|
Healthcode is the trusted provider of secure online systems for the private health market, clearing and validating medical bills electronically for all major PMI insurers in the UK. Healthcode enables you to automatically submit your invoices to the UK’s major insurance companies, saving both time and money.
PPS version 4.0.6804 and onwards includes Healthcode Electronic Billing functionality. To update to the latest version of PPS please follow our Updating PPS Guide - Please note that a Support Contract is required to update. If you currently do not have a Support Contract you can purchase or renew using our Help Guide or by contacting our Sales Team, on 0845 0680 7777 and selecting option 1.
If you do not have a Healthcode ID you will need to contact Healthcode customer services on 01784 263150. You can also visit their website by clicking here.
Note: As Healthcode requires submitting of Diagnosis codes for a successful billing claim you will need a Professional version of PPS to use the Healthcode Electronic Billing functionality.
The following Insurance companies can currently accept the Healthcode electronic billing function that PPS provides. For PPS to correctly work with Healthcode your Third Party insurance companies should be named as they are displayed here:
AXA-PPP
BUPA
BUPA International
AVIVA
CIGNA
EXETER FAMILY FRIENDLY
HEALIX HEALTHCARE SERVICES
SIMPLYHEALTH
PRUHEALTH
STANDARD LIFE HEALTHCARE
WPA
If your insurance companies are named differently to the above then please see our Third Party Contact Details help screen to modify an existing company name. Insurance company names are not case sensitive.
To enable the Healthcode Electronic Billing button on your 'Print Invoices' screen you will first need to input two settings in your System Options screen.
Healthcode ID
Currency
Both of these settings can be changed by going to Tools > Options > General System Options and then navigating to the 'Accounts' tab. You will see the Healthcode Electronic Billing section as displayed below.
Note: Although the Healthcode button will now be displayed on the Invoice Print screen (shown here), there are further steps to complete your setup.
After setting up the Healthcode ID and Currency you will need to setup the Look-up Tables via Tools > Look-up Tables. Within Look-up Tables there are 3 areas that will need to be addressed.
· Standard Charges and Stock Items
· Insurance Provider Codes
· Diagnosis
Diagnosis Codes
The first part of the system to setup for Healthcode to work correctly is Diagnosis codes. These are numerical codes assigned to specific diagnoses by your insurance company. Usually these codes are the same for all Insurance companies, but please contact the necessary insurance provider for a valid list of Diagnosis codes.
"Standard Charges and Stock Items" Table
Each charge raised that is submitted for Healthcode Electronic Billing needs a procedure code assigning to it. These procedure codes are unique to the type of treatment you are claiming for. For a full list of procedure codes please contact the the necessary insurance provider.
"Insurance Provider Codes" Table
Each Practitioner that you are claiming bills for needs their own Insurance Provider Code. This may be the same for all Insurance Companies (tick "Apply to Any Insurance Company") or you may have different codes for different Insurance companies in which case you may have to enter a practitioner multiple times for each insurance company. Additionally your insurance provider may require different provider codes for different "Locations" - this can also be setup from this screen.
Once all the initial setup is complete you should now be ready to begin sending your bills electronically. A number of fields are mandatory for a claim to be successful, these are:
· Surname (Client Details screen)
· First Name (Client Details screen)
· Date of Birth (Client Details screen)
· Address (Client Details screen)
· Postcode (Client Details screen)
· Policy Number (Client Details screen)
Additionally you will need to ensure the following details are also in place.
Provider Code (Look-up Tables – for each practitioner)
Procedure Code (Look-up Tables – within Standard Charges and Stock Items) Diagnosis Code (Set in the treatment episodes screen (Clinical Details tab))
The charge/invoice being claimed for needs to be associated to a Treatment Episode; this can be done on the appointment booking screen by selecting the Treatment Episode or by completing the appointment through the Consultation screen and raising the charge from there.
Each invoice will also need a diagnosis code associated to it. This is done during the consultation by clicking “Consultation Complete” which brings up the “Update Treatment Episode Details” screen. Under the Clinical Details tab there is an entry for “Diagnosis / Code”. Assign this and then complete the appointment as normal.
Once you are happy that the client has all the correct details set in their Client Details screen (see above) you will need to raise the charge on the account.
You can do this by completing the appointment from the Appointment Diary screen by either double clicking on the appointment and selecting “Complete Appointment” or right-clicking on the Appointment and choosing “Completed”.
This will bring up the Appointment Completed screen, where you will need to assign a charge to complete the appointment (the charge will need to have an associated Procedure Code).
