Group Maintenance

Use Group Maintenance to maintain information about groups within your practice.  Use groups to set up financial areas within your practice.  You can group your practice by providers or by locations.  Once you have created groups you can set INSight parameters that allow you to perform billing by groups or by providers.  Group codes hold billing numbers as well as month-to-date and year-to-date financial totals for services, payments, adjustments, last year's A/R amounts and the total number of cases seen by providers in the group.  In addition, you can use Group Set Maintenance to maintain additional information required for processing the billing claims for the provider services.

Grouping Examples:  

• Grouping providers within a practice
  One way to group your practice is to organize provider groups by the types of specialties provided.  For example, you can place all pediatric providers in one group and all OB/GYN providers in another group.  These providers can all render services at the same physical location but can be maintained in separate groups for financial reporting purposes.  To do this, first create the groups in Group Maintenance, then assign providers to groups by entering a Group code in the Group Number field in Provider Maintenance.

• Grouping by locations within a practice
  Another way to group your practice is to organize location groups.  If your practice has multiple locations you place a single location to a group or place multiple locations within a group.  For example, your practice may have a Falmouth location, a Portland location and a Windham location.  You can place all 3 locations within one group or place each location in its own group.  To do this first create the groups in Group Maintenance, then assign locations to the groups by entering a Group code in the Group Number field in Location Maintenance.

Notes:

• You must set up a Group Code called TOTAL, which will hold the running A/R balances of your entire practice, as well as billing numbers.

• During the installation, you and your account representative will determine how your practice will be grouped.  Once groups are set, any group changes you make can affect your billing.

• For a printed version of the group financial summary information, see the Group Analysis Report.

• For more information about working with data in fields, see Data Entry Guidelines.

Directions:

To see directions for...

• Opening Group Maintenance, click More.

   

  1.  Click File Maintenance from the Menu Bar.

  2.  Click Standard Maintenance.

  3.  Click Groups.
  
  Or, use the keyboard shortcut:  [ALT] [m] [t] [g].

   

  Groups Maintenance Window Example:

  

• Creating a new Group, click More.

   

