Coding visits and billing

Support
1

Since I am new to this software. Can somebody help me and direct how to code office visits/ bill them to insurance companies? can I bill them directly through open EMR?

Can I customize my coding and office visits as cardiologist/ Cardiology visits/ services, e.g new cardiology visit, follow-up visits, EKG and echo, etc… coding?

When creating a new patients visits or follow-up visits, do I need to upload templates or there are prepopulated visit notes/ templates like chief complain, HPI, PE, A&P since I didn’t see any!!

How I code and bill consults and procedures that I perform in hospital through this open EMR?

Thanks

2

Check this demo:
https://two.openemr.io/e/openemr/

Can somebody help me and direct how to code office visits/ bill them to insurance companies? can I bill them directly through open EMR?
Yes, when you creat an encounter you can write your note and under Administrative there is a fee sheet that you can bill the insurance.

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Can I customize my coding and office visits as cardiologist/ Cardiology visits/ services, e.g new cardiology visit, follow-up visits, EKG and echo, etc… coding?
Yes, under Admin → Coding → Codes you can set your only frequently used cods description and fee. Then you can use these codes to bill the insurance at an encounter level.

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When creating a new patients visits or follow-up visits, do I need to upload templates or there are prepopulated visit notes/ templates like chief complain, HPI, PE, A&P since I didn’t see any!!
You have options here. I build a LBF LBV Forms - OpenEMR Project Wiki with some feild that would auto fill and some that I do fill myself. There are a list of options under Admin → Forms → Forms Administration that you can use edit and customise.

How I code and bill consults and procedures that I perform in hospital through this open EMR?
I have not done so. I think you can you have to pay attention to place of service

2 Likes
3

Check these links:
https://www.open-emr.org/wiki/index.php/Getting_Started

https://www.open-emr.org/wiki/index.php/OpenEMR_6.x_Billing_-_Claims_Workflows

https://www.open-emr.org/wiki/index.php/A_Generic_Medical_Encounter_Workflow_in_OpenEMR_6.1

2 Likes
4

Thank you very much for those useful information,

I created encounter and clicked on it and it gave me option to fill out vitals, ROS, A&P but no physical exam!

I tried the forms you mentioned under admin but they are not clickable to open them! it say PHP extracted and DB installed! but cant open them.

Regarding forms you suggested under Wiki, not sure how to upload them to my system, if you have any instructions?

For billing once generated per your instructions, can I submit it electronically to insurance company through open EMR?

Last question for now, how can I enter the name of provider who referred the patient to me?

Sorry for multiple questions, but this system a bit hard for me since I am starting my own practice and before I was in hospital setting and was all answered by hospital IT.

Thanks

5

I created encounter and clicked on it and it gave me option to fill out vitals, ROS, A&P but no physical exam!

  • Under Admin → Forms → Forms Administration → Unregistered there is Physical Exam form, click register . It will move the form to Registered area. Then click on install DB , then disabled. Make sure it is enabled . If you want the form under clinical make sure you change Misc to Clinical
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For billing once generated per your instructions, can I submit it electronically to insurance company through open EMR?

  • Claims do not go to insurance. They usually go to Clearinghouse then insurance. You have to set a Clearinghouse first. I use office ally. I think there is one that is easily integrated with openemr . You also have to set your insurace (see links below)

https://www.open-emr.org/wiki/index.php/Setting_Up_Your_Clinic
https://www.open-emr.org/wiki/index.php/ClaimRev_Clearinghouse_Module

how can I enter the name of provider who referred the patient to me?
When yu create / edit a patient under Choices there is an area for Referring Provider. I changed it in the Demographic LBF to be List with Add to make it easier on me to add refering physicians

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There will be some learning curve. Once these initial setup is done things will be much easy later on.

