: The options in this section are connected to the Reference field in the Apply Insurance Payments wizard, the Apply Patient Payments wizard, and in the Managed Care Payments window. They are also connected to the Note field in the More Detail window of Charges and Payments. The Reference field is normally used to enter a check number for the payment to which it is connected, but you can use it however you want.
Do not print references: Choose this option to exclude all references on the report.
Print all references: Choose this option to print all references from the Apply Insurance Payments wizard, the Apply Patient Payments wizard, the Managed Care Payments window, and the Note field in the More Detail window.
Only print lines with this reference: Choose this option and then enter a specific reference in the field to the right to print only those transactions to which the specific reference is
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attached. This option is normally used to look at finance charges or to see all the payments that were applied from a certain check number.
Include 1 and Include 2 Tabs
The Include 1 and Include 2 tabs let you filter the information that appears on the report. When you enter values in the ranges, it limits the information that prints on the report to those values. The more values you enter in the ranges, the less information will print on the report. If you want to print all the transactions available, leave all the ranges blank.
Exclude Tab
The Exclude tab also lets you filter the information that appears on the report. When you enter values in the ranges, it leaves the information that falls within those ranges off the report.
Included in the Transaction Journal
A Transaction Journal includes a transactions section, report totals, and optional bank deposit sheet. The following lists the included items in each part:
Transactions
Transactions: chart numbers, date of the transaction, provider code, place of service code, diagnosis code, transaction code, and the amount
Totals
Provider balance by location: charges, credits, adjustments, and location totals
Total provider balance: charges, credits, adjustments, and provider totals
Report Summary: charges, credits, adjustments, and report totals
Bank Deposit Sheet (optional)
Payments received: date, reference, description, and amount
Totals: checks, cash, and deposit
Monthly/Yearly Summary
The Monthly Summary summarizes financial activity for each day of the current (or specified) month. The Yearly Summary summarizes financial activity for each month in the year.
Click Reports and click Summary Reports. Select the Monthly Summary or Yearly Summary report. The Print Monthly Summary or the Print Yearly Summary window will appear.
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Options Tab
Month: When printing the Monthly Summary, select the month for which you want to print the report in the Month field. When printing the Yearly Summary, select the month for which you want to start the report in the Month field.
Year: For both reports, choose the year for which you want to print the report in the Year field.
Date of Service or Entry Date: Choose one of these options to sort the report by the selected option.
Include 1 and Include 2 Tabs
The Include 1 and Include 2 tabs let you filter the information that appears on the report. When you enter values in the ranges, it limits the information that prints on the report to those values. The more values you enter in the ranges, the less information will print on the report. If you want to print all the transactions available, leave all the ranges blank.
Exclude Tab
The Exclude tab also lets you filter the information that appears on the report. When you enter values in the ranges, it leaves the information that falls within those ranges off the report.
Included in the Monthly/Yearly Summary
These reports include summaries of each different type of transaction in the practice: charges, inventory charges, sales tax charges, adjustments, insurance payments, patient payments, etc. They also show summaries by location.
Analyzing Revenue
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You can use the Practice Analysis, Referring Physician Analysis, and the Insurance Reimbursement Analysis to identify the sources of your revenue.
Practice Analysis
This report prints information about the financial status and the service performance of the practice. Many practices use this as one of their monthly reports by entering monthly dates in the Comparison Dates range.
Click Reports and click Practice Analysis. The Print Practice Analysis window opens.
Options Tab
Subtotal by Provider: Click this option to include an individual subtotal for each provider in the practice, and then select Summary or Detail.
Summary: Select this button to break out data in the charges and credits section of the report by provider(s). This option is the default selection when the Subtotal by Provider check box is selected.
Detail: Select this button to add charges, payments, and adjustments to the report in a new section. When this option is selected, a practice analysis report will include for a provider(s) a new section subtotal that breaks out charges, payments and adjustments by provider at the end of the report. This section also includes provider line item totals in the Charges, Payments, and Adjustments section.
Subtotal by location: Click this check box to include a subtotal for each provider’s location.
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Include charges only: Click this check box to exclude payments and credits from the report.
Include YTD and MTD: Select the Include YTD and MTD box to display month-to-date and year-to-date data for the current fiscal year. The system uses the month displayed in the Year-to-Date Starting list on this tab for determining the beginning of the financial year; you can modify this setting before running the report or set a default value on the Preferences Year-to-Date Tab for reporting. If you do not select a specific date range on the Ranges tab, the month-to-date value is based on the first day of the current month and the current day while the year-to-date would include up to twelve months of data depending on when your financial year begins. If you do enter a narrower range of dates, the results of the report use these filter dates for the start and end dates for the month-to-date and year-to-date. This information is displayed on the report in a column for year-to-date data, month-to-date data, and also another column that captures data through today's date. These totals display for each of the sub-sections of the report. If you select this option, you can also then select to define if the system uses the Entry Date or Date of Service for running the report.
