COVERAGE/BENEFIT DEFINITIONS

                                                                    

         OVERVIEW:    The Table Maintenance Menu programs allow offices 

                      to record all the information necessary to

                      bill for services rendered.  This would

                      include provider numbers; procedure codes

                      and fees; as well as diagnosis, referring,

                      and facility codes.

 

        PROCEDURE:    From the Main Menu, select Number 4 and 

                      press <ENTER KEY>. 

       EXAMPLE MENU: 

 

 

______________________________________________________________________

        After you select Number 4 from the Main Menu, the Table Maintenance 

        Menu on the following page will be displayed.

 

                  COVERAGE/BENEFIT DEFINITIONS 

                                                                     v8.4

         [OVERVIEW]:  The Coverage Definitions program takes each type 

                    of insurance benefit profile and

                    assigns a single alpha character to represent

                    it when calculating benefits.  Combinations of

                    insurances are also defined in the same manner.

                    You may assign all alpha characters, A-Z uppercase

                    and a-z lowercase.  Use of 40-50 coverages will

                    handle all the major insurance companies.

                    Miscellaneous companies can be put under a

                    Single designation of Commercial.

 

 

        [PROCEDURE]:  From the Table Maintenance Menu select Option 1, Coverage 

                    Definitions, and press <ENTER KEY>.     

______________________________________________________________________

                              

 

 

 

 

 

 

COVERAGE DEFINITIONS

 

         [TRAINING NOTE]:  The training and development staff at OMNI 

         strongly recommend that you think and choose carefully

         when entering these definitions into your system.  The

         process will become confusing once you begin assigning

         coverages to patients and then continually change them.

         Below is a list of the most commonly used codes.

 

       [EXAMPLE OF SAMPLE CODES]: 

          INSURANCE TYPE                                CODE           

          BLUE CROSS/BLUE SHIELD, FULL COVERAGE          A             

          BLUE CROSS/BLUE SHIELD, $5 LAB & XRAY          B              

          BLUE CROSS/BLUE SHIELD, 10% DEDUCTIBLE         C             

          BLUE CROSS/BLUE SHIELD, 20% DEDUCTIBLE         D             

          BLUE CROSS/BLUE SHIELD, 25% DEDUCTIBLE         E             

          BLUE CROSS/BLUE SHIELD, 30% DEDUCTIBLE         F             

          BLUE CROSS/BLUE SHIELD, WITH OVC               G             

          BLUE CROSS/BLUE SHIELD, WITH PRIVATE INS       H             

          BLUE CROSS/BLUE SHIELD, WITH MEDICAID          I             

          BLUE CROSS/BLUE SHIELD, WITH MEDICARE          J             

          MEDICARE                                       K             

          MEDICARE---HIGH OPTION BLUE CROSS/BLUE SHIELD  L             

          MEDICARE---BLUE CROSS/BLUE SHIELD              M             

          MEIDCARE---MEDICAID                            N             

          MEDICARE--PRIVATE INSURANCE                    O             

          MEDICARE--BLUE SHIELD--MEDICAID                P             

          MEDICARE--PRIVATE--MEDICAID                    Q             

          MEDICAID                                       R             

          PRIVATE INSURANCES                             S             

          PRIVATE INSURANCE WITH OVC                     T              

          PRIVATE WITH BLUE SHIELD                       U             

          PRIVATE WITH BLUE SHIELD                       V             

          PRIVATE WITH MEDICAID                          W             

          PRIVATE WITH MEDICARE                          X             

          WORKMEN'S COMP                                 Y             

          AUTO ACCIDENTS                                 Z             

          PROFESSIONAL COURTESY                          a             

          NO INSURANCE                                   z             

       After you choose Option 1 from the Table Maintenance Menu and press 

       <ENTER KEY>, the submenu below will be displayed. 

       [EXAMPLE MENU]: 

 

 

______________________________________________________________________

         1.  [Basic Coverages]: 

         Select this for entry of all basic coverage codes. That means

         codes that are not specific to Site or GROUP coverages. Select

         Option 1 and press <ENTER KEY>.  The screen below will be

         displayed. 

      [EXAMPLE SCREEN]: 

 

         Enter the letter for your first type of insurance coverage at

         the flashing cursor and press <ENTER KEY>.  If this code is not on 

         file, the system will display the following message.

