The CPT codes are available to the billing department during charge entry, since they are linked initially to the appointment.  The user may view the transcribed report and complete the charge by adding such information as facility, physician, outside facility, modifier, and ICD-9 codes, all from the billing screen.  The user also has access to the patient’s demographics, authorizations, and notes entered by other users.

Once the charge is entered, it is then sent to the Claims Processing screen where it will be checked for errors prior to electronic submission.  Standard claim edits are programmed into the system but these are also customizable based on the needs of the practice.

Besides electronic eligibility, RamSoft One offers electronic claim submission, claim status, and remittance processing.

Electronic Claim Submission
Claims are submitted in the ANSI format directly to Medicare, Blue Cross, and Medicaid in most states.  Commercial claims are sent through a clearinghouse.  Claims that cannot be submitted electronically due to the limitation of an insurance carrier may be printed to paper or sent to a clearinghouse electronically where they may be dropped to paper for the practice.

Electronic Claim Status
RamSoft One allows practices to check the status of claims submitted to insurance carriers.  Practices can access information electronically, displaying the receipt and payment status of their pending claims.

Electronic Remittance Processing
Electronic remittance processing can increase the efficiency of any practice by eliminating the need to manually post payments received from some insurance carriers.  RamSoft One has the ability to import electronic remittance files directly in ANSI format from Medicare and Blue Cross in most states.  Commercial claim electronic remittance is also available through some clearinghouses.

Forms and Reporting
Customizable forms and letters are available with RamSoft One.  Forms can merge patient data from any field stored in the Microsoft SQL database with text.  Letters and forms may be printed individually or in batch.

The RamSoft One reporting capabilities are nearly limitless.  Every field stored in the Microsoft SQL database may be pulled onto reports and used to sort, group, or filter.  Various types of graphs can be added and the reports can be exported in multiple forms including, Excel, Word, HTML, and ASCII.

Collections
Collection screens on RamSoft One facilitate the follow-up of not only patient balances but also claims.  One of the collection tools used by most practices is Collection Queue Management.  This feature allows accounts to be assigned to specific users on the system based on criteria, such as aging, responsible party, account, patient name, doctor, and denial code.  Once accounts are assigned, the user can add notes or ticklers to the account, re-bill claims, or send letters.  Managers are able to track the progress of each collector and regenerate or reassign queues if needed.