Year-to-Date Using
Entry Date: Select the Entry Date button to filter data based on the date the service was entered in Lytec for reporting. F1 See the topic Preferences Year-to-Date Tab.
Date of Service: Select the Date of Service button to filter based on the actual date the service was rendered for reporting. F1 See the topic Preferences Year-to-Date Tab.
Year-to-Date Starting
Month: From the list, select the month in which your financial year starts. The default value is January. If you select a fiscal month that occurs after the current calendar month, the report uses the month from the previous year as the fiscal year start date for filter date (for instance, if you run the report on September 1 but select a fiscal year starting in October, the data displayed range would start in October of the previous calendar year. F1 See the topic Preferences Year-to-Date Tab.
Active: Click this option to print active transactions on the Practice Analysis.
Archive: Click this option to print the archived transactions on the Practice Analysis.
Active Codes: Click this option to include active transaction codes in the report.
Inactive Codes: Click this option to include inactive transaction codes in the report. You can mark a transaction code inactive in the Transaction Codes window.
Include 1 and Include 2 Tabs
The Include 1 and Include 2 tabs let you filter the information that appears on the report. When you enter values in the ranges, it limits the information that prints on the report to those values. The more values you enter in the ranges, the less information will print on the report. If you want to print all the transactions available, leave all the ranges blank.
Exclude Tab
The Exclude tab also lets you filter the information that appears on the report. When you enter values in the ranges, it leaves the information that falls within those ranges off the report.
Included in the Practice Analysis
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The Practice Analysis includes the charges and credits for the practice. It also gives an accounting summary for the practice. The following lists each part of the report in greater detail.
Charges
Charge information: transaction code, description, amount, percent total, and count
Totals by provider: amount, percent total, and count
Totals by location: amount, percent total, and count
Report total: amount, percent total, and count
Credits
Credit information: transaction code, description, amount, percent total, and count
Totals by provider: amount, percent total, and count
Totals by location: amount, percent total, and count
Report total: amount, percent total, and count
Accounting Summary
Summary items: charges, credits, adjustment, and report total
Referring Physician Analysis
This report prints a list of all the referring physicians’ information. Click Reports and click Analysis Reports. Select Referring Physician Analysis. The Print Referring Physician Analysis report opens.
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Options
Include Patient Detail: Click this option to see the patients a physician referred as well as detail about those patients. The patient detail includes the patient’s chart number, name, number of visits, and diagnosis. If you click this option, you will see a somewhat different report than if you do not. See the Included in the Referring Physician Analysis section below for the differences.
Ranges
Ranges: This section lets you filter the information that appears on the report. When you enter values in the ranges, it limits the information that prints on the report to those values. The more values you enter in the ranges, the less information will print on the report. If you want to print all the transactions available, leave all the ranges blank.
Included in the Referring Physician Analysis
Without patient detail
The referring physician analysis without patient detail includes the following information:
Referring physician information: referring physician code, charges, percent of total charges, payments, percent of total payments, adjustments, net due attributable to referring physician, the percentage of the net due amount, and the number of patients referred
Totals: charges, percent of total charges, payments, percent of total payments, adjustments, net due attributable to referring physician, the percentage of the net due amount, and the number of patients referred
With patient detail
The referring physician analysis with patient detail includes the following information:
Referring physician information: referring physician code, charges, payments, adjustments, net due attributable to referring physician
Patient information: Patient chart number, patient name, number of visits, diagnosis
Totals: charges, payments, adjustments, net due attributable to referring physician
Insurance Reimbursement Analysis
To analyze the differences between charges billed to an insurance company and the amount reimbursed from the insurance company on a transaction code basis, print an Insurance Reimbursement Analysis. You must enter line item payments to use this report.
Click Reports and click Insurance Reports. Select Reimbursement Analysis. The Print Insurance Reimbursement Analysis window will appear.
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Options Tab
Subtotal by insurance: Click this check box to include subtotals for each insurance company on the report.
Active: Click this check box to print active transactions on the Insurance Reimbursement Analysis.
Archive: Click this check box to print the archived transactions on the Insurance Reimbursement Analysis. For information on archiving transactions, see page 79.
Primary, Secondary, and/or Tertiary: Click these check boxes to include payments from the selected insurance companies on the report. The default for this section is to have all three boxes checked.
