Modifying Line Item Dates

Occasionally, you will need to change the date on a line item of the invoice without changing the entire invoice.

To reveal the line item dates of an invoice:

Click on the double triangle symbol above the CPT Code field to shift the line items.


The dates on the invoice will them appear.


You may then modify the dates on the line items as needed.

Receivables Activity - securing your office (version 10.3.43)

The Receivables Activity report gives you a snap shot of your current receivables - basically, how much money is outstanding at any given point in time. Invoices increase your receivables, and payments and adjustments decrease your receivables.

When you backdate an invoice, payment, or adjustment, you are actually affecting the receivables for that date in the past. Many security issues are related to staff being able to pre-date payments or adjustments far enough in the past to make them invisible to the practice owners.

In an effort to clean up your receivables and secure your practice, KIP is now limited to how far back you can date an invoice, payment, or adjustment. The default maximum number of days KIP allows is 45. This number is not modifiable by the end user at any password level.

What this means is, you must enter all your invoices into KIP within 45 days of when the patient was treated, and you must enter all payments into KIP within 45 days of when the money was deposited into the bank.

As you can see, these dates are quite reasonable, since many insurance companies now require that all claims be submitted within 90 days of the date of service.

By instituting these parameters, we have already uncovered improper accounting practices in several facilities. The offices are now more secure from payment tampering, and receivables numbers are now accurate and reliable.

KIP Deluxe 10.3 compatibility with Mac OS 10.5 (Leopard)

Is KIP Deluxe 10.3 compatible with Mac OS 10.5 (Leopard)?

KIP Deluxe version 10.3 is written with 4D 2003.

The official statement by 4D is that 4D 2003 will not be supported with Mac OS 10.5 (Leopard) and they do not recommend upgrading to Mac OS 10.5 if you are using 4D 2003.

However, it seems that 4D 2003 users are currently using Mac OS 10.5 without problems.

4D is supporting 4D 2004 and 4D v11 SQL compatibility with Mac OS 10.5, and KIP Deluxe will move to 4D v11 SQL sometime this year.

We understand that new Apple computers will be shipped using Mac OS 10.5, so if it becomes necessary to use Mac OS 10.5, we expect that using KIP Deluxe should not be a problem.

In the meantime, we recommend staying with Mac OS versions earlier than 10.5 until you upgrade to KIP Deluxe versions created using 4D v11 SQL.

This brings up the question:

Why are we using 4D 2003 and not 4D 2004 (or 4D v11 SQL)?

Our users are medical practices and businesses that require the most stable versions of software possible. 4D releases updates and patches of their software continually to improve stability. The most stable version of 4D is the one they are no longer updating. With the recent release of 4D v11 SQL, 4D 2004 has just reached this level of stability, and we will therefore be moving a newer version of 4D shortly.

Initial releases of 4D v11 SQL have already proven to be extremely fast and stable enough to use in a critical business environment. Once 4D Server v11 SQL is released, expect us to move to that version.

Fine tuning printing of the claim form

Adjusting HCFA form printing (version 10.3.40):

KIP has moved to a more flexible alignment of the HCFA claim form. The latest version of KIP now adjusts printing of each claim form horizontally and vertically. In addition, parts of the claim form can now be adjusted.

This adjustment process now allows the most flexibility when printing your claim forms.


As you can see from this view of the HCFA preferences, the entire form can be adjusted horizontally and vertically, as well as portions of the form.

If you have forms that print with the line items slightly off but the top and bottom of the forms print fine, you may now adjust the form so that all fields print to your exact specifications.

Sorting Lists

Many times users wish to sort lists such as the Ledger or Tickler file to get more insight as to which invoices require attention first. The most intuitive way to sort a list is to click on the column header above the items.

You will notice which lists can be sorted this way by the presence of an arrow () next to one of the column headers.

For example, when you go to the Ledger of a patient, an arrow () is next to the header "Type." This means that the ledger is sorted on that column. Click on the header "Charges" and the ledger with be sorted by the Charges column and the arrow now moves to that column.

Whenever a list has an arrow () present, it may be sorted on any column in that list.

So the next time you think you might like the ledger or tickler file sorted a different way, look to the column headers and just click.

Co-management claims: DATE ASSUMED CARE

Re: KIP 10.3.36

Co-management claims require you to attach the date you assumed care of the patient to each claim.

An example of this type of claim would be an optometrist who begins caring for a patient who had a surgical procedure by an ophthalmologist.