You can then either:
- “Create Charge, Invoice Later” (if you have other charges you want to add on to the invoice)
or
- “Invoice Now, Pay Later” (if no more charges are to be included on the invoice).
Once your charges have been created and you have raised your invoice, you will need to submit all invoices raised to Healthcode.
Navigate to your PPS Accounts Menu and then click on Accounts. Click the radio button to “Third Party” if it has not been selected already and then click “Search for 3rd Party”. From this next screen you can search for the insurance company you wish to create a claim file for. Search and select the required insurance company.
All the accounts for the selected Insurance Company are now displayed. At the top of the Accounts screen there is a button to “Print” if you click this button and select “Print Invoices” you should see the normal Print/Email screen which now also displays the “Healthcode” button.
You can now select the required invoice(s) and click “Healthcode” to generate a claim file. These files are created in a folder titled “Healthcode” within your PPS-Database folder (C:\PPSv4.0\PPS-Database by default).
Note: Holding down the CTRL key and clicking on the invoices will let you select multiple invoices to include in one claim file
A successful claim file generation will display a message including the exact location and file name.
These files can then be selected and uploaded to the Healthcode website using the standard process. Please contact Healthcode Customer Services if you are having problems uploading Claim Files.
If for any reason the file is not generated successfully, please see the error code list below.
Error: The Insurer selected for this claim (Company Name) is not part of the compatible list of insurers. Please check and try again.
Reason: The Insurance Company that you are trying to claim for is not in the accepted insurers list. Please ensure the invoice you are claiming for is being billed to a valid insurer and that the insurance company is spelled correctly in your 3rd party contact list. Error: The Client <client name and number> does not have a postcode
Reason: The client on the selected invoice does not have a valid postcode set. Please go to the client details screen of the specified client and input a postcode.
Error: The Client <client name> does not have a valid Date of Birth.
Reason: The client on the selected invoice does not have a valid Date of Birth set. Please go to the client details screen of the specified client and input a Date of Birth.
Error: <System User> (associated with Charge ‘<charge name>’ does not have an associated Insurance Provider Code.
Reason: The practitioner the charge was associated with does not have an insurance provider code set. Please go to Insurance Provider Codes under look-up tables and associate a provider code with the specified practitioner.
Error: The Charge ‘<charge name>’ does not have a valid Procedure Code.
Reason: The charge raised does not have a Procedure code set. Go to Charges and Stock Items under the look-up tables and add a valid procedure code with the specified charge. Accounts
The PPS Accounts system includes facilities for you to bill your clients, or third parties, record payments received, and manage all invoices that are overdue for payment. In addition, PPS also offers an additional module called PPS Expense that can be used to record details of practice expenditure. The Accounts system in PPS is not designed to be a full accounts system with ledgers, balance sheets, etc. but it can be used to supply revenue and expenditure information directly to another accounts system by way of exporting the information through reports.
PPS Accounts billing is structured into three areas: Charges, Invoices and Payments. Firstly Charges must be created, then an invoice produced, then a payment recorded. A Charge, or charges simply become “line items” on an invoice, and a payment recorded is “allocated” to the invoice. PPS is flexible enough to accommodate all requirements for practice billing including third-party billing, split billing (between client and third party), recording several payments against one invoice, or recording one payment against several invoices. There are various points throughout PPS that enable charges to be quickly created and “paid off” in one step. This single step still produces the correct Charge, Invoice and Payment records. Add
Look this up under the type of new record you want to add – e.g. Client - Add or Appointment - Add Address
See: Client - Address Appointment
An Appointment is an entry in the Appointments Diary for a client. When you set up your diary, you are setting up the free appointment slots. You then book Appointments into these free slots. Each Appointment can be marked with a status, represented by a colour, to show that the client has arrived for their appointment (green), is currently being seen by the practitioner (orange) or the appointment is completed (purple). You can also mark an appointment as DNA (did not attend) and select a reason why the client has not attended – these are marked in red. When booking an appointment on the diary, this is normally done by highlight a free slot then selecting to add the new appointment. When doing this, the appointment details such as date, time, duration, diary user, treatment room, etc. are already known and you do not have to enter them. Charge
A charge is the first step for PPS billing. You have to create a charge before you can raise an invoice – a charge is a “line item” on an invoice. Charges can be either for various types of treatment, or for stock/sundry items you may sell. PPS has a “list of standard charges” that you set up yourself giving you quick access to your charges via a code, or description. There are several ways in PPS that you can create a charge, you can also skip very quickly from creating a charge to recording a payment and PPS creates the invoice for you as you go.