         

 

         If you do not want to enter this information into the system,

         type an N for NO.  If you do want this code to be added to 

         the system, type a Y for YES and press <ENTER KEY>.  The screen 

         on the next page will be displayed.

      EXAMPLE SCREEN: 

       

 

        

         DEFINITION OF FIELDS: 

         1. [FULL NAME]:  Enter the name of the insurance coverage on 

         Line 1 of the screen and press <ENTER KEY>.  The first 20 

         characters of this name will display when you search for 

         a coverage code for a patient. 

           EXAMPLE:  1. LONG NAME: BLUE SHIELD $5 LAB/XRAY

 

         2. [SHORT NAME]:  You may enter an abbreviated version of the 

         long name here.  This may be the same as Line 1, but this 

         field is limited to 15 characters.

           EXAMPLE:  2. SHORT NAME:  BS $5 LAB/XRAY 

 

         3 TO 42 RANGE TO DEDUCT AMOUNT:  Lines 3 through 39 are used 

         when you want to charge the patient less than 100%.  You use

         these lines to identify a specific range of procedures that

         the insurance requires the patient to pay.  The amount may be

         either a flat deductible or a percentage portion.  These

         ranges are set up using the BCBS codes, not the In-house

         codes.

 

         Enter the appropriate information on Lines 3 through 39 and 

         press <ENTER KEY>.  Enter procedure codes in low to high order. 

         Enter numerical procedure codes first, alpha codes second.

          EXAMPLE: RANGE: 80000 TO 89999 DEDUCT $ 5.00 OR 010% (>AMT) 

         If deductible procedure codes do not exist for this particular

         insurance type, you may leave the fields blank by pressing

         <ENTER KEY>.

 

         43 TO 45 FIELDS:  These fields allow the user to instruct 

         the system which amount on each procedure to bill and which

         amount you should expect to receive.

 

             43. BILLED AMOUNT CODE (1-20): Field 43 identifies which 

             amount to pull from the Charge Codes Table Maintenance as the 

             billed amount. This must be one of the first 20 amounts.

 

             44. EXPECT AMOUNT CODE (1-80): Field 44 identifies which 

             amount to pull from the Charge Codes Table Maintenance as the 

             expected amount for this particular insurance. This is one

             of 1-80 amounts.

 

             45. BELOW DEDUCT. CODE (1-80): Field 45 identifies which 

             amount to pull from the Charge Codes Table Maintenance as the 

             dollar amount the patient should be charged for services

             not covered by the insurance company being defined.  This

             is one of 1-80 amounts.

             Field 45 codes may be different, based on the following 

             criteria of your practice:

                A)  You may choose not to charge patients the full

                billed amount and only the approved allowed amount.

                B)  You may be required to charge patients only the

                approved or allowable amount for carriers with which

                you participate; are required by law to charge a

                maximum amount (e.g. Medicare).

                    Example:

                        43 - BILLED FEE AMOUNT   - 1 

                        44 – REEMBURSEMENT FEE   - 2 

                        45 – NOT COVERED FEE     – 2

 

         These fields instruct the system to bill whatever dollar amount

         is in AMT#01 (Field 56) from the Charge Codes Table Maintenance, to 

         the insurance company.  The office expects to receive the dollar

         amount in AMT#02 (Field 57) for covered services.  If the 

         service is not covered, the patient is charged the dollar amount

         in AMT#01 (Field 56), the actual billed amount. 

         This may be difficult to understand (at this point) because this

         data is tied into the amounts that you load into the Charge 

         Codes Table Maintenance, selection 2 of the Table Maintenance Menu.  If you 

         do not understand this procedure, go into the Charge Codes 

         Table Maintenance for clarification.

 

         46. SPLIT OPTION (1=OFF 2=ON):  Line number 46 allows the user 

         to enter a SPLIT OPTION.  This means you may bill the patient

         the difference between the billed amount and the amount expected

         from the insurance carrier.  This option may vary with carrier

         participant agreements and when in doubt, leave the option OFF. 

         When a 1 is entered, the system will not bill the patient the 

         difference (the option is OFF). 

         When a 2 is entered, the system will charge the patient the 

         difference between the billed amount and the amount expected,

         for every procedure performed (the option is ON).

 

         47. OUTPUT (1=YES, 2=NO, 3=?): This option affects (A)uto

         Billing 

         only, hardcopy or telecommunication.

