QHR Product Ideas

It would be nice to have the optional ability to assign Insurance Provider, Service Code and Diagnostic Codes to a form. For instance in Alberta, Driver Medicals are always patient pay and could be assigned Service “Drivers”, and Diagnostic Codes of "V68, 0, 0". That form's billing could be automatically completed.

Some forms may need to go to a different office depending on which province/city the request for it originated from, but the form is the same. In that case, the billing claim dialog should pop up. You could also optionally add a clickable option in the Form Editor for “Always Show Claim Details” that would bring up the dialog no matter what (useful if the billing amount varies, you might need to adjust the number of Billing Calls, you want to print/fax an invoice or you usually submit to one office but occasionally to a different one).

The pseudocode logic for this would be:

IF (SERVICE_CODE NOT BLANK AND DIAGNOSTIC_CODE NOT BLANK AND ALWAYS_SHOW_CLAIM_DETAILS IS FALSE) THEN

...AUTO BILL LOGIC

ELSE IF (SERVICE_CODE IS BLANK OR DIAGNOSTIC_CODE IS BLANK OR ALWAYS_SHOW_CLAIM_DETAILS IS TRUE) THEN

...DISPLAY CLAIM DETAILS DIALOG

The AUTO BILL LOGIC pseudocode would be:

IF (INSURER IS ‘GOV’ OR INSURER IS ‘-PP-') THEN

...APPLY INSURER, DIAGNOSTIC_CODES AND DEFAULT_BILL_AMOUNT

ELSE

...APPLY INSURER, DIAGNOSTIC_CODES

IF (INSURER IS BLANK OR BILL_AMOUNT IS 0) THEN

...ASSIGN NEW TASK TO BILLING USERS WITH TASK_TYPE ‘Complete Billing’

For smaller offices without a designated billing person, or for forms that may vary in price depending on circumstances, selecting “Always Show Claim Details” in the Form Editor will enable the provider to optionally assign a price and print out an invoice/receipt. For larger offices, not having “Always Show Claim Details” selected will delegate those responsibilities to other staff.