HINTS FOR PATIENT ACCOUNTING
By Orville Pennant
Siemens Medical Solutions’ Patient Accounting Applications provide a great deal of
flexibility, but at times this is a double edged sword. Below are the highlights of the
more common issues and setup requests that you may come across. Some of these can be used
when troubleshooting day-to-day issues; while others may be requests you have or will
receive.
- Bills Not Producing.
Inpatient Final Patient and Insurance Bill, not producing may be caused
by:
Missing DRG, check records 22198, 22367 for hold criteria.
Missing DIAGNOSIS check HPPI records 06005, 06008, 22171- 221820
Missing Guarantor Information, 13 record not on account.
Missing Insurance Verification, check HPPI record 06015.
Missing Policy Number, check value on PRM 511 record.
Missing Treatment Authorization Number, check value on PRM 511 record.
Statement Code Hold, value of ‘N’ placed on the account.
User Bill Hold, 18D record
Zero Insurance Balance on account.
Inpatient Cycle Insurance Bill, not producing may be caused by:
Missing DIAGNOSIS, check profile 22170 – bit D
Missing Insurance Verification, account must have at one verified plan.
Missing Policy Number, check value on PRM 511 record.
Missing Treatment Authorization Number, check value on PRM 511 record.
Statement Code Hold, value of ‘N’ placed on the account.
Zero Insurance Balance on account.
User Bill Hold, 18D record.
Outpatient Patient Bill, not producing may be caused by:
Missing DIAGNOSIS, check HPPI record 36056, 36060-36071
Missing Guarantor Information, 13 record not on account.
Missing Procedure, check HPPI record 36054 and 86451-86940
Missing Guarantor Information, 13 record not on account.
Statement Code Hold 18D record.
User Bill Hold, 18D record and HPPI 36057.
Outpatient Insurance Bill, not producing my be caused by:
Missing DIAGNOSIS, check HPPI record 38023 and -36060 - 36071
Missing Guarantor Information, 13 record not on account.
Missing Insurance Verification must have at least one verified plan.
Missing Procedure, check HPPI records 36054, 86451-86940)
Missing Policy Number (PRM 511 record)
Missing Treatment Authorization Number (PRM511 record and HPPI record 36005.
Statement Code Hold 18D record
User Bill Hold (18D record)
Zero Insurance Balance
- CDM price update retaining old price: Value the ‘Roll Indicator‘ on the 40C
record to 1, to retain old price when performing CDM price update.
- PRM report: If you want the PRM report to page break by plan code put a
‘Y’ in card column 38 of second data record of PRM Demand Job PAD46rrh.
- HPPI report: To print Bill Forms section of the HPPI put a ‘1’ in card
column 79 of the second data record of Demand Job PAD41rrh and for the Case Mix
section a ‘1’ in card columns 8,9,13 of the second data record.
The above are just a few of the most common set up issues or places to check should you
run into problems with your Patient Accounting System. We have a depth of Siemens talent
that is unmatched. Please feel free to call us at (610) 444 1233 or read additional articles
at www.getvitalized.com.