Make an appointment:
1. Navigation Menu: Calendar
2. In Provider list under calendar at screen left, select Provider
3. Click in schedule on desired time
4. In popup "Add New Event" select appointment category, select patient, provider, time, duration (if time not desirable, click button 'Find Available' and select from 2nd popup).
5. Enter any comments; these will appear to Provider in beginning of encounter form and on the calendar as a mouse-over function,
6. Click 'Save' button
Check Patient In/ Track Appointment Status
Any staff with calendar privileges may change appointment status
1. At Calendar Screen, click on the appointment time in the Patient's schedule slot
2. In 'Edit Event' panel select from 'Status' dropdown menu the appropriate status
3. Click 'Save' button at popup bottom
Start / Conduct Encounter
1. Double click on Patient name in calendar to begin encounter. Hit the + symbol to create an encounter.
If new encounter screen does not appear click navigation menu Patient/Client > Visits > Create Visit
2. Enter Consultation Brief Description
3. Select if not already present, Visit Category, Sensitivity, Date of Service
4. Click issues associated with this encounter if present (right hand issues list)
5. Click the 'Save' button at top
6. New encounter summary panel appears; proceed with encounter using forms from shaded menu bars at top of encounter summary panel.
Encounter Summary - returns to this summary screen
Administrative - quick access to modules in navigation menu:
Fee Sheet - also accessible from Administrative (grey bar) > Fee Sheet
Misc Billing Options HCFA - from Patient/Client > Visit Forms
New Encounter Form - also from Patient/Client > Visits > Create Visit
Procedure Order - also from Patient/Client > Visit Forms
Clinical Instructions - also from Patient/ Client > Visit Forms
7. Click 'Save' buttons at top or bottom of all forms
8. Add Medications, New Problems, Issues, etc in Patient summary screen
9. If new Issues were introduced, click Issues link in patient summary screen and associate Issue with encounter
10. Return to Calendar and select next patient
In the Encounter summary screen select Fee Sheet from menu bar, also accessible from Administrative > Fee Sheet
- Select the price level if not Standard
- Select CPT4 codes from service category drop-downs
- 'Search' – select diagnosis and procedure codeset; enter partial search term;
- Click 'Search' button
- Click on search result to add to fee sheet
- Select Diagnoses from search tools
- Itemize inventory products and their prices dispensed from 'Products' drop down menu
- 'Review' button - survey fee summary to this point
- 'Add Copay' button - to fees, if applicable
- Add item 'Modifiers', 'Price', 'Units', select 'Justification'
- Select from drop-down menu, 'Rendering Provider'
- 'Refresh' display if multiple changes have been made
- Click 'Save' button or 'Cancel'
Add Patient Issues
- In Patient summary screen click on link at top, 'Issues'
- Click on relevant Issue or click 'Add' button in desired issue category
- Select issue title (text to be displayed) or enter other title
- Search for select diagnosis code
- Enter other data
- Click 'Save' button on popup
- Click small button (with zero in it) at right in “Enc” column
- Click encounter in right half of new popup with today's date in it
- Click 'Save' button on popup
Add Prescription/Order Medication
- Click 'Edit' button for 'Prescription' at bottom right of Patient summary screen
- Click 'Add' button
- Provide info as appropriate
- Click in 'Drug' field to select drug name, click text (click here to search)
Things to Remember:
- Quantity = dispense quantity
- Medicine Units = is strength, eg 200, then select units from drop0down menu
- Take = number per dose;
- Select from drop-down menus: form, route, frequency
- Refills = how many the Rx is good for
- # of tablets = number to dispense in each refill (even if not tablets)
- Notes = will appear on the Rx
- Add to med list: select 'yes' and this med will appear in the issues list.
- Click 'Save' button at top
To print a Rx, click 'List' button at top of Prescriptions panel, and select type of printout for the desired prescription .
Add Note About Patient for Other Staff
- In Patient summary screen next to Notes item click on '(expand)' link to view all current notes
- Click 'Edit' button next to Notes item to invoke Patient Notes screen
- Click 'To add notes, please click here' text. If notes are already there, click 'Click here to view them all' and then the + symbol for a new note
- Select from 'Type' drop-down menu for the type of note; i.e. what sort of concern it refers to
- Select from 'To' drop-down menu for the recipient of the note
- Enter note in text area
- Click button 'Save As New Note'
Note will appear in patient's summary page and recipient's Messages and Reminders on their next login
Create Referrals/ Transactions
1. At the top of Patient summary screen click link, 'Transactions'
2. On Patient Transactions panel click 'Add' button at top
3. Set Referral date, Refer By
4. Select External Referral: Yes/No
5. Select Refer To:
if 'External Referral' = no, displays in-house providers
if 'External Referral' = yes, displays names of all external entities entered into the facility's Address Book.
6. Enter Reason
7. Referrer Diagnosis: free text
8. Select Risk Level
9. Requested Service: Service Code search dialog box
10. Click on appropriate search return
11. Select Include Vitals? Yes/No
12. At top right, check or not: Sent Medical Records
13. Click 'Save' button at top of panel
14. At Patient Transaction panel click 'View' button to print
15. Click anywhere off the Referral Form to exit Patient Transaction panel
- On Patient Summary Screen, at the bottom right locate item 'Immunizations'
- Click 'Edit' button at left
- Click in 'Immunization (CVX code)' text area
- In search popup enter partial vaccine name in 'Search for' text area
- Click 'Search' button
- Click on desired 'Code Description' in search results
- Description is transferred to “Immunizations” display
- Enter remaining information
- Click 'Save Immunization'
OpenEMR's Billing and Batch Payments modules are structured so their workflows may be performed separately, in any order.