Include 1 and Include 2 Tabs
The Include 1 and Include 2 tabs let you filter the information that appears on the report. When you enter values in the ranges, it limits the information that prints on the report to those values. The more values you enter in the ranges, the less information will print on the report. If you want to print all the transactions available, leave all the ranges blank.
Exclude Tab
The Exclude tab also lets you filter the information that appears on the report. When you enter values in the ranges, it leaves the information that falls within those ranges off the report.
Included in the Insurance Reimbursement Analysis
Reimbursement information includes: transaction code, count (number of procedures), charges, average charge, insurance payments, and average reimbursements
A comparison of charges billed versus payments received
Printing Patient Information
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You can use the Patient Ledger, the Patient Statistics report, and the Responsible Party Report to view valuable patient account and demographic information.
Patient Ledger
This report prints a Patient Ledger for a specific period. Click Reports and click Patient. Select Patient Ledger. The Print Patient Ledger window will appear.
Options Tab
Include paid billings: Click this check box to include paid billings on the report. To qualify as a paid billing, the billing must have a zero balance and all the transactions on the billing must have been printed and closed on a Day Sheet.
Show billing detail: Click this check box to include the billing detail on the report.
Subtotal by billing: Click this check box to subtotal each billing on the report.
Subtotal by provider: Click this check box to subtotal the report by provider.
Start a new page after each patient: Click this check box to start a new page after each patient’s information.
Active: Click this check box to print active transactions on the Patient Ledger.
Archive: Click this check box to print the archived transactions on the Patient Ledger.
Patient/Insurance: Click this option to display the insurance company balances and the patient balances on the Patient Ledger.
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Charge/Credit: Click this option to break up the Patient Ledger into charge and credit balances.
Sort Patients By: The fields in this section determine how the Patient Ledger sorts. Choose Chart #, Name, or Social Security # to sort the report by that field.
Reference: The options in this section are connected to the Reference field in the Apply Insurance Payments wizard, the Apply Patient Payments wizard, and in the Managed Care Payments window. They are also connected to the Note field in the More Detail window of Charges and Payments. The Reference field is normally used to enter a check number for the payment to which it is connected, but you can use it however you want.
Do not print references: Select this option to exclude all references on the report.
Print all references: Select this option to print all references from the Apply Insurance Payments wizard, the Apply Patient Payments wizard, the Managed Care Payments window, and the Note field in the More Detail window.
Only print lines with this reference: Select this option and then enter a specific reference in the field to the right to print only those transactions to which the specific reference is attached. This option is normally used to look at finance charges or to see all the payments that were applied from a certain check number.
Ranges Tab
The Ranges tab lets you filter the information that appears on the report. When you enter values in the ranges, it limits the information that prints on the report to those values. The more values you enter in the ranges, the less information will print on the report. If you want to print all the transactions available, leave all the ranges blank.
Included in the Patient Ledger
Patient information: chart number, name, home phone, work phone, insurance ID, and insurance phone
Billings: date of billing, provider code, place of service code, billing number, diagnosis code, transaction code, and amount
Patient totals: patient debits, patient credits, and patient balance
Provider totals: provider debits, provider credits and provider balance or patient portion, insurance portion, and provider balance
Report totals: report debits, report credits, and report balance
Patient Statistics
This report prints the demographic data for the specified range of patients. Click Reports and click Patient. Select Patient Statistics. The Print Patient Statistics window will appear.
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Sort By: Choose either Chart or Name to sort the report by that field.
Ranges: The Ranges section lets you filter the information that appears on the report. When you enter values in the ranges, it limits the information that prints on the report to those values. The more values you enter in the ranges, the less information will print on the report. If you want to print all the transactions available, leave all the ranges blank.
Included on the Patient Statistics Report
Demographic data for the patient
Patient association information, patient claim information, and patient insurance information
Patient Payment Annual Detail
Use the Print Patient Payment Detail window to select data and then print or preview the report. This report is particularly helpful for patient tax purposes.
You can access this report by clicking Reports and clicking Patient. Then select Patient Payment Annual Detail. Or select Patient Payment Annual Detail from the Print button on the Patients window.
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The report lists patient payments, including copay and non-copay prepayments, and patient refunds.
Options: Use the Calendar list field to select a date (calendar year) for the report. You cannot run this report on a current calendar year and the range of available years is limited to twenty years previous the current calendar year.
Sort Patients By: Select Chart to sort the order the report data is displayed based on chart number. Select Name to sort the order the report data is displayed based on the patient's name.
Ranges: From Patient list box, click the magnifying glass to select a range of patients to include in the report.
Responsible Party Report
This report prints a list of responsible parties and the patients who are attached to them. You can use this report to see which patients and guarantors are set as responsible parties. You will also be able to see the patients for whom each responsible party is accountable. Click Reports and click Family Reports. Select Responsible Party. The Print Responsible Party Report window will appear.
