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CHARGES MENU OPTIONS

 

 

Specialty Charges

 

Lab Charge Set Up

 

When Lab services are a part of any billable transaction, there may be one of two types. Each type requires a slightly different set up, depending on the service:

 

No Purchased Services: The office bills for the drawing of the specimen

 

Purchased Service, Outside Lab Billing: The office sends the patient to the lab for everything, the lab bills the offices, and the office bills the insurance.

 

 

No Purchased Services

Set up the fields as indicated:

 

1. Utility --►Procedure

 

1.1 <Status>                     

Must be set to L.

 

1.2 <Cost>                        

Must be left at 0.00 (zero).

 

2. Utility --►Provider

 

2.1 <CLIA>                        

Must have a CLIA Number.

 

3. Utility --►Insurance

 

3.1 <Print CLIA (Y/N)>    

Must = 'Y'.

 

4. Utility --►Facility

Create a Utility --►Facility for the lab where the specimen will be sent.

 

4.1 <Type>                        

Set to TL for the lab where the specimen will be sent.

 

4.2 <Qualifier>                  

Required for electronic claim submission. Where lab charges are involved, this should be set to X4.

 

5. Charges --►Charge

5.1 <Facility>                     

Must match the Utility --►Facility <Facility Code> for the lab where the specimen will be sent.

 

 

Purchased Service, Outside Lab Billing

Set up the fields as indicated:

 

1. Utility --►Procedure

 

1.1 <Status>                     

Must be set to L.

 

1.2 <Cost>                        

Must be completed with the lab's fee.

 

2. Utility --►Facility

Create a Utility --►Facility for the lab where the specimen will be sent.

 

2.1 <Name>                      

Must be completed.

 

2.2 <Address>                  

Must be completed.

 

2.3 <Type>                        

Set to TL for the lab where the specimen will be sent.

 

2.4 <NPI>                           

Must be completed.

 

2.5 <CLIA>                        

Must be completed.

 

2.6 <Qualifier>                  

Required for electronic claim submission. Where lab charges are involved, this should be set to F4.

 

3. Charges --►Charge

3.1 <Facility>                     

Must match the Utility --►Facility <Facility Code> for the lab where the specimen will be sent.

 

4. Charges --►Encounter --►Generic

 

4.1 <Referred Lab>           

Must match the Utility --►Facility <Facility Code> for the lab where the specimen will be sent.

 

NOTE: If billing includes some charges with their CLIA and some as purchased service, they must be billed on separate claims.

 

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