Maybe this needs to be posted in both places, here on Hardhats and on Open Forum. I think it reaches two different audiences and both have something to gain and to offer.
On Saturday 05 February 2005 04:39 pm, Chris Richardson wrote: > Thurman; > > It would be even more interesting if we could move this discussion to the > Open FORUM. In the future we are expecting to have these discussions > indexed for hypertext and for people to do research with. Existing general > Fileman messages and discussions will be retro-fit to hypertext. We will > try to capture some of these discussions later, but no guarantees. This > is important knowledge-base for the whole community. Thanks for your > input, Thurman. > > Best wishes; Chris > > > ----- Original Message ----- > From: "Thurman Pedigo" <[EMAIL PROTECTED]> > To: <hardhats-members@lists.sourceforge.net> > Sent: Saturday, February 05, 2005 9:20 AM > Subject: RE: [Hardhats-members] differential charging for diagnostic tests > > > Nancy, thanks for the invite. Our homepage got out of date and we took it > > down. My wife is working on new site which should be back online by the > > end > > > of 02/05. I will post appropriate to that site. For now, I offer the > > following scheme. First I will post a series on RBRVS. It will be in 3-4 > > installments and is a series I already posted to another list (AAFP > > Practice > > > Management). > > > > Next I will give a brief history of the tribulations of AR in private > > practice, including the migration to Practice Management software. Each > > post > > > will be limited to one or two screens to avoid bandwidth overload. All > > this > > > will later be posted to our website when is restarted. The series can be > > stopped anytime on request. > > > > Let me know any recommended plan modifications....tx/t > > > > > -----Original Message----- > > > From: [EMAIL PROTECTED] [mailto:hardhats- > > > [EMAIL PROTECTED] On Behalf Of Nancy Anthracite > > > Sent: Saturday, February 05, 2005 9:45 AM > > > To: hardhats-members@lists.sourceforge.net > > > Subject: Re: [Hardhats-members] differential charging for diagnostic > > tests > > > > Thurman, this billing issue is such a thorn in the side of VistA users > > > that I > > > certainly hope you will continue this thread ONLINE and that others > > > will contribute to it. I think it is a major cause for the > > > non-adoption of VistA > > > and something important for the VistA-Office adopters to consider. > > > Remember > > > that the archive of this mailing list is an important reference for > > > many of > > > us strugglers, and this is an important topic to have included in it. > > > > > > On Saturday 05 February 2005 09:39 am, Thurman Pedigo wrote: > > > > This is an excellent example to demonstrate the use of adjustment > > codes. > > > > It > > > > > > > is important to remember the systems doesn't care how one names these > > > > codes. The code names only need have meaning to you and your > > > > correspondents. Below are just a few examples: > > > > ========================= > > > > 4 Employer Reduction > > > > 5 Not Approved > > > > 6 Lab Rejected > > > > 7 Additional Emp Payment > > > > 8 Professional Courtesy > > > > ========================= > > > > These codes can be unlimited (1,000s) and represent insurance > > companies, > > > > > special employer arrangements, or special indigent categories such as > > > > unemployed, disabled, or whatever applies to your population. > > > > > > > > The added value of this system is the ease of adding cost accounting. > > > > > > Any > > > > > > > material or activity coat may be attached to the procedure. I don't > > > > > > want > > > > > > > to chew up a lot of bandwidth on this post, but will be glad to > > continue > > > > > this thread online of off line. Strongly advise understanding this > > > > > > concept > > > > > > > before adding complications to charges. > > > > > > > > Example below- partial AR record: Notice the $62.03 write off > > > > (Adj)hopefully format works...tx/t > > > > =============================================== > > > > Company: XXXXXX COMPANYXXXXXXXXXX DOI:03/29/01 > > > > > > > > CHG SLIP # PATIENT DR > > > > 17065.0 PATIENT NAMEXXXXXX - 1006901 Pedigo > > > > DOS DISCRIPTION AMT ADJUSTMENTS > > LINE > > > > > BAL 032901 99203 - Office/outpa 110.00 > > > > 043001 COMPANYXXXXX 8 -110.00 > > > > > > 0 > > > > > > > 032901 73564 - X-ray exam o 118.00 > > > > 043001 COMPANYXXXXX 8 -55.97 -62.03Ins Adj > > > > > > 0 > > > > > > > 032901 L1810 - KNEE SUPPORT 25.00 > > > > 043001 COPANYXXXXX 8 -25.00 > > > > > > 0 > > > > > > 0.00 > > ----- > > > > --- > > > > > > > TOTAL > > > > > > 0.00 > > > > > > > > -----Original Message----- > > > > > From: [EMAIL PROTECTED] > > > > > [mailto:hardhats- [EMAIL PROTECTED] On Behalf Of > > > > > Nick James Sent: Friday, February 04, 2005 10:48 PM > > > > > To: hardhats-members@lists.sourceforge.net > > > > > Subject: RE: [Hardhats-members] differential charging for > > > > > diagnostic tests > > > > > > > > > > Hi Thurman, > > > > > > > > > > Thanks, that is certainly helpful. > > > > > > > > > > But the issues also relate to a categorisation of > > > > > direct paying patients which includes free (only some > > > > > select tests are free) subsidy, semi-subsidy, normal > > > > > private and luxury provate. The hospital where we once > > > > > worked for had six categories, each with differing > > > > > charges for the same test. I suppose one could treat > > > > > each category as a different employer using the same > > > > > logic as in industrial billing. Please comment. > > > > > > > > > > --- Thurman Pedigo <[EMAIL PROTECTED]> wrote: > > > > > > This is a little different philosophy that has > > > > > > worked well for me over the > > > > > > past 30 years. > > > > > > > > > > > > Billing for commercial insurance, Medicare, and > > > > > > Medicaid, have no need for > > > > > > "multiple rate" billing. Adjustments/write-offs, > > > > > > bring the payments into > > > > > > compliance with the charge and provides a powerful > > > > > > tool to assess > > > > > > performance in the accounts receivables. > > > > > > > > > > > > Industrial billing, where one contracts to with an > > > > > > employer to do specific > > > > > > services at a set price uses modification of the > > > > > > last 2 characters in the > > > > > > CPT code AND includes the company name in the > > > > > > description. > > > > > > > > > > > > Thanks, > > > > > > > > > > > > thurman > > > > > > > > > > > > > -----Original Message----- > > > > > > > From: [EMAIL PROTECTED] > > > > > > > > > > > > [mailto:hardhats- > > > > > > > > > > > > > [EMAIL PROTECTED] On Behalf Of > > > > > > > > > > > > Nancy Anthracite > > > > > > > > > > > > > Sent: Friday, February 04, 2005 1:11 PM > > > > > > > To: hardhats-members@lists.sourceforge.net > > > > > > > Subject: Re: [Hardhats-members] differential > > > > > > > > > > > > charging for diagnostic tests > > > > > > > > > > > > > I believe the majority of the billing is not done > > > > > > > > > > > > within VistA. The > > > > > > > > > > > > > recent > > > > > > > billing patches, to my knowledge, only gather > > > > > > > > > > > > together information for a > > > > > > > > > > > > > third party billing service to use to process a > > > > > > > > > > > > claim, and it may not even > > > > > > > > > > > > > include charges at all, as I believe that is > > > > > > > > > > > > probably handled by the > > > > > > > > > > > > > processing entity or information provided to that > > > > > > > > > > > > entity separately. Even > > > > > > > > > > > > > if > > > > > > > there are charges withing VistA, I doubt there are > > > > > > > > > > > > any rates that would > > > > > > > > > > > > > differ from patient to patient. > > > > > > > > > > > > > > On Friday 04 February 2005 07:22 am, Nick James > > > > > > > > > > > > wrote: > > > > > > > > can multople rates be maintained by VistA? > > > > > > > > > > > > > > > > If the charges applicable for a test are to be > > > > > > > > > > > > based > > > > > > > > > > > > > > on the patient type, and multiple rates apply > > > > > > > > > > > > for the > > > > > > > > > > > > > > same test depending on the patient type. > > > > > > > > > > > > > > > > If so how is it defined and which file is it > > > > > > > > > > > > stored in? > > > > > > > > > > > > > > __________________________________ > > > > > > > > Do you Yahoo!? > > > > > > > > All your favorites on one personal page - Try My > > > > > > > > > > > > Yahoo! > > > > > > > > > > > > > > http://my.yahoo.com > > > > > > > > > > ------------------------------------------------------- > > > > > > > > > > > > > This SF.Net email is sponsored by: IntelliVIEW > > > > > > > > > > > > -- Interactive Reporting > > > > > > > > > > > > > > Tool for open source databases. Create > > > > > > > > > > > > drag-&-drop reports. Save time > > > > > > > > > > > > > > by over 75%! Publish reports on the web. Export > > > > > > > > > > > > to DOC, XLS, RTF, etc. > > > > > > > > > > > > > > Download a FREE copy at > > > > > > > > > > > > http://www.intelliview.com/go/osdn_nl > > > > > > > > > > > > > > _______________________________________________ > > > > > > > > Hardhats-members mailing list > > > > > > > > Hardhats-members@lists.sourceforge.net > > > > > > > > > > https://lists.sourceforge.net/lists/listinfo/hardhats-members > > > > > > > > > > > > -- > > > > > > > Nancy Anthracite > > > > > > > > > > ------------------------------------------------------- > > > > > > > > > > > > This SF.Net email is sponsored by: IntelliVIEW -- > > > > > > > > > > > > Interactive Reporting > > > > > > > > > > > > > Tool for open source databases. Create drag-&-drop > > > > > > > > > > > > reports. Save time > > > > > > > > > > > > > by over 75%! Publish reports on the web. Export to > > > > > > > > > > > > DOC, XLS, RTF, etc. > > > > > > > > > > > > > Download a FREE copy at > > > > > > > > > > > > http://www.intelliview.com/go/osdn_nl > > > > > > > > > > > > > _______________________________________________ > > > > > > > Hardhats-members mailing list > > > > > > > Hardhats-members@lists.sourceforge.net > > > > > > > > > > https://lists.sourceforge.net/lists/listinfo/hardhats-members > > > > > > > > > > > > > > > > > > > > > > > > > ------------------------------------------------------- > > > > > > > > > > > This SF.Net email is sponsored by: IntelliVIEW -- > > > > > > Interactive Reporting > > > > > > Tool for open source databases. Create drag-&-drop > > > > > > reports. Save time > > > > > > by over 75%! Publish reports on the web. Export to > > > > > > DOC, XLS, RTF, etc. > > > > > > Download a FREE copy at > > > > > > http://www.intelliview.com/go/osdn_nl > > > > > > _______________________________________________ > > > > > > Hardhats-members mailing list > > > > > > Hardhats-members@lists.sourceforge.net > > > > > > > > > > https://lists.sourceforge.net/lists/listinfo/hardhats-members > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > __________________________________ > > > > > Do you Yahoo!? > > > > > Yahoo! Mail - You care about security. So do we. > > > > > http://promotions.yahoo.com/new_mail > > > > > > > > > > > > > > > ------------------------------------------------------- > > > > > This SF.Net email is sponsored by: IntelliVIEW -- Interactive > > > > > > Reporting > > > > > > > > Tool for open source databases. Create drag-&-drop reports. Save > > time > > > > > > by over 75%! Publish reports on the web. Export to DOC, XLS, RTF, > > etc. > > > > > > Download a FREE copy at http://www.intelliview.com/go/osdn_nl > > > > > _______________________________________________ > > > > > Hardhats-members mailing list > > > > > Hardhats-members@lists.sourceforge.net > > > > > https://lists.sourceforge.net/lists/listinfo/hardhats-members > > > > > > > > ------------------------------------------------------- > > > > This SF.Net email is sponsored by: IntelliVIEW -- Interactive > > Reporting > > > > > Tool for open source databases. Create drag-&-drop reports. Save time > > > > by over 75%! Publish reports on the web. Export to DOC, XLS, RTF, > > > > etc. Download a FREE copy at http://www.intelliview.com/go/osdn_nl > > > > _______________________________________________ > > > > Hardhats-members mailing list > > > > Hardhats-members@lists.sourceforge.net > > > > https://lists.sourceforge.net/lists/listinfo/hardhats-members > > > > > > -- > > > Nancy Anthracite > > > > > > > > > ------------------------------------------------------- > > > This SF.Net email is sponsored by: IntelliVIEW -- Interactive Reporting > > > Tool for open source databases. Create drag-&-drop reports. Save time > > > by over 75%! Publish reports on the web. Export to DOC, XLS, RTF, etc. > > > Download a FREE copy at http://www.intelliview.com/go/osdn_nl > > > _______________________________________________ > > > Hardhats-members mailing list > > > Hardhats-members@lists.sourceforge.net > > > https://lists.sourceforge.net/lists/listinfo/hardhats-members > > > > ------------------------------------------------------- > > This SF.Net email is sponsored by: IntelliVIEW -- Interactive Reporting > > Tool for open source databases. Create drag-&-drop reports. Save time > > by over 75%! Publish reports on the web. Export to DOC, XLS, RTF, etc. > > Download a FREE copy at http://www.intelliview.com/go/osdn_nl > > _______________________________________________ > > Hardhats-members mailing list > > Hardhats-members@lists.sourceforge.net > > https://lists.sourceforge.net/lists/listinfo/hardhats-members > > ------------------------------------------------------- > This SF.Net email is sponsored by: IntelliVIEW -- Interactive Reporting > Tool for open source databases. Create drag-&-drop reports. Save time > by over 75%! Publish reports on the web. Export to DOC, XLS, RTF, etc. > Download a FREE copy at http://www.intelliview.com/go/osdn_nl > _______________________________________________ > Hardhats-members mailing list > Hardhats-members@lists.sourceforge.net > https://lists.sourceforge.net/lists/listinfo/hardhats-members -- Nancy Anthracite ------------------------------------------------------- This SF.Net email is sponsored by: IntelliVIEW -- Interactive Reporting Tool for open source databases. Create drag-&-drop reports. Save time by over 75%! Publish reports on the web. Export to DOC, XLS, RTF, etc. Download a FREE copy at http://www.intelliview.com/go/osdn_nl _______________________________________________ Hardhats-members mailing list Hardhats-members@lists.sourceforge.net https://lists.sourceforge.net/lists/listinfo/hardhats-members
