Glossary of Terms

This glossary defines some of the terms that are used throughout WebHelp.

Definitions

Accept Assignment

A status that determines whether the provider accepts responsibility to bill the insurance carrier, or the patient pays the bill and seeks reimbursement from the insurer.  If the Accept Assignment field is set to Yes the system directs the payment to the provider, while Accept Assignment set to No does not.

Tip:  See How Insurance and Accept Assignment Determine Billing

Action Console

A console available in most applications, which is used to keep track of actions such as phone calls, meetings, and "to-do" items.  Includes a "tickler" feature for application-specific items, such as overdue accounts.

See also:  Console

[ALT]

A special key on your keyboard that is used in conjunction with other keys to quickly perform a function.

Example:  To exit WebHelp, press [ALT] [f] [c].

See also:  Keyboard shortcuts

Alternate Fee

A special fee setup for a specific combination of procedures, providers, form types and insurance codes.

See also:  Procedure Maintenance

Application

A group of modules.

Examples:  Edifice™, INSight™, INVision™

See also:  Module

Backup

An electronic copy of programs or files stored separately from the original.

Base Point Units

The number of units provided for a particular anesthesia procedure as established by an insurance carrier and/or a provider.  Units are factors of time.

Example:  One Base Point Unit equals 15 minutes

Base Unit Value

The dollar value of each base point unit established by an insurance carrier for a particular anesthesia procedure.

Batch Window

A window within Charge Entry and Payment Entry that enables you to enter default values to expedite entry for a batch of charges and payments.  You can also enter identifiers to track batches (groups) of charges and payments.

See Also:  Work Window, Default

Browser

A software package that enables you to display and interact with documents (pages) hosted by web servers on the Internet. Popular browsers include Microsoft Internet Explorer and Mozilla Firefox.

Tip: Do not confuse the term browser with search engine.  A search engine, such as Google or Yahoo, works within the framework of a browser to help you find documents on the Internet.

Button

An image that is clicked to perform an operation.  Buttons sometimes appear raised when inactive and sunken (or depressed) when activated.

Examples: ,

 

Tip:  If a button appears focused, outlined like the first Save button below, you can automatically click the button simply by pressing [ENTER].

Focused

Not focused

See also:  Icon

Capitation

Insurance term meaning by the head or per person.  A Managed Care Plan pays participating doctors and hospitals a fixed fee per patient for care over a given period of time.  Managed Care pays a provider of medical services according to the number of members in a health benefit plan that the provider contracts to treat. The plan sponsor agrees to pay a uniform periodic fee for each member.

Because the fee is independent of how many services are performed, the doctor has an incentive to keep costs low.  The doctor's incentives not to render only minimal treatment include professional integrity, the risk of malpractice suits, loss of business if patients are dissatisfied, and the risk of simple illnesses becoming more severe and costly to treat.

See also:  Managed Care

Cause Codes

Cause Codes enable INSight to meet Medicare requirements for printing HCFA claims.  Cause Codes display during Patient Entry.

Examples:  Auto accident, workers' compensation

See also:  HCFA Claim Forms

Certification Number

A unique identifier used by the insurance carrier to track patients.  A Certification Number can be associated with an individual or group of family members.  The insurance carrier may also use prefixes and suffixes to identify particular products.

Also called:  Certificate Number

Character-Based

A text-only interface that only allows systematic keyboard entries.

Note:  Many of the application modules operate in two versions, character-based and GUI-based.

See also:  GUI

Choose

To position the pointer over an item, and then click the mouse button.

See also:  Select

Click

To press the left mouse button once.

See also:  Double-Click, Right-Click

Commit

Permanently enter a transaction, making it ready for posting.  Usually, you can easily edit and delete any transaction that has not yet been committed.  However, after you commit a transaction, you may have to use a special program to make changes.

Example:  You can edit or change uncommitted charge transactions during Charge Entry in the Transaction Detail Area.  However, to change committed transactions, you must use the Transaction Detail Inquiry.

Console

A program that is a portal into your applications, giving you access to your to-do list, favorite documents and reports, job scheduling, and the ability to monitor key performance indicators (KPIs).

See Also:  Action Console, Executive Console, Job Console, Schedule Console, User Console, Workflow Console

Console Item

A favorite file that appears in the Console Items Panel of the Executive Console and User Console.  Console items include word processing documents, spreadsheets, data bases, Crystal Reports, and reports from your NDS software applications.