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Sort By: Choose either Chart/Code or Name to sort the report by that field. The first radio button is named Chart/Code because a responsible party can be either a patient or a guarantor.
Include Responsible Parties: Click the Patients check box to include patients who are responsible parties on the report. Click the Guarantors check box to include guarantors who are responsible parties on the report.
Ranges: The Ranges section lets you filter the information that appears on the report. When you enter values in the ranges, it limits the information that prints on the report to those values. The more values you enter in the ranges, the less information will print on the report. If you want to print all the transactions available, leave all the ranges blank.
Aging Patient and Insurance Balances
The aging reports give you aging information for a specific time period. They tell you what charges accrued and when those charges were billed to either the patient or the insurance, depending on which report you print.
Before you print an aging report, you need to tell the program how to age balances. To determine the settings for aging balances, click Admin and click Preferences. The aging settings are on the Aging tab of the Preferences window.
You can also indicate how many days you want each aging bucket to last. For example, say you want to have aging periods of 0-35 days, 36 -70 days, 71-105, 106-140, and > than 141. You can make the adjustment in the Aging Buckets tab, and it will be reflected in all the areas where aging appears. Go to the Aging Buckets tab of the Preferences window to set your aging buckets.
Patient Aging
This report provides a breakdown of the patient charges accrued during a specified aging period. It is important to note that this report only prints the patient portion.
Click Reports and click Aging Reports. Select Patient Aging.
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Options Tab
Options
Age From: Enter the date from which the report will age.
Sort patients by: The option that you select will determine how the report sorts. Click the down arrow to the right of the field to select Chart, Name, Social Security Number, or Balance Due as the sorting option.
Show billing history: This option lets you select what billing history you see on the Patient Aging report. Click on the drop down arrow to the right of the field to access the options available: All Dates Billed, First Date Billed, and Last Date Billed. If you select All Dates Billed, you will see all of the dates on which the transactions were billed. If you select First Date Billed, you will see only the first day on which the transactions were billed. If you select Last Date Billed, you will see only the last day on which the transactions were billed.
Show Summary: Click this option to show a summary for each patient.
Show Detail: Click this option to show the transaction detail for each patient.
Show billing detail: Click this option to show the transaction detail for each billing.
Subtotal by billing: Click this option to subtotal the report by billing number.
Subtotal by provider: Click this option to subtotal the report by provider.
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Subtotal by location: Select this box to display a subtotal that captures location data. Locations are entered in Lytec from the Locations window, selected from the Lists menu.
Subtotal by facility: Select this box to display a subtotal that captures facility data. Facilities are identified in Lytec from the Facilities window.
Start a new page after each patient: Click this option to start a new page for each patient’s billings.
Print detail notes: Click this option to print any notes entered in the Notes field of the More Detail window.
Include Aging
All, 31 days and older, 61 days and older, 91 days and older, or 121 days and older: The option you choose in this section determines which aging categories appear in the report.
Include Tab
The Include tab lets you filter the information that appears on the report. When you enter values in the ranges, it limits the information that prints on the report to those values. The more values you enter in the ranges, the less information will print on the report. If you want to print all the transactions available, leave all the ranges blank.
Exclude Tab
The Exclude tab also lets you filter the information that appears on the report. When you enter values in the ranges, it leaves the information that falls within those ranges off the report.
Included in the Patient Aging Report
Patient information: chart number, name, home phone number, work phone number and the date, and amount of the last payment
Patient totals: billing number, current, 31-60 days, 61-90 days, 91-120 days, greater than 120 days, and the total owed
Provider totals: current, 31-61 days, 61-90 days, 91-120 days, greater than 120 days, and the total owed
Report totals: current, 31-61 days, 61-90 days, 91-120 days, greater than 120 days, and the total owed
Insurance Aging
This report provides a breakdown of the insurance company charges accrued during a specific aging period. Once an insurance payment is applied to a billing (and the secondary and/or tertiary insurance is not set up to bill after primary), the payment is no longer included in the aging report.
Click Reports and click Aging Reports. Select Insurance Aging. The Print Insurance Aging report window will appear.
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Options Tab
Options
Age From: Enter the date from which the report will age.
Sort Insurance by: The option that you select will determine how the report sorts. Click the down arrow to the right of the field to select Insurance Code or Balance Due as the sorting option.
Show billing history: This option lets you select what billing history you see on the Insurance Aging report. Click on the down arrow to the right of the field to access the options available: All Dates Billed, First Date Billed, and Last Date Billed. If you select All Dates Billed, you will see all of the dates on which the transactions were billed. If you select First Date Billed, you will see only the first day on which the transactions were billed. If you select Last Date Billed, you will see only the last day on which the transactions were billed.
