Prime Clinical
Systems, Inc.
3675
E. Huntington Drive, Suite A
Pasadena,
CA 91107
May 14,
2015
Dear
Client,
*** This information
is only for clients printing Superbills
from Intellect ***
With the
upcoming ICD-10 mandate, Prime
Clinical Systems has received
an influx of questions regarding
the use of current ICD-9 codes
and superbills. You may still
continue to use the ICD-9 codes
on your existing superbill(s)
and utilize Intellect's ICD-10
crosswalk to maintain your existing
superbill and still meet the mandated
changes for ICD-10. However, if
you would like to update your
superbill, we have provided a
blank
Superbill Template for clients
to use for these changes. The
template is in Microsoft
Word format and can be copied.
*** Please be
advised, any superbill changes
must now be made in Microsoft
Word format using the attached
template ***
Because
of programming requirements, the
top portion of the Superbill (the
top portion is the patient information
that pulls from the Intellect
program), cannot be modified,
and the spacing must remain as
is in the template provided.
The CPT
codes and Diagnosis codes need
to be entered by you, or your
designated staff, in the blank
boxes of the template. Your office
may need an additional
page for the diagnosis codes
(see attached).
All the
information in the top portion
is pre-programmed to print from
your Intellect program. If you
wish to opt out of some of the
fields, the fields will remain
and no data will print in that
portion of the Superbill.
Super Bill Restrictions:
1.
Superbill must be in Microsoft
Word format.
2.
Up to 200 spaces are allowed for
procedure & diagnoses codes,
including the Patient Demographics.
For additional Diagnoses, an additional
page
may be added which will print
on a second page or, if using
a printer that has duplex printing
capability, the additional page
may be printed on the back side
of the first page.
3.
Margins must be ¼" on top,
bottom, and sides. The spacing
in the top portion, the area that
pulls from Intellect, must also
remain the same.
4.
Due to the size limitations of
the Superbill, only the Company
Name may be included at the top
of the Superbill.
•
No changes may be made to the
top portion of the template (area
that pulls from Intellect).
•
Fee for loading and programming
is approximately $150.00 per form
(including additional diagnosis
page, if used).
Sincerely,
Prime
Clinical Systems, Inc.
Support
and Training
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