         1=YES:  This means (A)uto bill all claims that have this

         coverage code.

         2=NO:   This means do not (A)uto bill a claim that has this

         coverage code.  When A for (A)uto bill is done, these claims

         will not be included in (A)uto billing.

         3=?:    This means that when you take a patient through Patient

                 Checkout with this coverage code, the system will ask

                 you to answer the following prompt:

                     PRINT FORM (Y/N)?  Y= SAME AS 1 ABOVE. 

                                        N= SAME AS 2 ABOVE.

 

         48. ASSIGN (1=Y 2=N 3=? 4=D): Line number 48 allows you to 

         record whether the office accepts ASSIGNMENT on this type

         of insurance. Type 1 for YES or type 2 for NO, type 3 if 

         you are not sure, 4 for delayed.

 

         49. BUDGET AMOUNT CODE:  This is reserved for future use. 

         50. AUTO LOAD AMOUNT:  This is reserved for future use.

 

         51. OPTION-1 (1-OFF 2=ON):  This is reserved for future use.

 

         52. OPTION-2 (1=OFF 2=ON):  This is reserved for future use.

 

         It will activate Field 54 if you select 2 for ON and press 

         <ENTER KEY>.  Used only for capitated carriers with copay amounts. 

         Copay must be uniform for all procedures.

 

         53. YEARLY DEDUCTIBLE AMOUNT:  This allows you to enter the 

         yearly deductible for this carrier.

         If you enter a yearly deductible for this insurance coverage,

         the OMNI Medical Software will calculate the deductible and

         charge the patient until the figure is met.

         NOTE:  Remember, the only charges applied to this amount are 

         those entered into your system.  Some patients may be treating

         with other providers and the deductible may be paid elsewhere.

 

         54. PER VISIT DEDUCTIBLE:  This field will set a per visit 

         deductible limit for those carriers with maximum copay amounts.

         Always use a dollar amount.  Used by capitated carriers.

         If the copay maximum out-of-pocket expenses apply, the

         range field must be completed and Option 52 set to ON. 

         An example of such limits are those patients with a copay

         on diagnostic services and a maximum amount of $10.00 per

         day.  The range field contains, in numeric order, all

         diagnostic codes.  Line 52 has $10.00 and Option 2 is ON. 

         When Patient Checkout charges are made, the patient will 

         pay $10.00 regardless of the number of tests performed.

         An example of a completed screen may be found on the next

         page.

         Below is an illustration of a completed screen.

 

      EXAMPLE SCREEN: 

     

       ENTER COVERAGE CODE-> C (TAB=SEARCH, *=LIST, Esc=END)          

     

 

         When you have completed a Coverage Code Definition screen, an

         Action Line will appear at the bottom of the screen.  An 

         explanation of the Action Line functions may be found on the 

         next page.

 

         DEFINITIONS OF ACTION LINE FUNCTIONS: 

 

      ACTION-> <Enter # to Correct,(P)rt,(F)wd,(B)ck,(K)py,(D)el,(V)fy,Esc=END

 

         Enter # to Correct:  Enter the number of the field you need to 

         correct and press <ENTER KEY>.  The cursor will move to the first 

         character on that line (information on that line will not be 

         erased). You may retype the entire line, or position the cursor

         on the character that needs correcting.  Press <Home> to go 

         back to the Action Line. 

 

         (P)rint:  Type P and press <ENTER KEY> to print a hard copy of the 

         screen.  The system will open a window in the middle of your

         screen listing output devices.  Please see the example below.

                  1. Okidata 393            (LP)                

                  2. Okidata 320            (P1)                 

                  3. HP Laser III           (P2)                 

                  4. Canon                  (P3)                 

                  5. Your Terminal Screen   (TE)                 

                  6. ----> EXIT <----                            

         Type in the number of your selection at the flashing cursor

         and press <ENTER KEY>.  You may also use the <Up> and <Down> 

         Directional Arrow keys to highlight your selection and then

         press <ENTER KEY>. 

 

         (F)orward:  To go forward one code (numerically or

          alphabetically), 

          type F and press <ENTER KEY>. 

         (B)ackward:  To go back one code (numerically or

          alphabetically), 

          type   and press <ENTER KEY>. 

