Patient Encounter Information

This feature is used to capture the required data for the patient's encounter. The information is needed for the 1500 Health Insurance Claim Form and for the Third Party Billing module.

The feature is only available if the Administration > Settings > Properties > Registry Settings > Third Party Billing Module option is enabled (selected) and the user has the Third Party Billing permission.

Search for a Patient Encounter

To search for insurance information, select Patient > Patient Encounter from the menu. (The link does not activate until a patient has been selected.) The Patient Encounter Search page opens. Enter the search criteria in the Patient Encounter Search section and click Search. The available search fields are as follows:

Field	Description
Date of Service	To search for patient encounters that occurred on a specific day, enter the date of service.
Rendering Provider ID	To search for a specific provider (the provider who provided the services to the patient), enter the provider's ID number.
Diagnosis Code	To search for patient encounters with a specific diagnosis code, enter it.
Procedure Code	To search for patient encounters with a specific procedure code, enter it.

If any matches to the search criteria are found, they are listed in the Encounter Search Results section. The number of records found is displayed at the top, with the search criteria displayed next to it. The following columns are used to display the patient encounter information:

Field	Description
Select	Click the arrow button in this column to view and/or edit the patient encounter record.
From Date of Service	The starting date of service.
To Date of Service	The ending date of service.
Rendering Provider ID	The ID of the provider who rendered the patient's service.
Diagnosis Code	If applicable, the patient's diagnosis for the specific encounter.
Procedure Code	If applicable, the procedure code for the specific encounter.

Add a New Patient Encounter Record

To add a new patient encounter record, click the Add Encounter Record button located at the bottom of the page, after the search results list. The Add Encounter page opens. Enter the information and click Save. The available fields on this page are as follows:

Field	Description
Full Name	The patient's full name. This field is read-only.
Address	The patient's address. This field is read-only.
Birthdate	The patient's birthdate. This field is read-only.
Patient Condition Related to: Employment (Current or Previous) Auto Accident Other Accident	If the patient's encounter record is related to one of these options, select Yes for that option. The default for each of them is No. If the Auto Accident option is selected, also select the state in which the accident occurred from the drop-down list.
Referring Provider	Select the referring provider from the drop-down list.
Date(s) of Service - From	Enter the date the service began.
Date(s) of Service - To	Enter the date the service ended.
Place of Service	Select where the service occurred from the drop-down list. Options may include Ambulance, Birthing Center, Emergency Room, School, Urgent Care Center, etc.
EMG	If the patient received an EMG, select Yes. The default is No.
CPT/HCPCS Code	Enter the CPT/HCPCS code, if applicable.
Diagnosis Code	Enter the diagnosis code. This field is required.
Modifier 1-4	Enter up to four diagnosis code modifiers.
EPSDT Rendered	If EPSDT was rendered, select Yes. The default is No.
EPSDT Code	If EPSDT was rendered, select the EPSDT code from the drop-down list. This field is only available if Yes was selected for the EPSDT Rendered field.
Days/Units	If applicable, enter the number of days or units.
Rendering Provider	Select the rendering provider from the drop-down list.
Outside Lab	If an outside lab was used, select Yes. The default is No.
Outside Lab Charges	If an outside lab was used, enter any lab charges. This field is only available if Yes was selected for the Outside Lab field.
Physician ID Qualifier	Select the physician's ID qualifier from the drop-down list. Examples include Federal Taxpayer ID Number, Medicaid Provider Number, and State License Number.
EOB Status	If an Explanation of Benefits was provided, the status appears here. Otherwise, it displays Not Submitted.
Charges	Enter the encounter charges.
Amount Paid	If an amount was paid toward the charges, enter it.
Facility Providing Services	Select the facility providing the services from the drop-down list.

Edit a Patient Encounter Record

To edit a patient encounter record, first search for (if necessary) and locate the patient encounter record in the list, then click the arrow button in the Select column to open the View Encounter Record page. Click the Edit button on the bottom. Make the necessary changes and click Save. On the View Encounter Record (where you are returned after clicking Save), click the Back button to return to the Patient Encounter Search page.