ideaman911 wrote on Sunday, May 31, 2009:
Hi;
I think there is a "kludge" way to do this, but it will require some awareness.
First, all insurers must be defined in the Admin - Practice - Add Insurance area, so are not patient unique. But there are a few possible ways to note the differences. My suggestion would be to start for the "accident" case by assigning that as the "Tertiary", as it is the least likely to be used previously. Then, make certain to add an "Issue" for that patient as "Auto Accident - Bill Geico" for example, and select THAT issue only for those encounters where services are related to the accident.
For example, a clinic might treat an open sore from the accident but treat the patient’s diabetes at the same time. However, that should be shown as two separate encounters, one for each insurer case, albeit with the same DOS. You would select the Accident related issue for the Geico wound care, but would instead select the Diabetes issue for the BCBS, for example.
Then at Billing there will be two encounters shown for the same day. Unfortunately, a change I submitted for CVS has nit yet been loaded which would show the DOS in the Billing, so you must click on the encounter number to actually view the encounter details from there. But doing so will show the encounter (your billing person must have view authority), and then (s)he can select the tertiary insurance for that bill in the Billing, click the checkbox, and print the CMS 1500 or produce the X12 as appropriate for that (if the X12, there should be an X12 partner associated with the Geico in this case).
As I indicated, it is a little "kludgy", but it does work.
Note: In testing this, I noticed that the selection of "Accident" fields in the "Misc Billing Options HCFA" did not properly print the Yes and NY when I entered Auto Accident there. I will add that to the "Bug" list and will ask developers if an "Accident" override can be added to the 2nd & Tertiary which would disable the "Other Ins" from field 11d. You might have to, in the interim, repair those on the CMS 1500 form.
Joe Holzer Idea Man
http://www.holzerent.com