         (K)opy:  To make a copy of this information (be sure you

         (zero) and <ENTER KEY> to save it before you copy) and assign

          it a different Code, type K and press <ENTER KEY>. 

          The cursor will move to the ENTER COVERAGE CODE prompt.

          Enter the code you wish this information copied to and

          press <ENTER KEY>. 

         (D)elete:  If you want to delete this code from the system, 

          enter a D and press <ENTER KEY>.  Do not delete a code that has 

          been assigned a patient. 

         (V)erify:  Displays who added this code and when.  Displays 

          who updated this code and when.  Type V and press <ENTER KEY>. 

          Esc=END:  To exit and save your information, type a

          0 (zero) and press <ENTER KEY>. 

          The cursor will return to the ENTER CODE prompt. 

          You may continue entering other codes, or type 0 (zero) \

          and press <ENTER KEY> again to go to the Policy Coverage

          Definitions Menu.

 

         SEARCH: 

         At the ENTER COVERAGE CODE prompt, type the first letter of the 

         the insurance name and press <Tab>.  All codes in the system 

         for that insurance company will be displayed to your screen.

      EXAMPLE SCREEN: 

 

         In this example we have entered Code B.  After you press 

         <Tab>, a screen similar to the one below will be displayed.

 

           EXAMPLE SCREEN: 

             SELECT or SEARCH: O                                 

             01.  C.  BCBS  5$ DED                               

             02.  B.  BCBS  5$ DED LAB X-RAY                     

             03.  F.  BCBS  5$ FEP                                

             04.  A.  BCBS FULL COVERAGE                         

             05.  A.  BCBS FULL POLICY                           

             06.  G.  MEDICARE                                   

07.    I.  MEDICARE AND PRIVATE 

                      

            <Up>=Last,<Dn>=Next,<R>-NPage,<L>=LPage,<Tab>=Add    

           <Up>/<Down>  <Right>/<Left> refer to the Arrow keys

 

         The screen displays the code with a brief description.  To

         select the code, at the flashing cursor type the number to

         the far left of the listed code and press <ENTER KEY>, or high- 

         light the line using the <Up>/<Down> Directional Arrow keys 

         and then press <ENTER KEY>. The system will then display the 

         coverage code information to your screen.

         To add a code when in a search screen, press <Tab>.  The system 

         will take you to the ENTER CODE prompt.  You may now enter a 

         new code.

         To exit the search screen, type 0 and press <ENTER KEY>. 

         2.  SiteCoverage Definitions: 

         This selection will allow you to define coverage codes

         as they apply to a specific SiteCenter, i.e.: clinic

         and/or doctor's office.

         After you select Option 2 and press <ENTER KEY>, the screen 

         below will be displayed.

 

          EXAMPLE SCREEN: 

 

         ENTER SITE:  Enter the code which identifies the Sitesource 

         as defined in the SiteCode Definition Table Maintenance.   Press 

         <ENTER KEY> to go to the next field. 

         COVERAGE CODE:  Enter the code which identifies the coverage 

         code that defines the insurance coverage.

         If this code is not on file, the system will display the

         message below to the bottom of your screen.

                      NOT ON FILE, ADD?      (Y=YES, N=NO) 

         If you do not want to enter this information into the system,

         type an N for NO.  If you do want this code to be added to 

         the system type a Y for YES and press <ENTER KEY>.  The screen 

         on the next page will be displayed.

 

      EXAMPLE SCREEN: 

      ENTER SITE->      COVERAGE CODE->__    (TAB=SEARCH, *=LIST, Esc=END )      

