Fast Service Detail section

Enter service detail information in the Fast Service Entry form.

Prerequisites:

To process a service authorization:

• The procedure code must be associated with a service authorization.
• The total service charge must be the same as the service fee.
• The service units must be equal to or less than the number of authorized units.

1. Select Add in the Fast Service Entry Summary table.
2. CPT is selected in the Procedure Code Type field.
3. For Member Name Or ID, enter the member name, and select.
4. For Funding Source, enter the funding source name, and select.
5. For Provider, enter the provider name, and select.
6. Select Process Report to generate the Valid Authorizations report, which details authorizations associated with the member, funding source, and provider.
7. For Select Dates Option:

• Select Single date to enter one service
  OR
• Select Multiple Dates to select multiple Dates of Service

8. Select the date(s) of service for Service Entry. Enter the date range using From Date and Through Date fields. Select the dates in the Select Dates field.
   Note: This requires enabling the Enable Multiple Service Date Entry registry setting. If the registry setting is not enabled, enter a date range and the services are applied to each day in the range.
9. Enter the Date of Service.
10. For Date of Service (End), enter the end date of the associated service for any service that spans more than one day.
11. For Procedure Code, enter the CPT code.
12. For Total Charge, enter the charge for the associated service.
13. For Service Units, enter the number of units rendered.
14. For Duration (Minutes), enter the service duration in minutes.
15. Select Display Valid Authorizations to display the Authorization Listing screen.
16. Select the authorization then select OK.
17. Enter the Authorization Number.
18. When an authorization number is chosen in the Authorization Listing screen, that number populates.
19. For Does This Service Represent An Admission:

• Select Yes if the service is an admission.
  Note: The admission number (in the member's number of admissions) must be lower than the maximum number of admissions set up in the Benefit Plan Definition form (set up in the Provider Fee Definition form).
  OR
• Select No if the service is a service unit.

20. The Total Fee Table Amount displays the total service charge when a valid authorization number is entered in the Authorization Number field.
    • The service fee times the number of units displays.
    • If no valid authorization number is entered, 0.00 dollars displays.
    • The maximum fee is defined by the total available units in the Service Authorization, multiplied by the service fee.
21. If appropriate, for Third Party Amount Paid, enter the amount.
22. The Approved Units displays the number of service units.
    • The maximum value is limited to the total available units in the service authorization when the number of units field is greater than that value.
23. The Expected Disbursement displays the expected service payment.
    • This amount is the provider fee definition amount minus any member deductible or member co-pay.
24. The Private Pay Amount displays private pay.
25. The Member Deductible displays the amount in the Out of Network Deductibles field (Plan Definition form).
    • The amount displays for out-of-network providers. For network providers '0.00' displays.
26. The Member Co-Pay displays the co-pay visit ceiling amount or co-pay visit ceiling percentage fields (Plan Definition form).
    • The amount displays for out-of-network providers. Network providers '0.00' displays.
27. The Explanation Of Coverage displays the service approval status.
    • This field updates as information is entered in this form.
    • This field is blank when the service has been approved.
28. The Claim Status displays Approved when the service is approved.
    • The claim status can be overridden by making a different selection.
29. If Pending is chosen, select the Claim Status Reason.
30. For the Third Party fields:
    • In the Third Party Payer Assigned Client fields, select the payer.
    • In the Amount fields, enter the billed, allowed, and amount paid.
31. If appropriate, in the Adjustment Reason fields - select the adjustment reason.
32. For Amount, enter the adjustment amount.
33. Enter the Patient Account Number. This number allows the claims/services to be included in the 835 Health Care Claim files.
34. For Copy Data On Add, select whether the current row of data should be copied to the next new row.