Important:  Certain console items, such as Word documents, are copied from their original location to the EMS server location.  When you edit the file from a console, you are not editing the original version; instead, your modifications appear only in the copied version.

Tip:  To maintain information about the items on the consoles, use the Console Item Wizards for your favorite files and the Job Console for NDS application reports and processes.

Console Items Panel

A panel in the Executive Console and the User Console that contains a list of favorite console items.

Tip:  The Executive Console shows items from all NDS application modules.  In contrast, the User Console shows only the items for the currently opened module.

Content View Panel

A panel in the Executive Console and the User Console that displays a key performance indicator or a favorite console item, such as a Crystal Report, text document, or web page.

Context-Sensitive Help

A type of Help built into the software that displays information related to the particular field or function in use.

See also:  Field-Level Help, Form-Level Help

Contractual Company

An insurance company that pays a provider an allowed amount for a specific procedure.

Coordination of Benefits

COB.  A system designed to prohibit payments in excess of charges for patients with multiple insurances.

Example:  Medicare evaluates the reimbursement paid by a primary insurance carrier to determine what they will pay as the secondary insurance carrier.

See also:  Explanation of Benefits

Copay

An arrangement where the covered person pays a specified amount for various services and the health care provider pays the remainder. The covered person usually must pay his or her share when the service is rendered. Similar to coinsurance, except that coinsurance is usually a percentage of certain charges where the co-payment is a flat dollar amount.

CPT® Code

Physician's Current Procedural Terminology.  CPT Codes are five-digit codes used for reporting medical services and procedures performed by physicians.  The purpose of the CPT terminology is to provide a uniform language that accurately describes medical, surgical and diagnostic services and provides an effective means for communication among healthcare providers, patients and third parties.

Example:  99315 - Nursing facility discharge day management; 30 minutes or less

See also:  Modifier, Procedure, Procedure Maintenance

[CTRL]

A special key on your keyboard that is used in conjunction with other keys to quickly perform a function.

Example:  To clear data, press [CTRL + x].

See also:  Keyboard shortcuts

Cue Cards

A level of help that displays information about entering data in a specific field, such as data type (alpha or numeric) and field length.

 

Note:  You can toggle the cue cards off and on by clicking Cue Card on the INSight Toolbar.

 

See also:  WebHelp, Tool Tips, Context-Sensitive Help

Data

Information that is stored and processed by the system.

Default

A pre-loaded setting or value for a field that is displayed in a field to save data entry time.  You can override the default value, if needed.

Desktop

See:  NDS Desktop

De-select

To remove or clear a checkmark from a check box, which prevents a function from being performed.

Diagnosis

A medical term identifying a disease or condition affecting a patient.

See also:  ICD-9 Code, Diagnosis Maintenance

Dialog Box

A small window that prompts for information or parameters for the operation being performed.

See also:  Prompt

dos

An abbreviation for Computing Disk Operating System.

Double-Click

To press the left mouse button twice in rapid succession.

See also:  Click and Right-Click

Drag

To move the mouse while holding the left mouse button down.  Dragging moves windows from one location on the screen to another.

Also called:  Drag and Drop

Email Profile

A special file that contains several preset parameters about a user and activates the email features within a module.

Tip:  For more information, contact NDS Technical Support.

Encounter

A face-to-face visit with a provider.

Encounter Form

A pre-printed form that lists the procedures, diagnoses, and miscellaneous information associated with a particular type of practice.  Patient demographics print at the top of the Encounter Form.  Practices use Encounter Forms to record key information about a patient visit, which is later entered and used by INSight.

Tip:  For more details, see the Scheduling - Print Appointment Forms Instructions and Encounter Form/Superbill Form Sample.

Also called:  Superbill

Enter

[ENTER]

  1. Without brackets, refers to typing data into a field.

  2. In brackets, refers to the [ENTER] key on the keyboard.  You usually click [ENTER] when ready to perform a function, such as saving a record.

Tip:  If a button appears focused, outlined like the first Save button below, you can automatically click the button simply by pressing [ENTER].

Focused

Not focused

[ESC]

A special key on your keyboard that is used to escape from the current function.  [ESC] usually closes the active window.

Executable File (*.exe)

A PC program identified by the .exe suffix.  You can run an executable file by opening it.

Tip:  You can add a favorite executable file, such as the Microsoft Calculator, to the Executive Console and the User Console.