             1. FULL  NAME:O____________________________________              

             2. SHORT NAME:_____________________________________              

             3. RANGE:       TO       DEDUCT   $00.00 OR 000 % (>AMT)         

             7. RANGE:       TO       DEDUCT   $00.00 OR 000 % (>AMT)         

            11. RANGE:       TO       DEDUCT   $00.00 OR 000 % (>AMT)         

            15. RANGE:       TO       DEDUCT   $00.00 OR 000 % (>AMT)          

            19. RANGE:       TO       DEDUCT   $00.00 OR 000 % (>AMT)         

            23. RANGE:       TO       DEDUCT   $00.00 OR 000 % (>AMT)         

            27. RANGE:       TO       DEDUCT   $00.00 OR 000 % (>AMT)         

            31. RANGE:       TO       DEDUCT   $00.00 OR 000 % (>AMT)         

            35. RANGE:       TO       DEDUCT   $00.00 OR 000 % (>AMT)         

            39. RANGE:       TO       DEDUCT   $00.00 OR 000 % (>AMT)         

      43. BILLED AMOUNT CODE (1-20):     49. BUDGET AMOUNT CODE (1-80):       

      44. EXPECT AMOUNT CODE (1-80):     50. AUTO LOAD AMOUNT   (1-80):       

      45. BELOW DEDUCT. CODE (1-80):     51. OPTION-1 ( 1=OFF, 2=ON ) :       

      46. SPLIT OPT( 1=OFF, 2-ON ) :     52. OPTION-2 ( 1=OFF, 2=ON ) :       

      47. OUTPUT   ( 1=Y,2=N,3=? ) :     53. YEARLY DEDUCTIBLE AMOUNT : $.00 

      48. ASSIGN (1=Y,2=N,3=?,4=D) :     54. PER VISIT DEDUCTIBLE AMT.: $.00 

     

      Action-><-Enter # to correct,(P)rt,(F)wd,(B)ck,(K)py,(D)el,(V)fy,Esc=END  

         [DEFINITION OF FIELDS - COVERAGE BY SITE]: 

         1. FULL NAME:  Enter the name of the insurance coverage on 

         Line 1 of the screen and press <ENTER KEY>.  The first 20 

         characters of this name will display when you search for 

         a coverage code for a patient. 

           EXAMPLE:  1. LONG NAME: BLUE SHIELD $5 LAB/XRAY 

         2. SHORT NAME:  You may enter an abbreviated version of the 

         long name here.  This may be the same as Line 1, but this 

         field is limited to 15 characters.

           EXAMPLE:  2. SHORT NAME:  BS $5 LAB/XRAY 

         3 TO 42 RANGE TO DEDUCT AMOUNT:  Lines 3 through 39 allow 

         you to identify a specific range of procedures that the

         insurance requires the patient to pay.  The amount may be

         either a flat deductible or a percentage portion.  These

         ranges are set up using the BCBS codes, not the in-house

         codes.

         Enter the appropriate information on Lines 3 through 39 and 

         press <ENTER KEY>.  Enter procedure codes in low to high order. 

         Please see the example on the next page.

          EXAMPLE: RANGE: 80000 TO 89999 DEDUCT $ 5.00 OR 010% (>AMT)  

         If deductible procedure codes do not exist for this particular

         insurance type, you may leave the fields blank by pressing

         <ENTER KEY>. 

         43 TO 45 FIELDS:  These fields allow the user to instruct 

         the system which amount on each procedure to bill and which

         amount you should expect to receive.

             43. BILLED AMOUNT CODE (1-20): Field 43 identifies which 

             amount to pull from the Charge Codes Table Maintenance as the 

             billed amount. This must be one of the first 20 amounts.

             44. EXPECT AMOUNT CODE (1-80): Field 44 identifies which 

             amount to pull from the Charge Codes Table Maintenance as the 

             expected amount for this particular insurance. This is one

             of 1-80 amounts.

             45. BELOW DEDUCT. CODE (1-80): Field 45 identifies which 

             amount to pull from the Charge Codes Table Maintenance as the 

             dollar amount the patient should be charged for services

             not covered by the insurance company being defined.  This

             is one of 1-80 amounts.

             Field 45 codes may be different, based on the following 

             criteria of your practice:

                A)  You may choose not to charge patients the full

                billed amount and only the approved allowed amount.

                B)  You may be required to charge patients only the

                approved or allowable amount for carriers with which

                you participate; are required by law to charge a

                maximum amount (e.g. Medicare).

                    e.g.

                        43 - BILLED AMOUNT   - 1 

                        44 - EXPECTED AMOUNT - 2 

                        45 - BELOW DED. CODE - 1 

 

         These fields instruct the system to bill whatever dollar amount

         is in AMT#01 (Field 56) from the Charge Codes Table Maintenance, to 

         the insurance company.  The office expects to receive the dollar

         amount in AMT#02 (Field 57) for covered services.  If the 

         service is not covered, the patient is charged the dollar amount

         in AMT#01 (Field 56), the actual billed amount. 

