Category: RFR

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All About the G5 Navigation Bar

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In software, the concept of “navigation” refers to the user interface elements that allow you to move around in the program.

By default, SOS G5 displays a Navigation Bar on the left edge of your screen as the primary way you get to the system’s various features.

 

Customization

You might be interested in some options for the placement and operation of the Navigation Bar. At the least, most everyone should take advantage of the Favorites feature to improve your efficiency while using SOS:

  • Copy the links you use most to the Favorites section at the top of the Navigation Bar.  After a short while using SOS, you will probably find that there are some navigation links that you use many times every day, and other links that you use rarely or never.  Copy those all-the-time links to the Favorites section of the navigation tree to eliminate the need to expand the tree and search for what you want. To add a link to the Favorites section, simply highlight the desired link and click the “Heart” button on the top toolbar. To remove a link in the Favorites section, highlight the desired Favorites link and click the “X-Heart” button on the top toolbar. (Video below.)
  • Make the bar wider or narrower by dragging the divider to the left or right. Move the mouse pointer over the divider, stopping when it changes shape, then click and drag. (Video below.)
    Windows interface – Adjust Nav Bar Width:
  • Auto Hide the Nav Bar. Right-click the “Navigation” title at the top of the Navigation Bar, then select the Auto Hide option. (Video below.)
  • Move the Navigation Bar to the right side instead of the left. Click the Navigation title at the top of the Navigation Bar and drag it to the right side of the screen. When you see the position anchor appear, continue to drag until your mouse pointer is over the anchor, then drop. (Video below.)
  • Change the Navigation Bar to a Navigation Tab (Dock as Tabbed Document). Similar to Auto Hide, the Tab option gives you the more screen space for your work than a docked Navigation Bar, but still keeps Navigation just one click away. There are two ways to make this change. Method One: Click the Navigation title at the top of the Navigation Bar and drag it to the desired position in horizontal area where the tabs are displayed. (Video below.)

Method Two: Right-Click the Navigation title, then select Dock as Tabbed Document. (Video below.)

Hide and Restore the Navigation Panel

If you suddenly find that the Navigation Panel is no longer visible on your screen, don’t panic. First of all, while the most convenient way to get around the software, the Navigation Panel is not the only way. In a pinch, you can always click View on the menu at the top of program, then click Navigation to show a drop down menu of all the navigation categories.

That will get you where you want to go, but you will probably want to restore the Navigation bar to its rightful place on the screen. Also on the View menu, right at the top, you will see a selection called Panels. Go ahead and click View, then Panels, then Navigation. You will probably find that the Hidden option is checked, so click Visible to restore the Navigation panel to its previous position. If you should ever prefer to hide the panel, use the same sub-menu change the option from Visible to Hidden. The other option on that sub-menu is Auto Hide, which we showed you previously.

Entering Payers for Patient Accounts

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There are two basic types of payers in SOS: Insurance and Non-Insurance payers.

Non-Insurance Payers

Examples of common non-insurance payers include:

  • The patient herself when the patient is an adult.
  • A parent or guardian when the patient is a child.
  • An attorney for certain types of forensic referrals.
  • A governmental or non-governmental agency that has accepted financial responsibility for treatment or evaluation costs.

You can detail any number of non-insurance payers on a single patient account. Furthermore, you can divide the non-insurance balance among them. For instance, you could name both of a child patient’s divorced parents as payers and specify that any amounts due should be divided 50-50 between them.

SOS also allows you to name the same non-insurance payer for more than one patient. You could, therefore, add a parent as a Non-Insurance Payer, then designate the parent as a payer on the accounts of each of the parent’s children. For details on adding and managing Non-Insurance Payers, see the article: Managing Patient Non-Insurance Payers.

Insurance Payers

Insurance payers in SOS are called Carriers. Each Carrier has one or more Insurance Plans. To link an Insurance Carrier and Plan to a particular patient, you add a new “Insurance Policy” to the patient, naming the desired Insurance Carrier/Plan on the Policy screen. See the article: Managing Patient Insurance Payers (Policies).

