BILLS PRINTED ON WRONG FORM TYPE

 

The billing forms (or Claim Form Types) are preset for you in the TPS2000 program. The Claim form code refers to the template that will be used to fill out your preprinted HCFA or other billing form.   Even if the carrier is Cash, this is the form you would use if an insurance company was being billed.

 

There are 4 form templates in "TPS!" that print on the Red HCFA paper form.  They are HCFA Work Comp/L&I Form,  HCFA Red Med 1.7 (Medicare Federal format), HCFA Red Med WA (Medicare SPECIFICALLY for Washington State) and HCFA General Red 1.7 (This will be used for any other carrier needing a Red HCFA form).

 

For the most part, you will use the HCFA General Red 1.7 for almost all carriers (with the exception of Medicare).  The  will fill out the blanks on the Red HCFA form with the data requested by the field.  In other words, if the block is titled Insured's ID number, then that is what will print on the HCFA form from our program.  It also places the carrier’s name and address at the top of the form.

 

For a sample of the HCFA “MAP” see the following HCFA form printout.  This list where each field is pulled to fill in the HCFA General Red Format.

 

The HCFA WorkComp\L&I is identical to the HCFA General Red 1.7 except it prints the Dr's W.C./L&I number in box 33 UPIN field. 

 

The HCFA Red Med 1.7  is currently setup to me the Federal Medicare Standards.  What that means specifically, is that there will be no Carrier Name or Address printed at the top of the HCFA form.  The word NONE will print in box 11 unless there is an insurance that is Primary to Medicare.  The remaining boxes in 11 (a, b, c and d) will remain blank.  The Diagnosis Change Date will fill into box 14 and the Last Xray Date or Last Exam Date (Part Date) will fill into box 19 and “For Local Use Box 19” prints to the right of this date for the extra ICD Codes if needed.  The Doctors Medicare ID number will print in box 24K and in box 33.

 

If, for your area, you may have the name and address at the top of the form for Medicare (please be sure that you check with your Medicare provider to be sure that this is OK), let us know and we will help you add this to the form layout.  However, in most states, the Federal format is the accepted version.

 

Remember, if you are setting up a secondary or supplemental carrier to Medicare, the Medicare format is NOT what is needed.  These will probably use the HCFA General Red 1.7.

If you are seeing a patient statement in a carrier bill batch, this could cause problems.  In the Carrier Master List and in the Attorney Master List you select what form would be used to bill a carrier should a carrier need to be billed.  If this is happening, please correct the carrier or the attorney file to reflect the correct form.

For a patient that has already been billed on an incorrect form you have 2 solutions:

First:  Go to the original bill batch that contains this bill (this can be found in the patient's ledger.  To the far right of the line of service you will see the carrier bill date, bill number and the batch number in which it is located).  Find the patient in this batch.  To the left of the patient's name is the form to which it has been processed.  Use the down arrow on the field to select a different form (i.e. HCFA General Red 1.7) then tag and reprint the bill.  NOTE:  This bill will still be addressed to the original carrier, in this case CASH, if that is not a problem, then you are ready to go).  You will need to repeat this action for any other batches that contain bills printed to CASH for this patient.

 Second:  Go to the original bill batch that contains this bill (this can be found in the patient's ledger.  To the far right of the line of service you will see the carrier bill date, bill number and the batch number in which it is located).  Find the patient in this batch.  Click the Print Selection ALL, this will tag all bills in this batch.  Now UNTAG  (remove the checkmark) from this patient.  Next, click the button [Delete Bills] in the upper right of the billing screen.  Once this bill has been deleted (you will need to repeat this action for any other batches that contain bills printed to         CASH for this patient).  Finally, correct the patient's claim to enter the correct carrier then create a new bill batch with no start date to bill these original dates of service to the new carrier.