Sort Insurance by: This option lets you select how the insurance companies are sorted. You can sort by the Insurance Code or the Balance Due.
Show Summary: Click this option to show a summary for each insurance company.
Show Detail: Click this option to show the transaction detail for each insurance company.
Show billing detail: Click this option to show the transaction detail for each billing.
Subtotal by billing: Click this option to subtotal the report by billing number.
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Subtotal by provider: Click this option to subtotal the report by provider.
Subtotal by location: Select this box to display a subtotal that captures location data. Locations are entered in Lytec from the Locations window, selected from the Lists menu.
Subtotal by facility: Select this box to display a subtotal that captures facility data. Facilities are identified in Lytec from the Facilities window.
Start a new page after each patient: Click this option to start a new page for each patient’s billings.
Print detail notes: Click this option to print any notes entered in the Notes field of the More Detail window.
Include Aging
All, 31 days and older, 61 days and older, 91 days and older, or 121 days and older: The option you choose in this section determines which aging categories appear in the report.
Include Tab
The Include tab lets you filter the information that appears on the report. When you enter values in the ranges, it limits the information that prints on the report to those values. The more values you enter in the ranges, the less information will print on the report. If you want to print all the transactions available, leave all the ranges blank.
Exclude Tab
The Exclude tab also lets you filter the information that appears on the report. When you enter values in the ranges, it leaves the information that falls within those ranges off the report.
Included in the Insurance Aging Report
Insurance name information
Patient totals: billing number, current, 31-60 days, 61-90 days, 91-120 days, greater than 120 days, and the total owed
Group totals: billing number, current, 31-60 days, 61-90 days, 91-120 days, greater than 120 days, and the total owed
Provider totals: current, 31-60 days, 61-90 days, 91-120 days, greater than 120 days, and the total owed
Report totals: current, 31-60 days, 61-90 days, 91-120 days, greater than 120 days, and the total owed
Percent totals: current, 31-60 days, 61-90 days, 91-120 days, greater than 120 days, and the total owed
Service Aging Report
This report provides a combined insurance and patient aging report so that you can determine your total accounts receivable for a specific aging period.
Click Reports and click Aging Reports. Select Service Aging. The Print Service Aging window will appear.
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Options Tab
Options
Age From: Enter the date from which the report will age.
Age using: Click the down arrow to select how the report ages: by Billing Created Date or Date of Service.
Sort patients by: Click the down arrow to select how the report sorts: by Chart, Name, or Social Security Number.
Show billing detail: Click this option to show the transaction detail for each billing.
Subtotal by billing: Click this option to subtotal the report by billing number.
Subtotal by provider: Click this option to subtotal the report by provider. Subtotal by location: Select this box to display a subtotal that captures location data. Locations are entered in Lytec from the Locations window, selected from the Lists menu.
Subtotal by facility: Select this box to display a subtotal that captures facility data. Facilities are identified in Lytec from the Facilities window.
Start a new page after each patient: Click this option to start a new page for each patient’s billings.
Print detail notes: Click this option to print any notes entered in the Notes field of the More Detail window.
Include Aging
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All, 31 days and older, 61 days and older, 91 days and older, or 121 days and older: The option you choose in this section determines which aging categories appear in the report.
Include 1 and Include 2 Tabs
The Include 1 and Include 2 tabs let you filter the information that appears on the report. When you enter values in the ranges, it limits the information that prints on the report to those values. The more values you enter in the ranges, the less information will print on the report. If you want to print all the transactions available, leave all the ranges blank.
Exclude Tab
The Exclude tab also lets you filter the information that appears on the Service Aging Report. When you enter values in the ranges, it leaves the information that falls within those ranges off the Service Aging Report.
Included in the Service Aging Report
Patient information
Patient totals: billing number, current, 31-60 days, 61-90 days, 91-120 days, greater than 120 days, and the total owed
Provider totals: current, 31-60 days, 61-90 days, 91-120 days, greater than 120 days, and the total owed
Report totals: current, 31-60 days, 61-90 days, 91-120 days, greater than 120 days, and the total owed
Percent totals: current, 31-60 days, 61-90 days, 91-120 days, greater than 120 days, and the total owed
AR Totals
The AR Totals report is an aging report that shows the aging for both insurances and patients. It breaks down the aging totals by what is the insurance’s responsibility and what is the patient’s responsibility. It also indicates the amount expected from either the insurance or the patient.
Click Reports and click Aging Reports. Select A/R Totals Aging.
