Condition Tab

• Choose whether the patient’s current medical condition is a result of employment, an auto accident, or another type of accident.
• Enter the patient’s date of current illness, injury, or pregnancy. Check the Gradual box if the illness or injury onset occurred gradually.
• If the patient has a recurring illness or injury, Enter the original date of the illness or injury.
• If the patient is unable to work, Enter the start date and end date (if applicable).
• If the patient was hospitalized due to their illness or injury, enter the start and end dates of their hospitalization.
• If the patient was referred by a physician, choose the physician’s name from the drop-down list.Referring Physicians for instructions on adding new referring physicians to this list.
• The Reserved for Local Use box can be used to enter data that does not have a corresponding field on the HCFA form.  For chiropractors, this information is usually an x-ray date, or the severity of an injury or illness. If you are required to populate this field for certain clients, you can use a Box 19 flag in the billing alert sets. If any of the charges in the batch are missing data in box 19 and this alert is activated, it will notify you of this missing information before creating the claim file. This field may be required to be populated by Medicare and other various payors. Most likely, this should not be populated for all clients.
• If you checked the Outside Lab? box,  enter a dollar amount in the Charges field for the cost to the patient of using an outside lab.

If your patient is a Medicaid patient, then you must leave the Outside Lab? box unchecked. Medicaid requires all lab tests to be billed directly by the patient’s provider. If an outside lab was used and the patient is not a Medicaid patient, then check this box.

If services were rendered somewhere other than the patient’s home or physician’s office, Enter the provider’s billing office, or the address of the supplier who furnished the services.

Click the binoculars to the left of the address field to search for a previously entered facility address. Check the Use Provider's Facility Address box to use the facility address that is stored in the Site Information section of the Maintenance application. To copy in the provider's facility address by default, set this option in the Patient Management Setup screen (Patient Management Setup).

You will only see this option if you have enabled EDI for the patient.

To assign release of information indicators for individual patients, select an option below Patient Release of Data. If you wish to set the default for all new patients, Patient Management Setup.