If you send the claims electronically, you will need to add the Date Assumed Care to your claim.

To enter the DATE ASSUMED CARE, open the invoice entry screen and click the SUPPLEMENTAL DATA tab. You will see the field COMGT CLAIMS: DATE ASSUMED CARE field.

Be sure to click OK to save the invoice after entering this date.

Paper claims require this data to be entered in BOX 19 of the CMS-1500 claim form.

New Features to look forward to in KIP 10.3.34

It seems that Medicare and the private insurance carriers have been changing their requirements as the year progresses, and so KIP has gone through some changes as well.

1) Three modifier codes appearing on invoices.

2) Line Item Report sorted by zip code.

This was added because of new competitive bidding requirements placed on our DME providers. This gives you the ability to show how many of each item was dispensed in each geographic area.

3) The ability to HIDE invoice lines when printing CMS-1500 forms and sending claims electronically.

If you frequently enter invoices with items billed to insurance and patients for a single date of service, you may enter them on a single invoice and "hide" the patient billed items from the insurance billing. This feature, however, does not add the hidden items to the "patient balance" until the invoice is marked as "billed to patient."

If you wish the patient to receive bills immediately for patient responsibility items, you should still create a separate invoice for the patient billed amount.

4) CMS-1500 Box 32 now prints on every claim no matter how you enter the treatment location name.

5) UPIN numbers and NPI numbers appear on all claims.

The NPI number was originally meant to replace the UPIN number. Now, however, both numbers are required on all claims and therefore are printed.

* * * * *

As you can see, many more changes are required when printing the claim forms than when sending the claims electronically. If you haven't moved to electronic claim submission, you may save some headaches down the road by using this method of billing.

We have also been informed that Medicare is requiring all new providers to receive payments via electronic fund transfer and intends to delay payments to providers who do not accept this method of payment. You may wish to consider registering for Electronic Fund Transfer for faster payments.

Remote Support Made Easy

In our continuing efforts to make things easier, we've set up a tiny little file you can download that can allow us to take control of your computer remotely (for either Mac OS X or Windows XP/Vista). This allows us to troubleshoot your computer problems so much more easily than trying to talk you through it.

Here's an example of how we used remote access to help a user:

The user was complaining of an error code when trying to save patient information. By logging into their computer, we discovered the problem. The user set up a limited user account with no access to change files on the computer. We deleted the account and had the user log into their computer with full access privileges which solved the problem.

The problem was solved in a matter of minutes rather than frustrating hours having the user follow directions on how to troubleshoot the problem.

If you have a computer expert who can assist you, you can also set up remote access where we are able to make repairs or install updates after your office has closed.

How to Truncate a CPT Code for Billing

There are instances where you may add a letter to a CPT Code so that you can generate different op reports for the same CPT Code.

A good example of this would be the CPT Code 11750 (matrixectomy of nail).

You may set up multiple CPT Codes to use with different op reports, such as:

11750P - Partial Matrixectomy
11750T - Total Matrixectomy
11750S - Subtotal Matrixectomy

The question is:

How do you take off the letter on the end to bill each one as 11750?

Use the new feature (in version 10.3) "BILL AS CODE."

Go to the Lists menu and Modify code 11750P.

In the lower right hand corner, enter "11750" in the field BILL AS CODE.

Now, whenever you enter 11750P on an invoice, the code will be billed as 11750 on all HCFA forms and electronic submissions.

Please note: You must have a code 11750 already entered as a CPT Code for this feature to work.

Mail Merge Made Easy

Today, I would like to help you share your NPI numbers with all the physicians who refer to you. Of course, you can modify this process to suit any need you may have.

First, I have created a template letter which you can modify for your practice.

Mac users should download the letter (called NPI_Letter.sit) here. Windows users download the letter (called NPI_Letter.4W7.zip) here.

Please note: These files are compressed. You can tell because they end in ".sit" (Mac) and ".zip" (PC). You will need to expand them before you can use them. Mac users need a program called Stuffit Expander to expand files. PC users use WinZip. Both programs come with a free version you can download.

Once you expand the file you downloaded, the Mac version will be called "NPI_Letter" and the PC version will be called "NPI_Letter.4W7".

Now, go to KIP and choose "Referral Sources" from the "Lists" menu.

Optional: Search for only those Referral Sources you want to send this letter to.

Next, choose "Word Processor" from the "File" menu.

Please note: The word processor window has its own menus. In all the following steps, we will use the menus at the top of the word processor window (not the main KIP menus).