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Options Tab
Options
Age From: Enter the date from which the report will age.
Show billing history: This option lets you select what billing history you see on the AR Totals report. Click on the down arrow to the right of the field to access the options available: All Dates Billed, First Date Billed, and Last Date Billed. If you select All Dates Billed, you will see all of the dates on which the transactions were billed. If you select First Date Billed, you will see only the first day on which the transactions were billed. If you select Last Date Billed, you will see only the last day on which the transactions were billed.
Sort Insurance by: This option lets you select how the insurance companies are sorted. You can sort by the Insurance Code or the Balance Due.
Show Summary: Click this option to show a summary for each insurance company.
Show Detail: Click this option to show the transaction detail for each insurance company.
Show billing detail: Click this option to show the transaction detail for each billing.
Subtotal by billing: Click this option to subtotal the report by billing number.
Subtotal by provider: Click this option to subtotal the report by provider.
Start a new page after each patient: Click this option to start a new page for each patient’s billings.
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Print detail notes: Click this option to print any notes entered in the Notes field of the More Detail window.
Include Aging
All, 31 days and older, 61 days and older, 91 days and older, or 121 days and older: The option you choose in this section determines which aging categories appear in the report.
Include 1 and Include 2 Tabs
The Include 1 and Include 2 tabs let you filter the information that appears on the report. When you enter values in the ranges, it limits the information that prints on the report to those values. The more values you enter in the ranges, the less information will print on the report. If you want to print all the transactions available, leave all the ranges blank.
Exclude Tab
The Exclude tab also lets you filter the information that appears on the report. When you enter values in the ranges, it leaves the information that falls within those ranges off.
Included in the AR Totals Report
Insurance name information
Insurance portion of patients’ balances: billing number, current, 31-60 days, 61-90 days, 91-120 days, greater than 121 days, and the total owed
Patient portion of patients’ balances: billing number, current, 31-60 days, 61-90 days, 91-120 days, greater than 121 days, and the total owed
Provider totals: current, 31-60 days, 61-90 days, 91-120 days, greater than 121 days, and the total owed
Report totals: current, 31-60 days, 61-90 days, 91-120 days, greater than 121 days, and the total owed
Lists
The Lists Reports menu option in the Reports menu lets you print all the different lists available in the Lists tab menu of Lytec. Use these reports to review and analyze the patient/practice/user data entered into Lytec.
Click Reports and click List Reports. Select a list report.
Custom Reports
For information on creating, editing, or printing a custom report, go to the online Help files and look up Custom Reports.
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Running Utilities The various utilities in Lytec are available to help you manage your data. With these utilities, you can delete, archive, and un-archive patient records. You can do the same with patient billings. You can also delete old managed care payments, old appointments, and old audit trail entries when these files get too large. And finally you can rebuild your data files. All of these utilities are found in the Activities menu.
NOTE: Some of these functions will delete data that you cannot retrieve. Therefore, we strongly recommend that you create a backup of your data before running any of these utilities.
Inactive/Archived Patients
Before you can delete or archive any patients, the following steps must be taken:
You must be logged in as the SYSTEM user. If you do not have security set up in your program, you are logged in as a SYSTEM user.
You must be the only user in the system while you run these utilities.
The patients you want to archive must be marked inactive in the Patients window.
All the patients’ billings must be paid, meaning the billings must have a zero balance and all the transactions must have been printed and closed on a Day Sheet.
To run utilities for patients, click Lists and click Patient.
NOTE: Delete Inactive Patients and Archive Inactive Patients require that you mark the appropriate patient records inactive. To mark patients inactive, go to the Patients window and check the Inactive box.
Delete Inactive Patients
Select Delete Inactive Patients (click Lists and click Patient) to completely delete both the patient records that you have marked inactive and their billings. Once you delete a patient record with this utility, you cannot retrieve the data, so be sure to make a backup before you continue.
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When you select Delete Inactive Patients, a data selection question box will appear asking you for the range of Patients, the range of Dates of Last Visit, the range of Patient Codes, and the range of Patient Types that you want to delete.
The Dates of Last Visit range refers the date on which a procedure was last entered for the patient.
Enter the appropriate ranges for the patient records that you want to delete and click OK to run the utility. To delete all the inactive patient records that have paid billings, leave all the ranges blank.
Archive Inactive Patients
Select Archive Inactive Patients (click Lists and click Patient) to archive both the patient records that you have marked inactive and their billings. Once you archive patients, their records will be in a different file from the patients who have not been archived. The patient records will no longer appear in the Patients window. You can reverse the archival process, but you should make a backup of your data in any case in the event of some unforeseen problem.
When you select Archive Inactive Patients, a data selection question box will appear, asking you for the range of Patients, the range of Dates of Last Visit, the range of Patient Codes, and the range of Patient Types that you want to archive.
Enter the appropriate ranges for the patient records that you want to archive and click OK to run the utility. To archive all of the inactive patient records that have a zero balance, leave all of the ranges blank.
Unarchive Patients
Select Unarchive Patients (click Lists and click Patient) to put the patient records you previously archived back into the Patients window. This utility will only retrieve records that have been archived but not deleted. Before you proceed with this utility, make sure you make a backup of your data in the event of an unforeseen problem. For information on archiving patient records, see the previous section.
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When you select Unarchive Patients, a data selection question box will appear, asking you for the range of Patients, the range of Dates of Last Visit, the range of Patient Codes, and the range of Patient Types that you want to unarchive.
Enter the appropriate ranges for the patient records that you want to unarchive and click OK to run the utility. To unarchive all of the archived patient records, leave all of the ranges blank.
Delete Archived Patients
Select Delete Archived Patients (click Lists and click Patient) to delete both archived patient records and their billings completely from your practice. This utility will only delete patients that have been previously archived. Once you delete an archived record with this utility, you cannot retrieve the data, so be sure to make a backup before you continue.
When you select Delete Archived Patients, a data selection question box will appear, asking you for the range of Patients, the range of Dates of Last Visit, the range of Patient Codes, and the range of Patient Types that you want to delete.
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Enter the appropriate ranges for the patient records that you want to delete and click OK to run the utility. To delete all the archived patient records, leave all the ranges blank.
Paid/Archived Billings
Before you can delete or archive any billings, the following steps must be taken:
You must be logged in as the SYSTEM user. If you do not have security set up in your program, you are logged in as a SYSTEM user.
You must be the only user in the system while you run these utilities.
The billings you intend to delete or archive must be paid billings, indicating not only a zero balance but also the transactions in the billing have been printed and closed on a Day Sheet.
To run utilities that pertain to billings only, click Billing and click Charges and Payments.
Delete Paid Billings
Select Delete Paid Billings (click Billing and click Charges and Payments) to delete selected paid billings that have a zero balance.
For this utility to remove a billing, all transactions attached to the billing must have been printed and closed on a Day Sheet.
NOTE: Once you delete a paid billing with this utility, you cannot retrieve the data; so be sure to make a backup before you continue.
Data selection questions will appear, asking you for the range of Patients, the range of Billing Numbers, the range of Billing Created Dates, the range of Patient Codes, the range of Patient Types, and the range of Providers for which you want to delete paid billings. Enter the appropriate ranges for the paid billings that you want to delete and click OK to run the utility. To delete all the eligible paid billings, leave all the ranges blank.
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Archive Paid Billings
Select Archive Paid Billings (click Billing and click Charges and Payments) to archive selected paid billings that have a zero balance. For this utility to remove a billing, all transactions attached to the billing must have been printed and closed on a Day Sheet.
Once billings are archived, they only appear on certain reports, such as the Patient Ledger, Transaction Journal, and Practice Analysis. They will not appear in the Charges and Payments window. You can reverse the archival process, but you should make a backup of your data in the event of some unforeseen problem.
When you select Archive Paid Billings, data selection questions will appear asking you for the range of Patients, the range of Billing Numbers, the range of Billing Created Dates, the range of Patient Codes, the range of Patient Types, and the range of Providers for which you want to archive paid billings. Enter the appropriate ranges for the paid billings that you want to archive and click OK to run the utility. To archive all of the eligible paid billings, leave all of the ranges blank.
Unarchive Billings
Select Unarchive Billings (click Billing and click Charges and Payments) to put the billings you previously archived back into the active transaction data files. This utility will only retrieve billings that have been archived but not deleted. Before you continue with this utility, make sure you make a backup of your data in the event of an unforeseen problem.
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When you select Unarchive Billings, data selection questions will appear asking you for the range of Patients, the range of Billing Numbers, the range of Billing Created Dates, the range of Patient Codes, the range of Patient Types, and the range of Providers for which you want to unarchive billings. Enter the appropriate ranges for the billings that you want to unarchive and click OK to run the utility. To unarchive all the eligible billings, leave all the ranges blank.
Delete Archived Billings
Select Delete Archived Billings (click Billing and click Charges and Payments) to delete selected archived billings. This utility will only delete billings that have been previously archived. Once you delete an archived billing with this utility, you cannot retrieve the data, so be sure to make a backup before you continue.