Creating Provider Fee Schedules

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It is relatively common in group practices and other organizations for different providers to have different fees for the same service. The fees may vary from provider to provider, or may be keyed to the type of provider, that is there is one fee for psychiatrists, another for psychologists, and yet another for mental health counselors, all of whom may be providing the service coded as “Psychotherapy, 45 minutes”. SOS provides the means to create fee schedules linked to each of a provider’s Billing Profiles, to each Provider Type, and a default fee schedule based only on service. As each new Charge transaction is created, once you specify the Provider Billing Profile and the Service, the system will lookup the appropriate fee as follows:

  1. Search for a fee that matches both the Provider Billing Profile and the Service. If one is found, it will be inserted into the transaction as the fee. If not…
  2. Search for a fee that matches both the Provider Type and the Service. If one is found, it will be used. If not…
  3. Search for a default fee for the selected Service. If one is found, it will be used. If not, the fee will be left blank and you will have to manually enter it.

To create your own Fee Schedules, first you will want to collect the relevant data — that is, who charges what for which service.

Default Fee for Each Service

If a more specific fee schedule is not found, the system will just check for a default fee for the Service being entered in the Daysheet. To specify the default fee for a Service:

  1. Expand the Common Lookups section in the Navigation Bar on the left of your screen, then click Services.
  2. Locate the Service for which you want to set the default fee.
  3. Double click that line in the list to open the Service’s detail view.
  4. Enter the desired amount for Default Fee Per Unit.
  5. Click the Save or Save & Exit icon.

Provider Type Fees

If your organization has standard fees for a handful of Provider Types, then your job is almost as easy as simply entering the default fee for each Service. Once you have compiled a list of the fees for each of your Provider Types, go to Common Lookups > Provider Types in the Navigation Bar on the left side.

  1. Double-click the desired Provider Type if it already appears in the list, or add a new one.
  2. The lower portion of the Provider Type form is a list box in which you can insert services with their appropriate fees for this type of provider.
  3. Select the desired Service using the drop list for that field.
  4. Enter the appropriate amount in Fee Per Unit.
  5. If your organization tracks the internal cost of providing units of service, indicate the appropriate amount in the Cost Per Unit field. If not, just leave that field blank.
  6. Click the Save or Save & Exit icon.

Provider Billing Profile Fees

If your providers have their own fee (different from both the default fee and the relevant Provider Type fee) for one or more service, then you can create a fee wherever appropriate in one or more of the provider’s Billing Profiles:

  1. Navigate to Providers in Common Lookups.
  2. Open the Provider for whom you want to enter a fee.
  3. Click the Billing Profiles tab.
  4. Select the Billing Profile for the fee.
  5. Select the Billing Profile Fees tab.
  6. Add the Fee entry, specifying the appropriate Service and Fee Per Unit values.
  7. Save.
  8. Repeat for other services and Billing Profiles as needed.

Managing Billing Providers (Suppliers)

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In older versions of SOS, “Billing Providers” were known as “Suppliers”. They represent business entities that bill and collect money. In the case of a provider, working alone without a surrogate legal entity such as a corporation, LLC, PA, or partnership, the Billing Provider might be the same as the person who actually renders patient care. Current day healthcare delivery in the United States, however, more often involves some sort of legal/financial entity, and in SOS that entity is the Billing Provider. It is the name on the bank account into which your fees are deposited. To generate insurance claims or patient statements, you will have to define at least one Billing Provider.

Expand Billing Lookups in the navigation bar on the left side of your screen and select Billing Providers (Suppliers).

From this list, you can add an new Billing Provider, or view, modify, or delete (if not already in use) any entry already in the list.

Create a new Billing Provider

As with other list views in SOS, to add a new item you can click the “New” icon in the upper left of the toolbar, press the <CTRL><N> key combination, or right click to select New from the pop-up menu. You will then see the Billing Provider form. Once complete, the form will look something like the example below. Note particularly that there is a panel on the form in which you can customize the “letterhead” that SOS will print at the top of your patient billing statements. In addition to the name of the organization to be paid, you can include any other information you would like to display there. It is generally a good idea to include the billing department contact information. On some SOS statement formats this information can be adjusted to print in the upper window of a dual window envelope, in which case you would adjust the text and layout appropriately. If you are using pre-printed letterhead for your statements, then you would normally leave these fields blank.

One note regarding the Pay-To Provider panel on this screen: When generating insurance claims, you will notice an option in which you can force the data entered in this panel to replace the default data for a specific claim run.

On the bottom of this form are several tabs. The currently-selected Communications tab allows you to add addresses, phone numbers, and emails if you wish. (Adding items to an SOS Communications list is detailed in an article about Patient Communications if you need the specifics.)