Choose File and then Open (from the word processor window's menu), and open the NPI_Letter you just downloaded.

You will now see the letter ready to be modified with your information (with references to the referring doctor's information merged within the letter).

Optional: You can add any field in KIP to this letter by placing the cursor (and clicking it) where you want the information to go, and then choosing "4D Expression..." from the "Insert" menu (from the word processor menus). Then select which field of KIP you want in your letter.

When you are finished editing your letter, you may print the merged letters as follows:

Choose "Print Merge" from the word processor "File" menu.

Click on "Referral Source" in the list which appears (to merge your letter with the Referral Source list) and then click the PRINT button.

This should make sending out letters to your referring doctors a snap.

Printing inconsistencies using Canon Pixma IP 5000

When printing the CMS 1500 form using KIP 10.3, the Canon Pixma IP 5000 printer has been shown to have printing inconsistencies from one form to the next.

The problem was solved by changing the default paper size in the page setup to LEGAL.

On the Macintosh, using OS X, this was done as follows:

1) Choose System Preferences from the Apple menu
2) Click on Print & Fax
3) Set Selected Printer in Print Dialog to Last Printer Used
4) Set Default Paper Size in Page Setup to US Legal


Using Windows XP, the default paper size is set for each printer and varies from printer to printer.

1) Click Start and then Control Panel
2) Open Printers and Faxes
3) Right click on your printer and choose Printing Preferences
4) Change your default paper size to Legal

Common Billing Errors by Medicare providers

The Centers for Medicare & Medicaid Services (CMS) recently published an article on the Medicare Learning Network about common billing errors by Medicare providers. Here are some of the tips:

• All Medicare providers must bill electronically unless they qualify for the “small provider” exemption (see 42 CFR 424.32(d)(1)(vii)). CMS considers physicians with fewer than 10 full-time employees to be a small provider. Small providers do not lose their exemption by submitting some claims electronically (but there could be HIPAA implications).
• Always use the Health Insurance Claim Number (HICN) and patient's name (without any title such as Dr. or Mr.) as it appears on the Medicare card. A correct HICN has nine numeric digits followed by one alpha suffix. Relatives may share the first nine digits but each of those individual will have a different suffix. Do not use dashes or hyphens. Railroad retirement numbers generally have two alpha characters as a prefix to the numeric digits and should be billed to Railroad Medicare Services.
• Always fill out the name and address of the place of service in item 32 on the Form CMS-1500. Make sure evaluation and management (E&M) procedure codes match the place of service recorded.
• For diagnostic services and consultations, include the referring/ordering physician's name and unique provider identification number (UPIN) in items 17 and 17a. There are new requirements for National Provider Identifiers (NPIs) taking effect this year.
• When billing for more than one provider within a group, use the additional individual provider number in item 24K because item 33 can only report one provider number.
• Use the appropriate provider identification number for the individual rendering care on each detail line, and make sure that the group number, when applicable, corresponds.
• Don't add digits to a diagnosis code even if there is space for five characters because some International Classification of Diseases, 9th Edition, Clinical Modification (ICD-9-CM) codes are fewer than five digits.
• Use current CPT books because procedure codes/modifiers no longer have a grace period when they are deleted.
• When Medicare is the secondary payer, complete items 11, 11a, 11b, and 11c.
• Do not use zeros to fill in items requiring an NPI or UPIN.
• See http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0712.pdf for the article.

Reduce Stress with Remote Access

Sometimes your computer can give you headaches. Maybe installing an update isn't going as smoothly as you like, or maybe you just want to access your computer from home.

Remote Access is the answer.

Remote Access allows us to work on your computer remotely, to install an update, repair a data file, or other data maintenance.

Remote Access also allows you to use your computer from home (or anywhere in the world).

Enabling Remote Access is not difficult and requires just a few simple steps:

1) Enabling Remote Access on your computer
2) Setting up a dynamic network service
3) Opening ports on your router

You can have someone help you with each of these steps, or you can attempt to do them yourself.

The whole process (for Macintosh) is explained here in an article titled MacWorld Secrets - No Files Left Behind.

Let me explain the three steps here in plain English. Please read the above article for more details.

1) Enabling Remote Access on your computer

You need to turn on the System Preference to allow for Remote Access.

Go to the Apple Menu and select System Preferences.
Click on Sharing and make sure the box next to Apple Remote Desktop is checked.