Billing and Batch Payments functions are restricted to the Administrator user and any others with the 'Accounting' ACL access permission.
You do NOT need to be logged into the Patient you're doing the billing work on.
- Navigation menu: Fees > Billing: reports the claims from fee sheets that are ready to be corrected and billed.
- Navigation menu: Fees > Batch Payments
- 'New Payments' tab: Log in an EOB / payment on patients' accounts may allocate funds to Patient's accounts at that time or later
- 'Search Payment' tab: find payments ready to be allocated, and allocate them
- 'ERA Posting' tab: process an incoming ERA file.
Navigation menu: Fees > Billing
Billing Manager module: on opening, by default it displays unbilled encounters from current date (today)
Use the two-panel 'Choose Criteria/Current Criteria' search tool to display encounters matching the criteria (Click 'Update List' to initiate search)
To delete existing “Current Criteria” in right window:
1. click criteria
2. click red X)
Generate Claims - Part 2
1. Choose criteria in left window
2. Enter specific criteria parameters in middle space. Criteria appears in right window
3. Click text '[Update List]' at top right
4. In lower panel results display click links:
[To Enctr (date)]: display that encounter to correct encounter (Fee Sheet) errors
[To Dems]: display that Patient's Demographics to correct Demographics errors
(Expand): show billing status message on encounter; also to locate previous x12 batch file
5. Click in checkbox at right end of all encounters for which a claim will be made
6. Click button 'Generate X12' to generate claim file popup reminds to check the log after producing x12 batch file
7. Click 'OK' to make x12 batch file and mark item as cleared
Click 'Cancel' to generate x12 and NOT mark claim as cleared
8. 'Save File' dialog appears
9. Click 'OK' to save the batch file to browser's Download directory/folder
10. Click link at top right, 'View Log'
11. View error log file
12. Reopen the claim with errors in it (see below) and correct errors
13. Re-submit the claim: repeat from Step 5 above including 'View Log')
14. Process next claim.
Reopen a Billed Encounter
In Billing Manager module:
If error log indicates an error condition in the encounter, the encounter must be re-opened:
- Search for encounter again (billing status = "Billed" or "All")
- Click link 'Update List'
- Select checkbox at right of faulty encounter (activates the 'Re-Open' button )
- Click 'Re-Open' button
- Read notification of re-opening; click link 'back'
Navigation menu: Fees > Billing Manager
Remove search criteria in right window
- Choose criteria, 'Billing Status'; parameter: 'All'
- Enter (or re-enter) date range
- Click 'Update List'
- Click in checkbox at right of encounter
- Click button to generate desired form
- Batch Processing EOB payments and Accounts Receivables
- Navigation menu: Fees > Batch Payments
Select task from the 3 tabs:
- New Payment: record received EOB's/payments on account;
- Search Payment: find EOB's/payments that have not been (fully) allocated
- ERA Posting: process an ERA file
On receipt of an EOB and payment from a Payor:
1. Select 'New Payment' tab reveals "Batch Payment Entry"
2. Enter information from the EOB:
Date: of EOB
Post to Date: payment posting date
Payment Method: defaults to 'Check Payment'
Check Number: If Payment Method is 'Check', enter EOB payment check number
Payment amount: Total amount of EOB payment
Paying Entity: Insurance or Patient
Payment Category: Family/Group/Insurance/Patient/Pre payment
Payment From: Payor name; enter partial name and select full name from popup
Deposit Date: the payment is to be deposited in facility's account
Description: (free text field) description of the payment; optional
Undistributed: red text area at right is amount of total payment yet undistributed
decreases as allocations made to Patient's accounts.
3. Finish logging EOB / payment:
4. If allocating these funds later:
Click button 'Save Changes' and answer 'Yes' to popup
Click on the 'New Payment' tab again and log another EOB
5. If allocating funds now:
Click button, 'Allocate' and answer 'Yes' to popup
1. In new panel below Batch Payment Entry panel, enter Patient's partial name as given in EOB
2. Select charge type:
Non-paid: charges which have not had any payments applied yet
Show Primary Complete: Primary Insurance has been paid
Show All Transactions: all, of whatever status.
3. New lower panel shows all unresolved charges for this patient from this payer
Note left column, 'Post For' gives the next payer due to pay.
If all insurances have paid, this displays 'Pat' (Patient)
'Remainder' column lists amount for that service that remains to be paid
4. Enter in 'Payment' column the EOB/ amounts for each of this Patient's services
5. Click in other text area to calculate amounts
6. When finished, if EOB has no payments for other Patients
7. Click button 'Finish Payments'
8. Enter next Patient's name in new panel OR
9. Repeat from Step #4 entering next patient name from EOB until all payments are allocated
10. Click button 'Post Payments'
To enter and allocate more EOB's, click tab 'New Payment' and repeat steps from #1 above
1. On Navigation menu: Fees > Batch Payments, tab: 'Search Payment'
Panel: Payment List
2. Enter one or more search criteria describing the desired EOB/ payment
Criteria are same as in "Workflow: Log EOB" above.
3. Click 'Search' button to generate list of EOB's
4. Note Columns, 'Pay Status' and 'Undistributed' to see which are available
5. Click on any blue text in the EOB line
6. 'Edit Payment' popup appears with identical functionality beginning at step #4 in 'Workflow: Log and Allocate EOB', found above.
- Two types of reports: Clinic-wide and Patient
- Select report parameters then generate report
- Report generation is similar in all reports:
- Set report date range
- Set other parameters e.g., participants names, code numbers, amount of detail of report
- Click 'Submit' button
- Click button for optional export or printing.