Of particular significance, however, is the second tab, Carrier Specific ID’s. From time to time an organization may have to use a different identifier when sending claims to a particular payer. You can add an entry on the Carrier Specific ID’s tab if you have that situation in your organization. For example, perhaps your state’s Medicaid program requires that claims be filed using your Medical Director’s NPI, rather than the organization NPI that you normally use. SOS will automatically use the default information from the main form above, except when creating claims for the insurance payer specified in your Carrier Specific ID configuration.

Managing Providers

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SOS Providers are actual people who provide services to patients or clients. (Note that the SOS system also has Billing Providers, which are legal/financial entities that bill for services and are associated with bank accounts to which fees are paid.)

To add a new Provider, or to view, modify, or (if not already in use) delete a Provider, expand Common Lookups on the navigation bar on the left side of the main screen, then select Providers.

The Providers list will appear. From here, use the New icon on the toolbar at the top of the screen to create a new Provider entry. Alternatively, you also can use the <CTRL><N> keyboard shortcut, or right-click and select “New” from the pop-up menu. If you just want to open a Provider already in the list to view or change the details, simply double-click that row on the list view. Below, you can see the Main tab of the Provider form. Notice that there are several other tabs (Billing Profiles, Provider Fees, Carrier Specific ID’s, and User Defined Fields) that are addressed in other articles.

The very first field on this form is the Provider-Prefix Code. This is the shorthand code that is used to indicate a particular provider when scheduling appointments or entering progress notes. You can enter up to three characters for this value. In SOS, the provider’s initials are often used as the Provider-Prefix Code, but any combination of between one and three characters can be used, as long as it is unique among your providers. An example would be “ABC”.

The Provider-Prefix code also serves as the first part of the Provider code to be used on a Charge transaction, that is, the record of a fee being charged for a service. Charge transactions are the records that are used to create billing. Unlike the provider designation for an appointment or progress note, however, the Charge entry also needs additional information, stored in one of the Provider’s Billing Profiles, that is specific to just billing actions. Each billing profile is designated by another code of up to three characters. That means you when entering a Charge in the daysheet you will be selecting a provider that has a two part code, for example “ABC-MC” or “JS-1”. The first part is the Provider-Prefix Code from this field. The second part of the two-part code comes from another code that designates which of the provider’s Billing Profiles should be used when billing this service.

If you have licensed the Appointment Scheduler module, you can use the Encounter Form field to specify which of your Encounter Form configurations should be used when printing encounter forms for patients to document visits. Encounter forms contain the patient’s identifying information including diagnosis, a notation of the service(s) provided, the provider’s information, and often some detail about insurance coverage, fee, and payment.

Provider Communications Panel

Add as many phone numbers, addresses, and emails as you like for this provider in the Communications panel. It works exactly as it does in the Patient form. If you need additional explanation, please see the Patient Communications article.

Defaults Section

The Defaults Section of the Provider form contains a set of fields that are also found on the Provider Billing Profiles form. Whenever you create a new Billing Profile for a provider, SOS copies all the values you specify here to the new Billing Profile. You can then change or add information as appropriate before saving the new Billing Profile. Among these Default fields are the following:

  • The Billing Provider is the name of the legal/financial entity used by this provider for claim filing, patient statements, and for depositing payments. In most cases this is official organization name, often a corporation of some sort. In SOS you can have more than one of these entities, so here you will indicate the appropriate one for this provider.
  • If desired, you can specify a Category to be used for data analysis. For example, a large behavioral health organization might want to compare utilization patterns among salaried staff, capitated providers, and fee-for service providers. Adding a code here for each of these types of providers would allow this type of analysis.
  • Provider Type allows you to create fee schedules that apply to all providers of the designated type (although individual exceptions are still permitted). If you have many providers with different credentials (for example: psychiatrists, psychologists, clinical social workers, nurse practitioners, and mental health counselors), then you should assign each provider to an appropriate Type. Assignment of types also can be handy for analytic purposes.
  • Taxonomy Code indicates the provider’s professional training and specialty area and must be specified on claims. One source for a current list of Taxonomy Codes is the National Uniform Claim Committee.
  • The Payroll Multiplier is used by some organizations to calculate the portion of the billed fee or payments the provider will receive as compensation for her work. For example, if a provider’s pay is based on 50% of the fees collected during the pay period, you should enter “50” in this field. Note that other types of payroll that are based on specific services provided rather than payments received may be better handled by setting a “cost” figure for each service/provider combination in Provider Fee Schedules.

There are several tabs at the top of the Provider form. For information about each of the following, click the link to go to the separate article about it: