CUSTOMIZED MEDICAID HCFA FORM

To customize a form for Medicaid, we need to copy the closest form. If they are mostly like HCFA General Red (usually this is the case), then go into REPORTS and find the HCFA General Red form. Click on it once to highlight. Now click on ADD/COPY. When the copy is done, click on EDIT. Find the line that reads HCFA General Red 1.7 - Copy (today’s Date). Edit this name to read HCFA Medicaid. When this is done, close the edit window. You will now need to close TPS2000 and reopen so that this new form may be “found” by the lists.

The easiest way to edit this form is to do this from billing. In this way, we can test to be sure that everything is doing what we need. Once in billing, pick a patient to test with and change the claim form code to the new HCFA Medicaid. Now click on EDIT. This brings up a screen with all the small “boxes”.

(1) Change the “X” in Coverage to the letter “P”

You will see a row of small boxes with only the letter U showing ([U]). The first one on the left hand side is the one for Medicare, the next one to the right is Medicaid. Double click on the box for Medicaid to bring up the Expression Format. Replace the expression that is there with the following: “P”

(Note: you will need to type in the quotes (“) in this expression. The works the same as the USER entry from the DOS program).

OK this expression back to the “boxes” screen.

(2) Adding “Dr.” to the Doctor’s Signature in Box 31

Move the right hand slide bar to the bottom of the form. You will see several “gray” bars. Below the gray bar titled Group Footer, you will see a row of boxes. These represent boxes 25-30 on the HCFA form. In the lower left, below this row, you will see a large box. This is the formula for the Doctor’s Name. Double click on the box to bring up the Expression Format. Now click on the […] button to the right of this expression field to expand the expression. You need to add the following to the beginning of the expression:

“Dr. “+ When you are done, the expression will look like this:

"Dr. "+UPPER(CHRTRAN(TRIM(MFDOCTOR.FIRST_NAME)+" "+TRIM(MFDOCTOR.LAST_NAME),"./,"," "))

OK this expression back to the “boxes” screen. Across from this field are the boxes that make up box 33. The first box on the right will be the other Doctors name. . Double click on the box to bring up the Expression Format. Now click on the […] button to the right of this expression field to expand the expression. You need to add the following to the beginning of the expression: “Dr. “+ When you are done, the expression will look like this:

"Dr. "+UPPER(CHRTRAN(TRIM(MFDOCTOR.FIRST_NAME)+" "+TRIM(MFDOCTOR.LAST_NAME),"./,"," "))

OK this expression back to the “boxes” screen.

(3) Pulling the PA_ID number from the Doctor’s file

The Number field will be the last box on the right hand side of the form. Double click on the box to bring up the Expression Format. Now click on the […] button to the right of this expression field to expand the expression. The formula needs to read as follows:

UPPER(CHRTRAN(MFDOCTOR.PA_ID_NUM,"./,"," "))

(4) No Number in Box 24K (If you cloned HCFA General Red, there will be no entry for this field. If you cloned HCFA Red Med read on).

When looking at the “boxes” screen. You will see four gray bars that traverse the screen. The top one is titled Page Header, the next is Group Header. There will be a row of boxes, then below this row will be the bar titled Detail and below that Group Footer. This row of boxes in between these gray bars are the service lines. The farthest box to the right (almost off the screen), this is the box that contains the Doctors ID. Click once on this box then click the Delete key.

OK this expression back to the “boxes” screen. When all changes that you need have been made, hold down the CTRL key and press the letter “W” to save this new layout.

If other changes are needed that are not listed above, please contact the technical support department, Monday through Friday from 9:00am until 7:00pm Eastern Time at (727) 298-5501 or you may fax your needs to (727) 298-5511.