         This may be difficult to understand (at this point) because this

         data is tied into the amounts that you load into the Charge 

         Codes Table Maintenance, selection 2 of the Table Maintenance Menu.  If you 

         do not understand this procedure, go into the Charge Codes 

         Table Maintenance for clarification. 

         46. SPLIT OPTION (1=OFF 2=ON):  Line number 46 allows the user 

         to enter a SPLIT OPTION.  This means you may bill the patient

         the difference between the billed amount and the amount expected

         from the insurance carrier.  This option may vary with carrier

         participant agreements and when in doubt, leave the option OFF. 

         When a 1 is entered, the system will not bill the patient the 

         difference (the option is OFF). 

         When a 2 is entered, the system will charge the patient the 

         difference between the billed amount and the amount expected,

         for every procedure performed (the option is ON). 

         47. OUTPUT (1=YES, 2=NO, 3=?):  This field allows you to choose 

         whether or not a claim should be available for Auto billing.

         If you wish to print forms or bill via telecommunication, enter

         1 for YES. If not, enter 2 for NO and press <ENTER KEY>.  A 3 

         response will ask if a claim is needed each time a patient with

         this code is taken through Patient Checkout. 

         48. ASSIGN (1=Y 2=N 3=? 4=D): Line number 48 allows you to 

         record whether the office accepts ASSIGNMENT on this type

         of insurance. Type 1 for YES or type 2 for NO, type 3 if 

         you are not sure, 4 for delayed. 

         49. BUDGET AMOUNT CODE:  This is the amount agreed upon between 

         you and the patient as a monthly payment amount.  This field may

         be used to identify a discounted price.

         50. AUTO LOAD AMOUNT:  This is reserved for future use. 

         51. OPTION-1 (1-OFF 2=ON):  This is reserved for future use. 

         52. OPTION-2 (1=OFF 2=ON):  This is reserved for future use. 

         It will activate Field 54 if you select 2 for ON and press 

         <ENTER KEY>. 

         53. YEARLY DEDUCTIBLE AMOUNT:  This allows you to enter the 

         yearly deductible for this carrier.

         If you enter a yearly deductible for this insurance coverage,

         the OMNI Medical Software will calculate the deductible and

         charge the patient until the figure is met.

         NOTE:  Remember, the only charges applied to this amount are 

         those entered into your system.  Some patients may be treating

         with other providers and the deductible may be paid elsewhere.

         54. PER VISIT DEDUCTIBLE:  This field will set a per visit 

         deductible limit for those carriers with maximum copay

         amounts.

         If the copay maximum out-of-pocket expenses apply, the

         range field must be completed and Option 52 set to ON. 

         An example of such limits are those patients with a copay

         on diagnostic services and a maximum amount of $10.00 per

         day.  The range field contains, in numeric order, all

         diagnostic codes.  Line 52 has $10.00 and Option 2 is ON. 

         When Patient Checkout charges are made, the patient will 

         pay $10.00 regardless of the number of tests performed.

         An example of a completed screen may be found on the next

         page.

         Below is an illustration of a completed screen.

 

             1. FULL  NAME:BLUE SHIELD $5 LAB/XRAY______________              

             2. SHORT NAME:BS $5 LAB/XRAY_______________________              

             3. RANGE:70000  TO 79999 DEDUCT   $ 5.00 OR 000 % (>AMT)         

             7. RANGE:80000  TO 89999 DEDUCT   $ 5.00 OR 000 % (>AMT)         

            11. RANGE:93000  TO 93479 DEDUCT   $ 5.00 OR 000 % (>AMT)         

            15. RANGE:       TO       DEDUCT   $00.00 OR 000 % (>AMT)         

            19. RANGE:       TO       DEDUCT   $00.00 OR 000 % (>AMT)         

            23. RANGE:       TO       DEDUCT   $00.00 OR 000 % (>AMT)         

            27. RANGE:       TO       DEDUCT   $00.00 OR 000 % (>AMT)         

            31. RANGE:       TO       DEDUCT   $00.00 OR 000 % (>AMT)         

            35. RANGE:       TO       DEDUCT   $00.00 OR 000 % (>AMT)         

            39. RANGE:       TO       DEDUCT   $00.00 OR 000 % (>AMT)         

      43. BILLED AMOUNT CODE (1-20): 1   49. BUDGET AMOUNT CODE (1-80): 2     

      44. EXPECT AMOUNT CODE (1-80): 2   50. AUTO LOAD AMOUNT   (1-80): 1     

      45. BELOW DEDUCT. CODE (1-80): 1   51. OPTION-1 ( 1=OFF, 2=ON ) : 1     

      46. SPLIT OPT( 1=OFF, 2-ON ) : 1   52. OPTION-2 ( 1=OFF, 2=ON ) : 1     

      47. OUTPUT   ( 1=Y,2=N,3=? ) : 1   53. YEARLY DEDUCTIBLE AMOUNT : $.00 

      48. ASSIGN (1=Y,2=N,3=?,4=D) : 1   54. PER VISIT DEDUCTIBLE AMT.: $.00 

 