--br--
You can create a charge in the following ways (which way you regularly use will depend upon the way that you prefer to use PPS): 1) from the PPS Menu: Accounts – Create a Charge; 2) from the PPS Taskbar click on Create a Charge (if you have the diary open then highlighting an appointment first will create the charge related to that appointment); 3) from the PPS Menu: Accounts – Charges List, and click the New button; 4) from the diary, highlight an appointment, right-click on the appointment and select the Client Charge option from the pop-up menu; 5) when completing a consultation record, the “consultation complete” screen allows you to create the charge; 6) when completing an appointment the “appointment complete” screen allows you to create the charge; 7) Cash Desk can be used to create charges. The first four options above will show the Client Charge screen. This allows you to select / enter all the appropriate charge details and save the charge, or go on to create an invoice for the charge. An invoice can contain more than one charge so you do not always want to create the invoice each time.
--br--
Whenever creating a charge, you have the option to select who will be invoiced for the charge, this includes the Client, and any one of the Third-Part Contacts associated with the client. This is how to bill an insurance company directly, for example. If the client does not have a third party contact associated with them, then you can select one while creating the charge, and select to always associate this third-part with the client. This will update the third-party contact details for you on the Main Client Details screen. Client
Client records are the hub of your PPS database. PPS refers to these records as “Clients” rather than “Patients” because PPS is used across a variety of business and clinical disciplines, some of whom use the term “client” and others use “patient”. A client record can have either minimal details entered, such as first name and surname, or can be a comprehensive range of details including full address/contact details, alternative addresses, DOB, sex, “known as”, full profile details including “source of introduction”, occupation (plus a range of entries you can set up yourself). In addition you can associate a variety of third-parties to clients such as doctors, insurance companies, etc. The more comprehensive the details you store for each client, the greater the opportunities to use these details in your reports and mail-merge operation. For example, by recording the “source of introduction” for each client (such as yellow pages, local advert, recommendation, etc.) you can run almost any report in PPS to show a breakdown by “source of introduction”, for example “practice revenue” by “source of introduction” will show where you earn the most money from – thus where you should concentrate most on your advertising! Code
See: Charge – Code; Diagnosis Code; Outcome Code Company
Company is the “company name” element of a Third Party contact (as opposed to contact name). Third-party Contacts are individuals or organisations that can be associated with clients, for example Insurance Companies. You are able to set up your profile of third-party contacts yourself using the option from the PPS Menu: Tools – Options, and selecting the Client Contacts tab. Each type of contact (there are 9 in total) can be referred to via contact name, and Company name. An example is a Law Firm, where Contact Name would be an individual lawyer or solicitor, and the company would be the law firm. Complete
The term “Complete” is used in PPS for both Appointments and Consultations. You can select to Complete an Appointment – where is it marked in Purple, and you can then raise the charge, book another appointment, etc., and you can Complete a Consultation – where you can decide if the Treatment Episode is completed, or how many more consultations are required, you can raise the charge, produce a Discharge Letter etc. The term “Complete” is also used for Treatment Episodes that have an “End Date” entered – see: Completed Episodes. Consultation
PPS uses the term “consultation” to define each time you see a client, whether or not it is an initial session, or a follow up one. PPS has a clinical notes system that allows you to record Consultation notes each time you see a client, and these are all part of a Treatment Episode. If you see a client once, and their treatment is completed in one consultation, then the Treatment Episode will only have one consultation. If, alternatively, you see a client six times before the treatment for the presenting problem is complete, then the “one” treatment episode will have “six” consultations. To access the clinical notes system in PPS, either select from the PPS Menu: Client – Consultation, or click Consultation on the PPS Task bar. You can select an appointment, or client record first if required to give immediate access to the consultation screen for that client. Create
See: Add; Charge – Create Database
The PPS Database can be stored in a separate location on your computer/network from the main PPS application files. This would apply to a PPS installation on a network where the PPS Application files are installed onto each computer, and the database is located centrally on the network. There is the option to change the database location as part of the initial installation of PPS, and there is also a separate “database only” installation available if the database is to be installed onto a computer such as a server where PPS will not be used on that computer – servers often reside in a “back office” and are not used as a desktop computer. Details
This is a generic term used to describe the information stored in any particular part of PPS. For example Main Client Details is the information you enter to this screen. In addition, there are several “notes” type fields that allow you to enter further “free text” details against a record – these are also sometimes referred to as Details. Diagnosis
