DMEFree Installation and User's Guide version 1.0

This installation and user’s guide is designed to provide easy step-by-step instruction for installing your software and an introductory guide to putting the program to use.

The current version utilizes a program installer that lets you select the drive and directory to install upon. Unless you are knowledgeable about disk drives or directory structures, you should use the defaults.

If you have elected to place DMEFREE on a drive other than C: and/or in a directory other than DMEFREE then it is your responsibility to know where on your computer DMEFREE is located. You will need this information for upgrades and support. The program will put the files into the sub directory DMEFREE on drive C: unless you enter a different path during the install process. You are given the opportunity to abort or cancel the installation if desired.

THE SETUP PROGRAM ON THE CD SHOULD RUN AUTOMATICALLY. IF YOUR COMPUTER IS NOT CONFIGURED TO RUN PROGRAMS AUTOMATICALLY, FOLLOW THESE STEPS:

Click on Start
Click on Run
Type D:SETUP (WHERE D: Is the drive letter of your CD-ROM drive)

How to use this document

Terminology

· The terms “window” and “screen” may be used interchangeably and are enclosed in quotations.

§ Example:

From the “Browse your Company File Information” window

· The term “field” refers to a data entry space in the software (see example 1 below). The title will be enclosed in quotations and the case of the title will match its appearance in the program.

§ Example:

Enter the patient’s last name in the “Lookup by Lastname” field.

Example 1

· When instructed to click on a button, the title of the button will be capitalized.

§ Example:

Click on the Company Info File button

· When instructed to press a key on the keyboard, the key title will be enclosed in arrow brackets.

§ Example:

Press the <enter> key on your keyboard.

· When referring to the “browse” button, we are referring to the icon in example 2. This may also be used interchangeably with the term “lookup” button.

Example 2

· The term “menu bar” refers to both the textual bar and bar with icons located at the top of the main screen (example 3) and may be used interchangeably with the term “toolbar”

Example 3

Text Box: Note: The images in this document (screenshots) are not representative of the actual size of the windows that you will see while running the program.

Use this space for notes

Step by Step Installation

Step 1

Step 1. Insert DMEFree Installation CD into the CD Drive and click on “Install Purchased DMEFree Software”

THE SETUP PROGRAM ON THE CD SHOULD RUN AUTOMATICALLY. IF YOUR COMPUTER IS NOT CONFIGURED TO RUN PROGRAMS AUTOMATICALLY, FOLLOW THESE STEPS:

1. Click on Start

2. Click on Run

3. Type D:SETUP (WHERE D: Is the drive letter of your CD-ROM drive)

Step 2

Step 2. Click “Yes” to continue with the installation.

Use this space for notes

Step 3

Step 3. After exiting all Windows Programs on the computer, click “Next” to continue.

Use this space for notes

Step 4

Step 4. After reading the P.C. Solutions License Agreement, click “Yes” to accept the agreement and continue with installation.

Use this space for notes

Step 5

Step 5. We have provided you with an installation sheet titled “RxDME2000 for Windows Installation sheet” with passwords for the Purchased versions of the software. Make sure you enter the password exactly as show on the paper i.e. capitalized and with hyphens.

Use this space for notes

Step 6

Step 6. Enter your name and Company name here. Installation will not continue with blank values.

Use this space for notes

Step 7

Step 7. Click on “Next” to accept the default installation directory (recommended). To choose an alternate directory, select “Browse” and enter the directory, path and/or appropriate network path.

Text Box: Note: If you have elected to place DMEFREE on a drive other than C: and/or in a directory other than DMEFREE then it is your responsibility to know where on your computer DMEFREE is located. You will need this information for upgrades and support.

Use this space for notes

Step 8

Step 8. Review the settings for the installation and click “Next” to begin copying files. To change or review any setting, click “Back”.

Use this space for notes

Step 9

Step 9. Setup will now install program files.

Use this space for notes

Step 10

Step 10. Click on “Finish” to exit the install program. You are now finished installing DMEFree and can proceed to the User’s Guide.

Text Box: **Important**

FOR FIRST TIME INSTALLATIONS THERE IS AN EXTRA DISKETTE THAT MUST BE INSTALLED AFTER THE CD. TO INSTALL THIS DISKETTE, INSERT IT INTO DRIVE A:

1. Click on Start
2. Click on Run
3. Type A:SETUP (WHERE A: Is the drive letter of your floppy disk drive)

Use this space for notes

DMEFree User’s Guide

Getting Started

After a successful installation of the DMEFree Software, the program can be easily accessed by either clicking on the desktop icon , or by going to:

Start -> Programs -> PC SOLUTIONS DMEFree Desk Software and clicking on “DMEFree DESK”.

Adding Users

1. The following security window may open (figure 1); click “Yes” to add a new user.

Figure 1

2. At the “Update Users” dialogue window (figure 2), enter your First and Last (Surname) Names and a login that you will use later. This login will also be the password when you login to the software. At this point, no user input is needed for “Default Access”, “User Group” or “Workgroup”.

3. Click “OK” when done.

Figure 2

4. Now the “User Login” dialogue window opens (figure 3), enter the login name and password that you created in the previous step.

Figure 3

Auto Update feature

This feature (figure 4), allows you to check to ensure that you have the most up-to-date version of DMEFree. New users will most likely have the most current version and may wish to enter a number of days (for example 30) in the “Do an Update __ Days” box.

Clicking “Do Not Update Right Now” will reset the dialogue box to appear the next day.

Clicking on “Update Now!” will open up a new series of dialogue boxes and check for the most current version.

Figure 4

Configuring and Running DMEFree

Figure 5 shows the opening screen of DMEFree. The remainder of this document will display the features of DMEFree.

Figure 5

Getting Help

If at anytime you require assistance or software support, please start by going to the PCSolutions Homepage right from the main screen of DMEFree (figure 6). Here you can access PC Solution’s Knowledge Base, live chat support, email support, online documents, and training videos.

If contacting PC Solutions for support, you will get the fastest response by following these steps:

Email first
Try a live chat at www.dmefree.com
Fax support
Call our voice line

Figure 6

Setting Up DMEFree

Begin by clicking on the “File” menu from the menu bar at the top of the screen (figure 7)

Figure 7

Now select the “Data File Manager” (figure 8)

Figure 8

Next, click on the Company Info File button (figure 9)

Figure 9

From the “Browse your Company File Information” window, select the “Click here to Update Location file Information” button (figure 10).

Figure 10

Now you can add the appropriate information for your company (figure 11) and click OK when complete.

Text Box: Note: If you are going to be using online adjudication for your claims, please refer to the section entitled “Configuring DMEFree for the online claims adjudication system” to setup the program.

Figure 11

Adding Patients

1. The first step in doing claims is the adding of new patients. First, check to make sure that the patient does not already exist in the database. Steps a - c below explain how to do this.

a. Click the icon from the menu bar (or click on “Transactions”).

b. From the “Select Patient for Transactions” window, enter at least part of the patients name in the Search box (figure 12)

Figure 12

c. If no name appears in the list of names that match the name you wish to enter, click on the NEW PATIENT button.

2. A “Record will be added (new)” window will open up as shown in figure 13 below.

Figure 13

Text Box: Note: For this document, we will demonstrate the minimum entries required for a normal Medicare Primary / Medicaid Secondary Claim filed electronically through PC Solutions.

3. Enter patient’s:

a. last name

b. first name

c. address

d. city

e. state

f. zip

g. Phone number can be added without any spaces or dashes.

4. The account number is an optional field, but we recommend putting in either a few characters of the patient’s name or SSN, or perhaps an account number you use in your business.

5. Click on the “General (Cont 2)” tab and enter the following information:

a. sex

b. date of birth (as MMDDYY)

c. Enter a few letters of the patients default doctor’s name and click on the browse button to open the Doctor’s file lookup. Simply select the doctor or add the doctor (on the fly) if not in your system yet. See the section entitled “Adding Physicians”, step number 2, for more information.

d. Selecting the diagnosis file is similar to selecting a doctor in that you also enter a few characters of the diagnosis and click the browse button to bring you to the closest match. Once in the diagnosis lookup screen, you can also search by the Diagnosis ICD-9 code as well. DMEFree comes with a starter diagnosis file; however, you may modify it.

6. Click on the “Insurance data – Primary” tab

a. Click the browse button to search for an Insurance Plan ID:

b. Enter a portion of the plan’s name to quickly find it in the list.

c. Click SELECT to choose the plan.

d. The “Insurance ID #” is the patient’s policy number or Medicare number or whatever number that identifies the patient to the specific plan.

e. Select the appropriate “Relationship to Cardholder”

f. Click OK to save and exit this window. You have entered enough patient information to complete a primary claim submission.

Text Box: Note: There are many additional fields that can be completed for a patient. Select “Change Patient” to add additional information from the “Select Patient for Transactions” window (figure 12).

Adding Physicians

Adding a Physician to your database is similar to the process of adding a patient.

1. Begin by clicking on the icon from the menu bar. This will open up a dialogue box as shown in figure 14.

Figure 14

2. Click on INSERT and the new records window will open as seen in figure 15.

Figure 15

3. Enter the appropriate physician information and click OK when done. This will add the physician to your database.

Claims

Entering Claims

To enter a new claim, first click on the icon in the menu bar. This will open the window shown below in figure 16.

Figure 16

Select a patient by either entering the patient’s name (or portion of name) in the search box and press the tab key on your keyboard.

Alternatively, select by scrolling through the list of patient’s names. Select a patient by clicking once on their name and then clicking on the DO CLAIMS button.

Search button

After clicking on the DO CLAIMS button, a new window will open (figure 17) showing transactions for that patient. Click on ADD NEW CLAOM to begin the new claim process.

Figure 17

The ADD NEW CLAIM button will open the “Claim Transaction…(New)” window (figure 18).

Figure 18

After entering the appropriate data, click OK at the top of the window.

Completing the “Claim Transaction” Window

Header information such as Diagnosis, Doctor, and Primary Insurance ID will be automatically filled in based on the information in the patient record. Ordinarily you will only have to enter the line item information.

Transmit. By default, the software will put the claim automatically into the billing file for transmission. However, you can switch transmit to “N” to hold the claim until you are ready to send it.

Accept Assignment. By default, all claims are set to accept assignment, but you can change this to “N” by using the pull down arrow.

Claim Type. This is a very simple yet very important to the processing of your claims. If the claim is:

§ DME or DMERC, then the type of claim is D

§ Oxygen then the type of claim is O (letter, not number)

§ Paper claim for printing, use a P

§ N is used for Medicaid and commercial plans.

(These descriptions can be found by clicking on the “?” button.)

Blank Diagnosis Fields. Often, a patient will have a new diagnosis for the item being dispensed that is not on the patient’s record. You can add the diagnosis for this specific claim by clicking on one of the blank diagnosis fields to open the “Browse the DIAGFILE file” window (figure 19).

§ A fast way of finding codes is by using the ICD-9 code tab instead of the description tab.

§ Enter the first few numbers of the code and then click on “Select”; it will then be entered into the diagnosis.

Figure 19

Filling in the Claim Lines:

§ DOSFrom and DOSTo. Enter the dates of service (DOSFrom and DOSTo), but you only need to enter the month and day, the software will assume the current year.

§ POS. Now enter the Place of Service (POS), typically 12 for at home, but check with your specific insurance company and situation.

§ ITEM by Desc. Enter the first few letters of the item (for example, “wa” for “walker”) and press <enter>.

§ Browse the ITEMFILE file. Click on the correct item and then click on “Select”

§ UNITS. Click in the UNITS box and enter the quantity you are billing for this item then press Tab; the total being billed (unit price x units) will automatically appear in the TCHG box.

§ Modifiers. If you need to enter modifiers for this item, enter them in the MODIFIERS boxes; like the item file, you can bring up and select from the Modifier file by clicking on the browse button next to the appropriate modifier box (1, 2, or 3).

§ DIAG IND. Click in this box and enter the diagnosis which applies to this item. For example, if this item applies to the patient’s first diagnosis, enter a 1; if to the patient’s first and third diagnosis’s, enter 1, 3.

§ CLAIMSTATUS. The Claimstatus controls which lines of the claim will print or be transmitted. You can use the default status or use your own, but… here are the rules:

§ If you leave the claim at NA, it will default to FILE

§ FILE means print it, send it, transmit it, the claim is active, ready to go.

§ PAID, BLD, REJ, HOLD, CMN are codes that can be used for various functions and none of them will print or be transmitted.

Remember that the default is FILE, which is what you want to use when the claim is okay for billing.

§ Click OK and the transaction is done and ready for billing!

§ After saving a claim, you are prompted to attach a CMN or a Narrative to be electronically transmitted. If this does not apply, click No Complete Claim.

Text Box: Note: To see an example of how to attach a CMN for oxygen, visit www.dmefree.com/dmefree_vids.htm and view the video entitled “Online Adjudication Claims Processing”. CMN entry begins at frame 64.

Additional Claim Entry Fields

From the “Claim Transactions” window, select the “Claim Entry (cont.)” tab to add additional claim information (figure 20):

Sale or Rent. By default, all claims are Sale.

Rent Status. Choose the status of the rental unit:

NA – not a rental
Out – unit is out
In – unit is in
Ret – Returned

MCAREAPP. The software can post the Medicare allowable to the claim for reconciliation use if the allowable is updated in the product item file record.

SERIAL. Use this to track items by serial numbers.

Rental Information. Use this section to help track rentals for rebilling.

Other Claim Information. Used when there is an accident related claim such as worker’s comp.

Figure 20

Renewals

Renewing a claim is extremely fast and easy…

1. From the “Select Patient for Transactions” window, highlight a patient name and click on “Renewals”

2. Now select a claim and click on the “Click Here to do a Renewal for Highlighted claim”

3. Click the “AutoAdvance Dates of Service!” button.

4. Accept or change the number of days to advance the dates of service.

5. Click “OK” and you now have a new claim!

6. A window will open asking if this claim is a rental renewal or not.

7. Print your invoice and click “Close” to return to the previous screen.

Printing the Invoice

1. From the “Display This Patient’s Transactions” window, select “Print Forms” to open the “Print Options” window (figure 21).

Figure 21

2. Select any button to begin printing.

Transmitting Claims

Step 1 - Preparing the Audit Report

1. Begin by printing an audit report for your records. To do this, click on Billing from the main window’s menu bar and select “Billing File – Audit Report” (figure 29).

Figure 29

2. Select the claims that you want to transmit by clicking on the patient’s name and then the Select button (figure 30).

Figure 30

3. Once your selections have been made, click on the “Print Audit Report”. This report is your log of claims being sent to the clearinghouse.

4. The software will preview the report before you print it.

Step 2 - Preparing the Claims

1. Now you must prepare your claims for transmission.

2. Click on “Prepare Claims for Transmission” from the Billing menu of the menu bar (figure 29).

3. Choose “Create Claims for Transmission” and press <Enter> to create claims as shown in figure 31.

Figure 31

4. Press the <F10> function key to begin (figure 32).

Figure 32

5. The next window that appears is for optional information that can store the date and time your billing was created for historical uses. It is not required and you can either press <enter> or <Ctrl-enter> to bypass the screen.

Figure 33

6. Now the claims will be created and you can back out to the main window for transmission.

Transmitting to PC Solutions via Modem

Follow steps 1- 10 in Transmitting Claims to first print an audit report and prepare your claims for transmission
Click on “Transmit Claims via Modem – Telephone” (figure 29).
Now simply click on the “Send claims via modem” button to transmit and “exit” to return (figure 34).
Click on Clear Billing file (figure 29) to clear the files. This will prevent the same claims from being sent over and over again. This does NOT clear your DME transactions, Accounts Receivable, or any other area, just the claim selection file.

Figure 34

Transmitting to PC Solutions via the Web Page

Follow steps 1- 10 in Transmitting Claims to first print an audit report and prepare your claims for transmission
Click on “Transmit Claims via webpage” (figure 29)
The next screen will display which files will be uploaded and from where they will be gathered. (figure 35).

Figure 35

Click “Start” which opens a browser window and a logon screen as shown in figure 36.

Text Box: Notes: If your web browser is configured to not accept popups, you will not be able to access the web upload page.

Figure 36

1. Enter the proper User ID and Password.

2. The Secure Server Web Upload page opens (figure 37).

3. Enter the files to be uploaded by following clicking on the browse button and browsing to your C:\DMEFREE directory.

4. Click Upload Files

Figure 37

Figure 38

Figure 39

5. A status window should open up as shown in figure 39.

6. Click on either the DMEFREE link at the bottom of the screen (to return to DMEFree.com) or Close Window to exit.

7. Click on Clear Billing file (figure 29) to clear the files. This will prevent the same claims from being sent over and over again. This does NOT clear your DME transactions, Accounts Receivable, or any other area, just the claim selection file.

Text Box: Note: An often overlooked function is our Track Transmissions feature. Each transmission is logged so you can put in the number of claims sent, accepted by the clearinghouse etc.

How to Track and Reconcile Claims

In this section you will learn:

· how to reconcile claims

· how to apply payments to claims from insurance companies

· how to bill the secondary portion

The following steps begin after a claim has been:

· Entered and/or renewed

· Transmitted to the insurance company

· Payment has been received

· You are ready to reconcile the claim to mark it as paid

1. Begin by going to Transactions and selecting a patient.

2. From the “Select Patients for Transactions” window, click the “Reconcile” button (figure 40)

Figure 40

3. Now highlight the claim that you wish to reconcile (figure 41) and click the “Apply Payments / Reconcile” button.

Figure 41

Please refer to figure 42 for steps 4-10 below.

4. The “Quick Reconcile” window opens (figure 42). Note that there is a PAID IN FULL checkbox, and by default is unchecked.

5. If the claim has been billed electronically, the CLAIM BILLED? Checkbox will be checked.

6. The APPROVED amount for each claim can be overridden if needed.

7. Enter the amount paid in the PAID box. This amount is from the EOB or remittance.

8. The balance is calculated and displayed in the BALANCE column.

9. As you reconcile the claim, you should also change the claim status to reflect the situation.

10. Click on OK and you are done!

11. At any time you can review claims that have been paid in full by clicking on the DISPLAY PAID CLAIMS button (figure 41)

Text Box: Note: To see an example of how to reconcile a claim that has Primary and Secondary plans, check out the “How to track and reconcile claims” training video at www.dmefree.com/dmefree_vids.htm

Figure 42

Processing AR and AR Statements

The AR module allows you to send to your customers, statements for personal charges not covered by insurance and for the co-pay charge to be collected.

In this section you will learn how to:

· Enter AR charges

· Send statements

· Print Aging reports

· Apply payments

So, a patient can receive a charge via a copay from the reconcile module, AND a patient can have a charge posted directly onto their AR account by pressing the PATIENT CHARGES button or clicking on AR menu and selecting CHARGES.

Entering an AR charge

1. From the main DMEFree window, click on AR from the menu bar at the top and select ENTER ADDITIONAL CHARGES

2. Click on the ADD AR CHARGE button (figure 43)

Figure 43

3. Select the patient and you will be brought to the “Enter AR Charge (New)” window (figure 44)

Figure 44

4. The charge is given in today’s date; however, you can change the date if needed.

5. Enter a few letters of the item you wish to sell the customer in the “DESC:” field.

6. Press the <Enter> key, or the browse button for the item file.

7. From the “Browse the ITEMFILE File” window (figure 45), find the item, highlight it, and click on the SELECT button.

Figure 45

8. The price of the item will be posted in the “Pat AR/Chgd?” field of the “Enter AR Charge (New)” screen.

9. Click OK to finish.

Text Box: Note: An AR charge can also be added by selecting the patient from the “Select Patient for Transactions” window and clicking on the PATIENT CHARGES button. This will open a window identical to the one shown in figure 44, but WILL NOT automatically enter the price of the item.

Sending Statements

1. From the main DMEFree window, select AR from the menu bar.

2. Select “AR Reports / Statements”

3. From this sub-menu, you can choose to print individual statements on demand by selecting “Single Statement” (figure 46).

Figure 46

4. Most of the time, you would want to print statements for everyone that has outstanding charges. Do this by selecting “Statements to All Due”, which opens the window shown in figure 47.

Figure 47

5. The statement needs to print both current charges and recent payments. Enter the range of payments you wish to print on the statements.

Text Box: Note: You would typically enter the LAST months date range.
For Example, if last month was January, you would enter 01/01/04 thru 01/31/04

6. Next, click on PRINT.

Printing AR Aging Reports

1. After printing the statements, you should print an AR Aging Report. This will provide you with a fast way of looking up customer accounts.

2. This is done simply by choosing “AR Aging Report Detail” from the “AR Reports and Statements” submenu of AR (figure 46).

3. Choose the dates as was done for the patient’s statements above, and continue with printing.

Applying Payments

1. Begin by clicking on “Enter Payments” from the AR menu.

2. The AR Unpaid table that opens (figure 48) shows ALL AR charges that have outstanding balances. Once a charge is paid in full, it will be removed from this screen.

3. Highlight the customer that made the payment.

Figure 48

4. Click the APPLY PAYMENT button

5. Enter the payment amount and date paid in the appropriate fields (figure 49)

Figure 49

Text Box: Note: Similar to the reconcile claims module, only check off the “ENTIRE CHARGE PAID? CLOSEOUT?” checkbox once ALL Claim lines are paid in full.

6. Click OK to save your work and you are done!

Addendum

Configuring DMEFree for the online claims adjudication system

From the main DMEFree window, click on “File”, and then “Data File Manager” as shown in figures 50 and 51.

Figure 50

Figure 51

Next, click on the COMPANY INFO FILE button (figure 52)

Figure 52

This will open a window to select your company file information (figure 53).

Figure 53

Now click on the Click here to Update Location file Information button which opens the window shown in figure 54.

Figure 54

Now click on the “Clearinghouse Setup Tab” (figure 55).

Figure 55

Please refer to figure 55 for steps 6-10 below.

Enter your PCSolutions Account Number, if you are unsure of this number, please refer to the account number letter sent to you, or call support for more assistance.
Enter the IP address for the Web Uploads Secure Upload Site. Again, this IP address can be found in the letter sent with the software, or call support for more assistance.
Check the “Use Online Adjudication for Online Plans” checkbox