      Action-><-Enter # to correct,(P)rt,(F)wd,(B)ck,(K)py,(D)el,(V)fy,Esc=END  

         When you have completed a Coverage Code Definition screen, an

         Action Line will appear at the bottom of the screen.  An 

         explanation of the Action Line functions may be found on the 

         next page.

         DEFINITIONS OF ACTION LINE FUNCTIONS: 

      ACTION-> <Enter # to Correct,(P)rt,(F)wd,(B)ck,(K)py,(D)el,(V)fy,Esc=END 

         Enter # to Correct:  Enter the number of the field you need to 

         correct and press <ENTER KEY>.  The cursor will move to the first 

         character on that line (information on that line will not be 

         erased). You may retype the entire line, or position the cursor

         on the character that needs correcting.  Press <Home> to go 

         back to the Action Line. 

         (P)rint:  Type P and press <ENTER KEY> to print a hard copy of the 

         screen.  The system will open a window in the middle of your

         screen listing output devices.  Please see the example below.

 

                  1. Okidata 393            (LP)                

                  2. Okidata 320            (P1)                 

                  3. HP Laser 4220          (P2)                  

                  4. Canon                  (P3)                 

                  5. Your Terminal Screen   (TE)                 

                  6. ----> EXIT <----   

                        

         Type in the number of your selection at the flashing cursor

         and press <ENTER KEY>.  You may also use the <Up> and <Down> 

         Directional Arrow keys to highlight your selection and then

         press <ENTER KEY>. 

         (F)orward:  To go forward one code (numerically or

         alphabetically), 

         type F and press <ENTER KEY>. 

         (B)ack:  To go back one code (numerically or alphabetically), 

         type   and press <ENTER KEY>. 

         (K)opy:  To make a copy of this information (be sure you O

         (zero)and <ENTER KEY> to save it before you copy) and assign it a

         different Code, type K and press <ENTER KEY>. 

         The cursor will move to the ENTER 

         COVERAGE CODE prompt.  Enter the code you wish this information 

         copied to and press <ENTER KEY>. 

         (D)elete:  If you want to delete this code from the system, 

         enter a D and press <ENTER KEY>.  Do not delete a code that has 

         been assigned a patient. 

         (V)erify:  Displays who added this code and when.  Displays 

         who updated this code and when.  Type V and press <ENTER KEY>. 

         Esc=END:  To exit and save your information, type a 0 (zero) and 

         press <ENTER KEY>.  The cursor will return to the ENTER CODE

         prompt. 

         You may continue entering other codes, or type 0 (zero) and

         press <ENTER KEY> again to go to the Policy Coverage

         Definitions Menu.

 

         SEARCH: 

         At the ENTER COVERAGE CODE prompt, type the first letter of the 

         the insurance name and press <Tab>.  All codes in the system 

         for that insurance company will be displayed to your screen.

          EXAMPLE SCREEN: 

          

          ENTER JOB-> O  COVERAGE CODE-> M (TAB=SEARCH, *=LIST, Esc=END)B 

         In this example we have entered Code M.  After you press 

         <Tab>, a screen similar to the one below will be displayed.

 

           EXAMPLE SCREEN: 

 

         The screen displays the code with a brief description of the

         code. To select the code, at the flashing cursor type the

         number to the far left of the listed code and press <ENTER KEY>, 

         or highlight the line using the <Up> or <Down> Directional 

         Arrow keys and then press <ENTER KEY>. The system will then 

         display the coverage code information to your screen.

         To add a code when in a search screen, press <Tab>.  The system 

         will take you to the ENTER CODE prompt.  You may now enter a 

         new code.

         To exit the search screen, type 0 and press <ENTER KEY> or Escape.