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When you select Delete Archived Billings, data selection questions will appear asking you for the range of Patients, the range of Billing Numbers, the range of Billing Created Dates, the range of Patient Codes, the range of Patient Types, and the range of Providers for which you want to delete archived billings. Enter the appropriate ranges for the archived billings that you want to delete and click OK to run the utility. To delete all the eligible archived billings, leave all the ranges blank.
Delete Managed Care Payments
Select Delete Managed Care Payments (click Payments and click Managed Care Payments) to delete managed care payments that you have entered through the Managed Care Payments wizard. Once you delete managed care payments with this utility, you cannot retrieve the data; so be sure to make a backup before you continue.
When you select Delete Managed Care Payments, a window will appear with a Remove payments through range. Enter the date through which you want to delete managed care payments in this field and click OK to run the utility. To delete all of the managed care payments, leave the range blank.
Delete Appointments
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Select Delete Appointments (click Scheduling) to delete appointments through a certain date. If there are a lot of inactive or outdated appointments in your practice, you can use this option to delete them from the system. Once you delete appointments with this utility, you cannot retrieve the data; so be sure to make a backup before you continue.
When you select Delete Appointments, a window will appear with a Remove appointments through range field. This range includes all the appointments scheduled up to and including the date you enter. Enter the date through which you want to delete appointments in this field and click OK to run the utility. To delete all of the appointments, leave the range blank.
Rebuild Data Files
Each practice has an individual set of data files. If these files become corrupted or damaged by a power outage, a power surge, or a hardware failure, and a recent backup does not exist, you will need to conduct a rebuild. Rebuilding data files can repair some data problems; however, it does have its limitations. The best way to protect your data files in the event that they become corrupted is to make a backup every day.
NOTE: This utility is not designed to be run on a regular basis. You should only rebuild your data files if you have a problem with balances, links, or if a Lytec support technician tells you to rebuild them.
Select Rebuild Data Files (click Tools), and the Rebuild Data Files window appears.
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Click the Reset Patient Balances check box if you want to reset the patient balances. Click the Reset Transaction Headers check box if you want to reset the transaction headers.
Select the data files that you want to rebuild in the list of Data Files to Rebuild. Click the Select All button to check each file in the list. Then click OK to start the reset and/or rebuild process.
Index
175
Index A
A/R Management Activities ....................... 95
Aging Patient and Insurance Balances ... 130
Analyzing Revenue .................................. 120
Apply Insurance Payments ........................ 74
Apply Patient Payments ............................ 76
Appointment Grid Buttons ....................... 107
Appointment Grid Views and Buttons ...... 105
Assign Billings to an Agent ........................ 94
Assigning Rules ......................................... 38
B
Billing Claims and Statements ................... 82
Billing Insurance Claims ............................ 82
Billing Statements ...................................... 86
C
Calendar .................................................. 102
Charges and Payments Window Buttons .. 73
Creating a Practice .................................... 33
Custom Reports ....................................... 138
Customizing Your Program ....................... 34
D
Delete Appointments ............................... 145
Delete Managed Care Payments ............ 145
Diagnosis Codes........................................ 62
E
EDI Receivers ............................................ 47
Electronic Claims ....................................... 85
Electronic Statements ................................ 90
Eligibility Verification Setup ....................... 97
Entering an Appointment ......................... 104
Entering Charges and Payments............... 72
Entering an Attorney, Employer, or Other Addresses .............................................. 63
Entering and Editing Facility Information ... 51
Entering and Editing Insurance Company Information ............................................. 49
Entering and Editing Practice Information . 43
Entering and Editing Practice Information for a Billing Service...................................... 47
Entering and Editing Provider Information . 54
Entering and Editing Referring Physician Information ............................................ 57
G
Getting Started With Lytec .......................... 1
Guarantors ................................................ 64
I
Inactive/Archived Patients ...................... 139
L
Lists ......................................................... 138
M
Managing Overdue Balances ................... 93
N
Navigating in Lytec...................................... 7
New in this Version ..................................... 1
O
Opening a Practice ................................... 33
P
Paid/ArchivedBillings .............................. 142
Paper Claims ............................................ 82
Paper Statements ..................................... 86
Patients ..................................................... 65
Pending Transactions ............................... 81
Preferences ............................................... 42
Preparing Reports ................................... 112
Prepayments ............................................. 78
Printing Patient Information .................... 125
Printing Reports ...................................... 113
Put Billings in A/R Management ............... 93
R
Rebuild Data Files................................... 146
S
Scheduling Tasks...................................... 99
Security ..................................................... 41
Setting up the Program ............................. 33
Statement Pre-Run Report ....................... 91
T
Tracking Finances................................... 114
Transaction Codes .................................... 59
W
Wait List .................................................. 103
Index
176
Ways to Verify Eligibility ............................ 97