1 Like
6

Thank you,

when I registered physical exam and enabled it, the following error showed up when I try to enter physical exam to my note:

Warning: Undefined array key “id” in C:\xampp\htdocs\openEMR\interface\forms\physical_exam\new.php on line 84

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WNL ABNL System Specific Diagnosis Comments
GEN Appearance
EYE Conjuntiva, pupils
ENT TMs/EAMs/EE, ext nose
Nasal mucosa pink, septum midline
Oral mucosa pink, throat clear
Neck supple
Thyroid normal
CV RRR without MOR
No thrills or heaves
Cartoid pulsations nl, pedal pulses nl
No peripheral edema
CHEST No skin dimpling or breast nodules
RESP Chest CTAB
Respirator effort unlabored
GI No masses, tenderness
No organomegaly
No hernia
Anus nl, no rectal tenderness/mass
GU No testicular tenderness, masses
Prostate w/o enlrgmt, nodules, tender
Nl ext genitalia, vag mucosa, cervix
No adnexal tenderness/masses
LYMPH No adenopathy (2 areas required)
MUSC Strength
ROM
Stability
Inspection
NEURO CN2-12 intact
Reflexes normal
Sensory exam normal
PSYCH Orientated x 3
Affect normal
SKIN No rash or abnormal lesions
OTHER Other

Treatment:
Labs
X-ray
Return Visit

7

Hello @Amer_Aladin
@moussa has made some very helpful suggestions to your questions. It seems that one factor common to your problems might be that you have not set up your EMR’s practice configuration completely. Many of these procedures can be done in the demo (for example as shown with Wanda Moore’s record) but billing and encounter forms and several other workflows you want to do require in-depth configuration of your own EMR to function properly.

One thing to remember that much of the wiki documentation shows older versions of OpenEMR. The steps still apply but some things like the ‘getting around’ page have been updated to v7 so the screens look right.

When you get to the wiki page on the user guide for your version of OpenEMR
https://www.open-emr.org/wiki/index.php/OpenEMR_7.0.2_Users_Guide

look in the top sections that say they’re for newer versions than v 5:

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Try this as an introduction to setting up your practice. It has links to in-depth coverage of a lot of the advanced procedures.
https://www.open-emr.org/wiki/index.php/OpenEMR_7_New_Clinic_Setup

As far as creating your own set of billing codes look here:
https://www.open-emr.org/wiki/index.php/HOWTO:_Add_Custom_Service_Codes_To_The_Fee_Sheet_-_Updated

8
  • Try setting your practice in your openemr as Harley suggested and see if it works.
  • See if these are true errors or just warning by checking the forms in an encounter (under Clinical or Misc)
  • If you still having an issue, try building your own LBF (Admin → Forms → layout) and put it under Clinical. This is the route that I decided to take. It has all the fields that I needed. I also set some fields to carry over from last visit encounter and others to auto-fill so I do not have to type as much

https://www.open-emr.org/wiki/index.php/LBV_Forms

Note that with Nation Notes Nation Notes - OpenEMR Project Wiki you can style your text so it looks nicer when printing or downloading

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9

Thank you,

I followed all the steps you both sent me earlier but still physical exam showing warnings. I tried LBF form but was not easy for me to create one. Let me know if physical exam forms are available anywhere else so I can upload it to the system.

I tried to install ICD 10 and again showed me an error:
As fatal error!

My other question, you suggested “Clearinghouse” to be utilized with open EMR, if this step a must and what alternatives?

I just started my own new practice but this issues of EMR and billing backing me up and not able to proceed…

Thanks for all of you help and support and answering my questions…

10

Hello @Amer_Aladin

You have been pursuing the option of creating your own clinical forms but OpenEMR does have a collection of pre-coded forms that only need to be installed. Granted they may not have all the data fields you might wish but most of them do work as advertized. Take a look here and see if you can use them. The instructions for installing them are included on the page.

https://www.open-emr.org/wiki/index.php/OpenEMR_Contributed_Forms

As far as your billing issues are concerned you have a few options. OpenEMR can do paper invoicing direct to the patient but only if no insurance is involved. It is also capable of direct billing of an insurance company but only in special situations which are not typical. The most common arrangement is that the practice hires a clearinghouse to process their claims. The clearinghouse receives the claim files from the EMR, reformats them to be compatible with whichever insurance payer they will be sent to, and passes them on to the payer. When the payer returns the payment the clearinghouse relays it to the practice for entry into its EMR.

Both of the options for OpenEMR to bill insurance will require the help of a person who knows how to configure OpenEMR and to submit claims according to the requirements of the clearinghouse. Different clearinghouses provide assistance ranging from doing most of the work for you to requiring you to learn their system and do all the work yourself. Strictly speaking, between the information provided by the clearinghouse and the wiki documentation, all the information is available to do this yourself. But if you consider the time and effort required to learn everything it may be worth your while to hire somebody who already knows how to do it.
Best- Harley