2) Setting up a dynamic network service

Your computer logs into the internet using an IP address. For remote access, you need to know this IP address, but it can occasionally change. You can create a name for your IP address that remains constant (and easy to remember) using a dynamic network service such as dyndns.org.

You install a little program on your computer that tells dyndns.org whenever your IP address changes. Then all you need do is log in using the same address each time (like mycomputer.dyndns.org) instead of your IP address (like 123.123.123.123, which can change).

3) Opening ports on your router

You need to point a few ports on your router to your computer to allow it to communicate with the outside world.

Let's say you set your computer on your local network (the network inside your office) to have an IP address of 192.168.0.10. Your router needs to point ports 5900 and 3283 to the IP address 192.168.0.10 (ie. the computer you want to use remotely).

Windows users can use a program like TightVNC to control their computers (opening port 5900).

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By allowing us here at KIP to access your computer as well, you save time whenever you need an update installed or need data repair.

Setting Up KIP 10.3 with your NPI Numbers

Once you have installed your new KIP 10.3 update, you will need to add your NPI numbers and make a few changes to your data to keep it current.

The process is simple and requires only a few steps.


Update the Billing Providers

1) Go to the Lists menu and choose Billing Providers. Open your billing provider, and enter the NPI number in the spot provided.

Please note: If you have a corporate NPI number, put that number here.

2) Click on the Supervising Provider tab and clear the fields PROVIDER, TAX ID, and UPIN #.

Please note: To clear the PROVIDER field, click on the PROVIDER field and then click the ENTER key on the numeric key pad to the right of your keyboard.

3) Click the SAVE button.

4) Close the Billing Providers window.


Update the Treatment Providers


1) Go to the Lists menu and choose Treatment Providers. Open each treatment provider, and enter the NPI number in the spot provided.

2) Go to the TX PROVIDER FOR INVOICES field and make sure this field does not say "False." Either make this field blank, or choose a provider. The treatment provider you choose will show up on all invoices and electronic claims instead of the information for this treatment provider.

3) Click the SAVE button.

4) Close the Treatment Providers window.

Update the Payor ID List

For information on updating the Payor ID List, please read this post (iPlexus Claim Errors and Insurance Carrier Names).

iPlexus Claim Errors and Insurance Carrier Names

If you are submitting claims via iPlexus.net and are using KIP 10.3.22 or later, please read on.

iPlexus requires specific formatting of insurance carrier names. KIP has already been upgraded to handle these claim errors, but if you have upgraded to KIP 10.3.22 or later, you may not have the the updated Payor ID list on installed. If you are not sure, please install the patch again - it will not harm anything.

How to install the patch to correct iPlexus claim errors:

1) Go to the computer that you use to run KIP (multiuser versions, use a client computer) and download the patch (called PAYOR_ID.txt.zip) by clicking here.

The file you download is compressed as a ZIP file. Expand this file using your preferred expansion software.

Macintosh and Windows users may expand the file using the free program, Stuffit Expander. Go to http://stuffit.com to download this program.

Once expanded, you will find a new file on your computer called PAYOR_ID.txt

2) Place this file in your KIP Deluxe folder (Macintosh) or C:/KIP folder (Windows).

Multiuser versions, place this file in your 4D Client folder (Macintosh) or C:/4D Client folder (Windows).

3) With KIP running, go to the File menu and choose Preferences.

4) Once the main Preferences window is open, you will find a Repair menu to the right of the Graphs menu.

Choose Update Payor ID List from the Repair menu.

The patch should install automatically, and you should receive the message:

Payor ID List Updated Successfully.

If you have not placed the file, PAYOR_ID.txt, in the correct folder (or have modified the name of the file, PAYOR_ID.txt), you will receive the following error message:

Error. Payor ID List not modified.

Updating your Payor ID list will correct naming errors when using KIP and iPlexus.

New Features Coming in 2007

As your practice grows, expect KIP to grow as well.

Here are some things to look forward to this year:

1) Ledger transactions can be archived.

As your practice grows, ledgers will grow as well. To keep things under control, you will be able to hide ledger transactions that are cleared older than a time frame you specify. Of course, KIP makes this process totally reversible and modifiable - so if you don't like hiding transactions (or if you want transactions hid that are over 2 years old instead of 3), just change your preferences. Any invoices that retain a balance will always remain visible.

2) Backing up made easy.

Here it is, 2007, and still offices don't backup as they should. New KIP versions to be released this year will backup automatically to our internet servers. Just leave your computer on every night and your data will be transferred automatically to our secure backup site. You will finally be able to sleep securely knowing your data will be safe and sound.


3) The paperless office becomes a reality.

New KIP versions to be released this year will integrate with high speed scanners so that everything in your office will be totally computerized. Letters, lab reports, even insurance cards, can be scanned into KIP and stored electronically. Anytime you need a hard copy, just print it out or fax it. Anywhere you can log into KIP, you have access to everything.

4) Email your patients reminders and information.

Actually, KIP already emails patient appointment reminders, but look to KIP for increased emailing capability. You will be able to search for all diabetics and send them an email pertaining to a new treatment or medication, or email all patients not seen for a year and send them a reminder email.

5) Ledgers can be sorted on any column

Just click on the column header and your ledger will be instantly sorted by Date, Transaction Number, Description, Charges, Payments or Adjustments.

6) Mark one CPT or Inventory code to be billed as another.

Sometimes the CPT or Inventory Codes you want to use aren't the ones you want to bill.

Bar code your inventory items and scan them in for billing, then set which CPT Code that item should be billed as. Any item you dispense that has a bar code (or other code that may be convenient for you to enter), can be billed using a different CPT code.

We look forward to hearing your ideas as to where KIP should go next. Feel free to let us know what features you are looking forward to.

iPlexus Error 97 - Supervising Provider Error

Re: ERROR 97 SvcLine: 0 Error Desc: If Supervising
Provider First or Last Name is not blank then
Supervising Provider ID must be valid and Supervising
Provider ID Qualifier must be
in a list of valid values

Solution:

Please remove your supervising provider information by going to

Lists > Billing Providers > Modify

Click the SUPERVISING PROVIDER tab.

Click on the field PROVIDER.

Hit the ENTER key to make that field blank.

Remove the TAX ID and UPIN numbers and click the SAVE button.

NPI Compatibility

KIP Deluxe version 10.3.22 is fully compatible with the new CMS-1500 form. If you plan on upgrading to KIP Deluxe 10.3.22, you must begin using the new CMS-1500 form immediately.

Those interested in upgrading, please contact us with the following information:

1) Your current KIP Software (KIP Administrator, KIP Deluxe, KIP Deluxe Network Version).

2) Your current KIP version (version 6.7, 6.8, 10.3)

3) Your platform (Mac OS 9, Mac OS X, Windows)

4) The number of users you have installed (single user, network with two users, etc.)

We will then be able to determine the correct upgrade path and pricing for your upgrade.

Ledger errors using Mac OS 10.4.8

Those using KIP Deluxe 10.3 who upgrade to Mac OS 10.4.8 (or higher) will notice strange behavior in KIP, especially when accessing patient ledgers.

To correct this behavior, you must download the KIP Deluxe Precision Patch and apply this patch to your KIP software.

Those using KIP Deluxe Multiuser must apply this patch to either the 4D Client or 4D Server software program on each computer using Mac OS 10.4.8 (or higher). This patch is not required on other computers on the network not using Mac 10.4.8 (or higher).

To apply the precision patch (for those using Mac OS 10.4.8):

1. Quit all KIP and 4D applications.
2. Download the KIP Deluxe Precision Patch to the Macintosh computer using OS 10.4.8.
3. Open the DMG file you just downloaded. This will create a new disk image called "10.4.8 Precision Patch for 4D" and open it in a new window.
4. Open the enclosed application called "Mac OS X 10.48 Precision Problem Patch for 4D"
5. Click the "Select 4D Application" button
6. In the dialog box which opens:
Single User: Find and open your KIP Deluxe program
Multiuser: Find and open either the 4D Client program or 4D Server program which resides on the computer you are working on.
7. Click the "Apply Patch" button.
8. Quit the "patch" application.

Electronic Fund Transfers (KIP 10.3.21)

In addition to Check, Cash, and Credit Card, you will now notice the ability to select Electronic Fund Transfer for a payment type. The totals for each payment type will be reflected in the totals in the Day Sheet.

Checking Treatment Provider Activity (KIP 10.3.21)

Check Treatment Provider activity by using the Line Item Report. A new addition to this report, which adds the ability to create the report for a single treatment provider, will show the totals for that treatment provider for any given period of time.

Appointment Book Changes (KIP Version 10.3.20)

The KIP appointment book has been updated to be able to show a maximum of four schedules at the same time. Currently this feature works for the 15 minute schedules only and requires a minimum screen resolution of 1024 x 768.

Set this feature is set by going to the File menu, choosing Preferences, and then Appointment Book Preferences.