Example:  calc.exe (Microsoft Calculator)

Executive Console

A console in the Executive Management System (EMS), which is used to monitor your business activities, analyze key performance indicators, and to launch favorite documents and reports.  The Executive Console contains three major areas, the Key Performance Indicators Panel, the Console Items Panel for favorite files, and the Content View Panel for displaying data and charts.

Tips:

  • The Executive Console shows items from all application modules, including the General Ledger.  In contrast, the similar User Console in an NDS application only shows items from the open module.

  • To add items to the Executive Console, use the Console Item Wizards for favorite files and the Job Console for application reports and processes.

  • You can not use the Executive Console within an NDS application.  It is only available in EMS.

See also:  Console

Explanation of Benefits

EOB.  Documentation provided by the insurance carrier detailing the payments, adjustments, and patient deductibles associated with the processed claims and the enclosed reimbursement.  The EOB is used to accurately coordinate patient benefits.

See also:  Coordination of Benefits

Explosion Code

A code that groups multiple procedure codes associated with a standard service.  If you enter an explosion code during Charge Entry the description and fees for each of the respective procedures display.

Example:  Create a single Explosion Code for multiple procedures provided during a patient's annual check up.

See also:  CPT-9 Code, Procedure, Procedure Maintenance

Family Billing

Enables tracking of services for individual family members linked by a common guarantor.  Family billing allows you to make a single payment that affects the balance of each family member.  You can also bill all family members on a single statement.

Fast Access Maintenance

To open the file maintenance window for a data field in order to review, edit or create a new code for that field:

  • Click Fast Maintenance next to a data field.

  • Or use the keyboard shortcut:  [CTRL + o]

Tip:  This is commonly used for a data field that is a code.

Also called:  Fast Access File Maintenance

Fast Access Panel

A small floating panel containing buttons for quickly launching or switching to related programs and functions.

To display the fast access panel of buttons, select the appropriate menu option.

Example:

Tip:  Fast Access Panels are not available in all modules.

Federal Tax ID

The Identification Number issued to individual or group providers by the Internal Revenue Service for reporting purposes.

See also:  Provider Maintenance

Fee for Service

A conventional healthcare model where providers and hospitals charge patients by the individual services rendered, and are paid for the amount billed.

Field

A segment of a record pertaining to a specific data element.  There are multiple fields within a record.  You can enter or modify the data within one or more fields in a window.

Note:  Spreadsheet programs, such as Microsoft Excel®, often refer to fields as columns.

Example:  Last Name is a field within the Patient Master record.

See also:  File,  Key, Record

Field-Level Help

A level of help that displays the specific WebHelp® topic for the field in which you are working.

See also: Form-Level Help

File

A group of related records.

Example: The Patient Master file contains a separate record for each patient.

See also:  Field, Key, Record

Focus

Describes a button, field, or other area that is active.  If you tab to a button or a field, it is in focus.

Tip:  If a button appears focused, outlined like the first Save button below, you can automatically click the button simply by pressing [ENTER].

Focused

Not focused

Force Next Statement

A field setting that overrides the patient's billing cycle to print a statement during the next billing run, regardless of the patient's established schedule.

Form

A window containing fields in which you enter data.

Form Type

A classification used within INSight to group insurances by the type of claim form the insurer requires for reimbursement.

Form-Level Help

A level of help that displays the specific WebHelp® topic for the form (or window) in which you are working.

See also:  Field-Level Help

Function Keys

A sequence of 12 special keys that usually reside in the top row of your keyboard.  They provide a quick method for running pre-defined functions.  In some modules, you can change the operation performed by a function key by modifying the System Parameters.

Example:  [F1], [ F2], [ F3]

Group

A method of organizing providers that serves to accumulate financial totals for the companies or providers contained within.

See also:  Group Maintenance

Guarantor

Serves as the responsible party for a patient's private charges.  Statements are mailed to the patient's designated guarantor.

Tip:  In INSight, a guarantor who is not the patient, must have a patient record, even if not a patient of the practice.

Also called:  Responsible Party

GUI

Graphical User Interface.  Pronounced GOO-ee.

GUI is a graphical interface where you can interact with the program using both the keyboard and the mouse for point-and-click operations.

GUI is recognizable by its colored windows containing text and representations of buttons, icons, and other images or pictures.

Note:  Many of the application modules operate in two versions, character-based and GUI-based.

See also:  Character-Based

Hard Copy

A printed copy, especially of the output of a computer or word processor.

HCFA

Healthcare Finance Administration.  Pronounced HICK- fah.

The federal agency responsible for processing Medicare claims and making reimbursements for services rendered.

HCFA 1500 Claim Form

The universal claim form required by HCFA for submitting all Medicare claims.  Private insurers may also require use of this standard claim form.

See also:  UB04 Claim Form, UB-92 Claim Form

Help

Generally refers to any online documentation that describes how to use the software.  For more information, refer to Levels of Help.

See also:  WebHelp, Cue Cards, Tool Tips, Field-Level Help, Form-Level Help, Context-Sensitive Help

Highlight

  1. verb:  To mark text so that it becomes selected.

  2. noun:  Background color surrounding a block of text.

    Notes
    :  Highlighting can take the form of...

  3. Changed background color, which surrounds a block of text.

  4. Changed button color when hovering over the button with the pointer.

HIPAA

Health Insurance Portability and Accountability Act.  Pronounced HIP-pah.

A government mandate for protecting individuals' privacy.

HMO

Health Maintenance Organization.  Prepaid health plans that provide a comprehensive range of services for a fixed monthly premium.  The HMO combines the diverse functions of the provider, hospital and insurance carrier.

See also:  IPA, Managed Care, PPO, and POS

HTML

Hypertext Markup Language, the language of the Internet.

Hyperlink

Specially activated pictures or text that you can click to instantly display the information you need.

Tips:

  • When the mouse pointer passes over a hyperlink, it changes to a hand shape
    .

  • Text with a hyperlink is usually underlined and blue.  Click here for an example.

  • After you have visited a page for a specific hyperlink, the text usually turns purple.

Also called:  jump, link, hypertext, hot spot, hot link, or shortcut

ICD-9 Code

International Classification of Diseases Code.  Codes defined by HCFA for reporting of diagnoses within claims submitted for reimbursement.

See also:  Diagnosis, HCFA, HCFA 1500 claim forms

Icon

A graphical representation of an object that a user can select and open, such as a folder, document, or program.

Examples:   My Computer, Print

See also:  Button

INSight Toolbar

Contains a group of buttons for functions commonly used within the module.  The Toolbar is located below the Menu Bar, which is near the top of the window.

Example Buttons on the INSight Toolbar:
Save
, Search , and Clear .

 

Also called:  Control Menu

See also:  Menu Bar, Status Bar, Task Bar, Title Bar, Toolbar

Instant 1500 Forms

INSight provides a function that enables you to print HCFA 1500 forms without first building the Work file.

See also:  HCFA 1500 claim forms, Work file

Internet Explorer

The Microsoft® application used to browse the Internet (or an internal intranet), which displays HTML based documents and graphics.

Note:  WebHelp runs within Microsoft's Internet Explorer.

See also:  Browser

IPA

Independent Practice Association.  One of two types of HMO approved by the Health Maintenance Organization Act. (The other is the closed panel HMO.) Under this type, the HMO has a network of nonexclusive contracts with individual physicians or medical groups to provide services to the HMOs members, usually in the physicians' own offices, and usually on a capitation fee basis. The physicians maintain their own private practices and thus can contract with more than one HMO and see regular fee-for-service patients as well.

See also:  HMO, PPO

Job

A general term for any application function, including reports, processes, utilities, and auto notify items.

Tip:  You can manipulate jobs by adding them to the consoles and by scheduling them to be run at a later time.

Job Console

The Job Console is a portal for managing the jobs in your application.  The Job Console lists the eligible reports, processes, and auto notify items within an application module.  You can use the Job Console to launch the Job Manager and the Job Scheduler.

Tip:  You can not use the Job Console within EMS.  It is only available in an NDS application.

See also:  Console

Job Manager

The job manager performs the following functions:

  • Sets up jobs to appear on the Executive Console and the module's User Console.

  • Sets up email alerts.

  • Schedules jobs to be run in the background.

Tip:  You can not use the Job Console within EMS.  It is only available in an NDS application.

Job Scheduler

The Job Scheduler provides the means to manage jobs on the schedules to run in the background.

Tip:  You can not use the Job Scheduler within EMS.  It is only available in an NDS application.

JPEG

Joint Photographics Experts Group.  Pronounced JAY-peg.

JPEG is a type of graphic used for storing images in some software modules.  The JPEG file is recognized by the file name extensions .jpg or .jpeg.

Key

  1. noun:  A number, letter, symbol, or special function key on the computer keyboard.

  2. verb:  To type or enter data into a field.

  3. noun:  The field of information that is used to uniquely access records in a file.

    Example
    :  The Account Number is the key to the Patient Master file.