  Group Maintenance Prompts Tip:  To see more information about a field, click the hyperlink for that field name.
  Group Code	Enter the code assigned to this group. (2.0 numeric) Notes:   Use 1-99 for assigning Group codes and create a Group code called TOTAL, which contains your practice's summary of financial amounts. If you are building a new Group, displays near the Group code.  Default entries display and the first field is highlighted to let you know you can begin entering information.
  	To update the new or changed information click Save or press [ENTER]. Keyboard shortcut:  [ALT + s]
  	CAUTION:  If you forget to click Save, you may lose your changes.
  	You can use Search to view all of the existing groups.  From the Search list you can select a group to change or delete. Keyboard shortcut:  [ALT + r]
  	To display an existing Group, enter the Group code and click Retrieve or press [ENTER]. Keyboard shortcut:  [ALT + t]
  Group Name	Enter the abbreviated name of the group.  The group name displays whenever you enter the Group code in daily processing. (up to 20 characters)
  Prof Name	Enter the full name and title of the group. (up to 30 characters) Notes:   If your practice bills with paper claims, depending on how the Form Type Parameters are set, the group's professional name and address can print in box 33 on the claim forms. If your practice bills with electronic claims and your INSight parameters are set to allow billing by group, the group's name and address information display in box 33 on the electronic claims.
  SSN	Generally, leave blank.  If you are setting up a solo provider you can enter their Social Security Number here if desired. (up to 11 characters) Note:  The group Social Security Number is informational only.
  Address	Enter the group's address to print on the claim forms if you are billing by group. (up to 25 characters) Notes:   If your practice bills with paper claims, depending on how the Form Type Parameters are set, the group's professional name and address can print in box 33 on the claim forms. If your practice bills with electronic claims and your INSight parameters are set to allow billing by group, the group's name and address information display in box 33 on the electronic claims.
  City	Enter the city or town name or a valid City code to display the city, state, and Zip Code associated with the group's address. (up to 15 characters) Notes:   If your practice bills with paper claims, depending on how the Form Type Parameters are set, the group's professional name and address can print in box 33 on the claim forms. If your practice bills with electronic claims and your INSight parameters are set to allow billing by group, the group's name and address information display in box 33 on the electronic claims.
  State	The US Postal Service State code displays if you entered a city code above.  Press [TAB] to accept or enter the desired US Postal Service State code. (2 characters) Notes:   If your practice bills with paper claims, depending on how the Form Type Parameters are set, the group's professional name and address can print in box 33 on the claim forms. If your practice bills with electronic claims and your INSight parameters are set to allow billing by group, the group's name and address information display in box 33 on the electronic claims.
  Zip	The Zip code displays if you entered a city code above.  Press [TAB] to accept or enter the 5-digit Zip code or the 9-digit Zip+4 Code with the dash (-). (10 characters) Notes:   If your practice bills with paper claims, depending on how the Form Type Parameters are set, the group's professional name and address can print in box 33 on the claim forms. If your practice bills with electronic claims and your INSight parameters are set to allow billing by group, the group's name and address information display in box 33 on the electronic claims.
  Phone #	Enter the group's primary phone number. (14 characters)
  Prevent Autobill (Y/N/T)	To prevent tickets (charges) associated with the group from being billed electronically, click Y(es) in the drop-down list. To allow tickets (charges) associated with the group to be billed electronically, click N(o) in the drop-down list. To transmit tickets electronically and print a copy of the claim forms, click T(est) in the drop-down list.
  Federal ID NO.	Enter the group's Federal Taxpayer ID Number. (15 characters)
  Note:  Because you can tailor the labels of the nine Form Type fields, the field labels in your software may not match the field names listed.
  Form Type 1 Group Print Code	Enter the specific Group code to print for this Form Type.  The Group code is assigned by the insurance carrier for the Form Type.  The Group print code will print on the appropriate claim form. (up to 15 characters) Tip:  To quickly enter the same Group print code for each successive Form Type (if applicable) use the copy and paste commands. Keyboard shortcuts:  [CTRL + c] = copy and [CTRL + v] = paste
  Form Type 2 - 9 Group Print Code	Enter the specific Group code to print for this Form Type.  The Group code is assigned by the insurance carrier for the Form Type.  The Group Print code will print on the appropriate claim form. (up to 15 characters)
  Note:  The following fields are generally for viewing information only.  They are updated during the Charge/Payment Post Initialize process and under normal situations they do not need to be edited.
  Services MTD	Displays the dollar amount of services rendered by the providers in the group during the current period. (7.2 numeric)
  Services YTD	Displays the dollar amount of services rendered by the providers in the group so far this year. (9.2 numeric)
  Payments MTD	Displays the dollar amount of payments received for services rendered by the providers in the group during the current period. (7.2 numeric)
  Payments YTD	Displays the dollar amount of payments received for services rendered by the providers in the group so far this year. (9.2 numeric)
  Adj/Ref MTD	Displays the dollar amount of adjustments or refunds applied to services rendered by the providers in the group during the current period. (7.2 numeric)
  Adj/Ref YTD	Displays the dollar amount of adjustments or refunds applied to services rendered by the providers in the group so far this year. (9.2 numeric)
  Cases MTD	Displays the number of cases the providers in the group have seen during the current period. (7.0 numeric) NOTE:  If you Edit Patient Detail, you can affect the number of cases.
  Cases YTD	Displays the number of cases the providers in the group have seen so far this year. (7.0 numeric) NOTE:  If you Edit Patient Detail, you can affect the number of cases.
  Note:  The following fields are display-only and can not be edited.
  Totals MTD	Displays the A/R dollar amount accumulated by the providers in the group during the current period. (11.2 numeric)
  Totals YTD	Displays the A/R dollar amount accumulated by the providers in the group so far this year.  (11.2 numeric)
  Last Year End A/R	Displays the accounts receivable dollar amount the providers in the group had outstanding at the end of last year. (11.2 numeric)
  Current A/R	Displays the accounts receivable dollar amount currently outstanding for the group. (11.2 numeric)

• Editing an existing Group, click More.

   CAUTION!  If you forget to click Save, you may lose your changes.

  1.  To display the record to be changed, enter the Group code and click Retrieve or press [ENTER].
  Keyboard shortcut:  [ALT + t]
  Tip:  If you do not know the Group code, you can click Search to see a list of Groups.

  2.  To position the pointer to the information that you want to change, press [TAB] or click the field using the mouse.

  3.  Enter the data changes.

  4.  To complete the edit process, click Save or press [ENTER].
  Keyboard shortcut:  [ALT + s]

• Deleting a Group, click More.

  1.  To display the record to be deleted, enter the Group code and click Retrieve or press [ENTER].
  Keyboard shortcut:  [ALT + t]
  Tip:  If you do not know the Group code, you can click Search to see a list of Groups.

  2.  Click File from the Menu Bar, and then click Delete.
  Keyboard shortcut:  [ALT] [f] [d]

  3.  At the Delete Records prompt, click the Proceed button to delete the record
  or, click the Cancel button to escape from the delete routine.
  
  Example:
  
  
  
  Note:  After you click Proceed, you will see the following message on the Status Bar.
  
  

   

• Maintaining a Group Set record, click More.