When starting a new Treatment Episode as part of your clinical notes records, you can enter Diagnosis details. This can be useful for reporting purposes to help analyse the type of problems you are treating. There is a “Diagnosis Codes” table where you can set up your standard list of Diagnosis entries. To set up this table, select from the PPS Menu: Tools – Look Up Tables, and select the Diagnosis table from the Clinical Notes section. To make a Diagnosis entry as part of your clinical notes, from the PPS Consultation screen either use the <Update> button towards the top of the screen – this updates the Treatment Episode details for this consultation, or when completing the consultation enter the diagnosis details in the Treatment Episode details screen (can be accessed using the <More> button in section 1) of the Consultation Complete screen. The Diagnosis can be selected as a Breakdown option on many reports – especially clinical notes type reports. Diary
See: Appointments Diary EMail
E-Mails in PPS are part of the PPS Activities system. You can send E-Mails directly from within PPS. This is dependant upon your computer being configured to use Microsoft® Outlook or Outlook Express to send e-mails. To send an e-mail, either select from the PPS Menu: Activities – Send an E-Mail, or click on Send an E-Mail on the PPS Task Bar. You can also select the <New> button from the Activities List. The Send an E-Mail screen allows you to select either a client (the client you are currently working with is automatically selected) or a third party. You can type in the subject and body of the e-mail message, and you can attach a document to the e-mail. Like all PPS Activity records, the e-mail can be scheduled to send later if required by setting the due date/time.
See also: Client – E-Mail Address Error Messages
Error messages will appear on the screen if an error occurs whilst using PPS. This error could be for a wide variety of reasons. Most errors are controlled by PPS by recording the details in an error log file. Some errors however are caused by Windows™ rather than PPS. If you are returned to the PPS Log In screen, then PPS has been able to record the error details in the log file. The log file is located in the main PPS application folder on your computer (Normally called PPSv4.0). The file is called “error.log” This file can be sent to support@rushcliff.com where the PPS support team assess all errors that are reported and organise any corrections needed to the PPS program that can be included in a new release of the program. This process ensures that any errors can be quickly identified and quickly addressed. PPS Users that have a support contract receive the benefit of being able to download each new release to PPS free of charge. First Name
See: Client – First Name Grid
See: Client – Browse Include
This is a term used in the PPS Reports Wizard – on step 3 of the selections for your report. On most reports you can select to “include” a selection of details on the printed report. You can un-tick any items that you do not want to include. The “Include” options only apply when the report is printed or previewed – if you are exporting the report to a file or mail merge, then the “include” options do not apply. Insurance Provider Codes
When you bill insurance companies directly, most insurance companies give you a “provider code” that must be quoted on the invoice. This can be particular to a single practitioner, or to your practice. PPS allows you to set up insurance provider codes. These are done by selecting from the PPS Menu: Tools – Look Up Tables, and selecting “Insurance Provider Codes” from the “Accounts tables” section. You can add a provider code entry per practitioner/insurance company combination. If you have been allocated a practice-wide provider code from an insurance company, then add the same provider code for each of your practitioners for that insurance company. The insurance company must be set up first in your list of third-party contacts. To ensure that the provider code is included on the printed invoice, select from the PPS Menu: Tools – Invoice Options and select “insurance Company Invoices” from the list, then make sure that “Provider Code” is selected. Invoice
An Invoice in PPS is an official bill that can be issued for payment by a client. In accounting terms an “Invoice” and “Receipt” is the same thing – a receipt is a printed copy of a “paid” invoice. The invoice has an invoice number and a date for tax purposes. PPS keeps a “ledger” of all invoices, and allows you to print an aged debtors report. An Invoice is formed from individual “line items” which in PPS are called Charges, so an invoice can only be raised after charges have been created. An invoice is “paid off” by recording a Payment and allocating the payment to the invoice. PPS is very flexible in terms of allowing either one charge, or an unlimited number of charges to appear on the invoice; also to allow either one payment to pay off one invoice, or one payment to pay off more than one invoice, or several payments to pay off one invoice. There are several ways to raise an invoice in PPS, some of these are fairly transparent in term of creating the charge, raising the invoice and recording the payment all in one step. Whichever method is used, PPS will always create proper Charge, Invoice and Payment records. Line
See: Charts - Annotations List
List is the term used to describe information that either appears on the screen or on a report in rows and columns. The term List is also used in PPS as a list of items such as menu, or list of entries such as a look up table. See also: List style diary. Location
A Location in PPS is a physical clinic location. Older versions of PPS referred to treatment rooms as locations. Now Treatment Rooms are an additional field of information. You can set up locations to use in your PPS Appointments Diary. You can set up your diary for diary users/practitioners to be scheduled to work either in specific treatment rooms and/or locations on various days during the week. You do not have to use “Location” if you only work from one location. To set up locations, select from the PPS Menu: Tools – Look Up Tables, and select Location from the Appointments Diary Tables section. Here you can set up your various locations, and nominate a colour to each location to make each location clearly identifiable in the diary. Mandatory
Mandatory is the term used in PPS Custom Forms when a question included on the form must be answered. If you are setting up your own forms, you can decide if each question is mandatory or not. Modify
This is the term used throughout PPS to “change” any of your existing records. PPS has buttons on many screens with a <Modify> prompt. Clicking this button will normally take you onto a further screen that allows you to modify the selected details. For more information about modifying various types of record in PPS, see the “modify” entry under the various section of this help guide, for example Invoices – Modify, Appointments – Modify, etc. Options
PPS has a screen on the PPS Tools menu called Options. This screen can be used to set up a wide variety of system settings that affect the way that PPS works. You can make your changes to these areas and press the OK or Apply button to save your changes. The Options screen has four tabs along the top: General, Custom Client Fields, Set Up Client Contacts, and Clinical Notes. See the entries under each of these sections for more details, for example Options – General. PPS
PPS is the acronym for “Private Practice Software”. Practitioner
A practitioner in PPS is a system user. To add a practitioner to PPS, you need to add a new system user, and indicate that they are a practitioner as part of their user details. When a user is a practitioner, they appear on the list of practitioners to select to allocate to most PPS records. PPS allocates a practitioner to most types of records so that you can see which practitioner is responsible for that record, also you can break down most report in PPS by practitioner. PrintYou can print various types of information in PPS including client details, clinical notes, Invoices, letters, and a wide variety of reports. All printing in PPS is done using your standard Windows printer driver for your selected printer. Many screens in PPS have a <Print> button that is used to print details for that part of the system. See also: Reports – Report Output. Private
See: Clinical Notes – Public/Private; Custom Forms – Public Private Search
You can search for various records in PPS: Clients, Appointments, Third-Party contacts etc. Some screens include a <Search> button on the toolbar. The main PPS Client Search screen includes options to search on a variety of fields: for example Surname. This screen can be accessed from the Search Button on any of the client screens (main details, log, browse) or by clicking “Search” on the PPS Task Bar. The Search screen allows you to enter all or part of a value into a selected field, then when you press Enter a list of results that match what you have typed in is displayed. The most common information to search on is Surname. In the Surname field on the search screen, it is possible to enter all or part of the surname followed by a space, then all or part of the client’s First Name. This way you can narrow down your search results – useful with popular surnames. For example, you can search for Joe Smith simply by entering SMI J in the Surname field and pressing enter. All clients whose surname starts with SMI and whose First Name starts with J will be listed.
--br--
You can search for existing Client Appointments or Free Appointment Slots using the <Search> button on the Appointments Diary – see: Appointments Diary – Search for more details. Select
A term used when you choose something on the screen. Some PPS screens have a <Select> button, this normally means that you pick an option, or entry in a list, then click the <Select> button. This will “select” your chosen entry and proceed to the next screen, or return to the previous screen with your chosen entry selected. Surname
See: Client - Surname Time
See: Activities – Time; Appointments – Time Treatment Episode
All clinical notes in PPS are stored within the framework of Treatment Episodes; each time you see a client, this is a Consultation – one or more Consultations form a Treatment Episode. This allows you to see a client several times within the same Treatment Episode. Depending upon the nature of your business, it may be the case that each time you see a client this is a separate treatment episode, so the episode is “Started” and “Completed” all within the same consultation. It is possible to undertake more than one treatment episode for a client at the same time. If a client is currently in a treatment episode when you start a new consultation, you can select to start a new treatment episode from the Consultation Screen. If a client has more than one current treatment episode, then when you start a consultation, you can select which treatment episode that this consultation is for. A Treatment Episode in PPS includes a range of details that you can enter to give you a wide range of options for your reporting and statistics analysis. In addition to the Start and End dates of an episode, you can also categorise your diagnosis, treatment, outcome and discharge details, as well as entering certain information about the presenting problem such as Acute/Chronic, Time Present, etc. This is designed to assist you with your follow up consultations, as these details are displayed at the top of the Consultation screen while you are entering your consultation notes.
|
Post a reply