    See also
    :  Field, File, Record

Keyboard Shortcuts

Keyboard entries that quickly open or perform certain functions.

Also called:  hot keys or shortcut keys

Log On

1.  To launch an NDS software module, which requires your User ID and possibly a password.

2.  To gain access to a computer system by entering a name and password or other appropriate commands.  This also requires the User ID.

Managed Care

  1. An organization of providers and hospitals that form to provide quality, cost-effective healthcare.

  2. The main alternative model of healthcare coverage to standard health insurance. While health insurance relies primarily on indemnity payments for services, managed care plans (e.g., health maintenance organizations and preferred provider organizations) rely on a network of contracts with healthcare providers and capitation fees or other cost controls.

  3. The cost control methods (excluding traditional insurability criteria and benefit limitations) used by third-party payers, including utilization review, contracts with selected healthcare providers, financial incentives or disincentives for using specified providers or services, prospective payment schedules, case management, and payers' efforts to identify treatment alternatives for high-cost care. Traditional health insurers, as well as managed care organizations, use some of these methods.

Examples:  An HMO and a PPO are types of Managed Care plans.

See also:  Capitation, HMO, PPO

Medicare

Established in 1965, Medicare is a social insurance program, like Social Security, that provides health benefits for individuals age 65 and older and for younger people with permanent disabilities.  Medicare consists of four parts, each covering different benefits.
PART A, also known as the Hospital Insurance (HI) program, covers inpatient hospital services, skilled nursing facility, home health, and hospice care.
PART B, the Supplementary Medical Insurance (SMI) program,helps pay for physician, outpatient, home health, and preventive services.
PART C, also known as the Medicare Advantage program, allows beneficiaries to enroll in a private plan, such as a health maintenance organization (HMO), preferred provider organization (PPO), or private fee-for-service (PFFS) plan. These plans receive payments from Medicare to provide Medicare-covered benefits, including hospital and physician services, and in most cases, prescription drug benefits.
PART D is the outpatient prescription drug benefit, delivered through private plans that contract with Medicare, either stand-alone prescription drug plans (PDPs) or Medicare Advantage prescription drug (MA-PD) plans.

Medigap Insurance

Any secondary insurance that picks up charges not covered by Medicare, such as patient deductibles.

Example:  AARP

Medigap Number

The policy number for a supplemental insurance policy approved by Medicare and provided by a private insurance carrier.  The Medigap Number is assigned by Medicare.

See also:  Medigap Insurance

Menu Bar

Contains multiple menus that "drop-down" when you click the menu name.  The Menu Bar is usually located near the top of the window, below the Title Bar.

Menu Examples:  File, Images, Windows

See also:  INSight Toolbar, Status Bar, Task Bar, Title Bar, Toolbar

Menu Tree

A tree-structured navigation view containing multiple commands for programs frequently used.  The Menu Tree is located in the Side Panel, usually on the left under the Patient Load button.

Program Examples:  Patient, Inquiries, Charge Entry

See also:  Side Panel, Flip Control Menu

Modifier

A suffix (usually) added to the Procedure Print Code required for reimbursement by the insurance carrier for a particular service.  The modifier clarifies the standard procedure code, for example multiple procedures performed together.  The modifier prints on third-party claims as the procedure code.  The modifier may also serve as the key to applicable Base Point % reduction for anesthesia procedures.

Examples:  

  • Add modifier 50 to the end of the Procedure Code to indicate a bilateral procedure.

  • Add modifier 51 to the end of the Procedure Code to indicate multiple procedures (surgery to perform a cesarean section and a tubal ligation at the same time).

See also:  Procedure, Charge Entry

Module

A module is a group of programs within an application that work together within a specific business area.

Examples:

  • INSight modules:  INSight Practice Manager, INSight Records Manager

  • Invision modules:  Payroll Workbench, Assessing Workbench, Cash Receipts Workbench

See also:  Application

National Provider Identifier (NPI)

A unique identifier for health care providers.  The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of standard unique identifiers for health care providers and health plans. The purpose of these provisions is to improve the efficiency and effectiveness of the electronic transmission of health information. The Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign these unique identifiers.

Navigation Pane

The Navigation Pane is the left side of the WebHelp window and contains tabs for the Table of Contents, Index and Search.

 

Tip:  To show and hide the Navigation Pane, click
Show Table of Contents
or

Hide Table of Contents .

 

See also:  Viewing Pane

NDS

Northern Data Systems, Inc.

NDS Desktop

The main screen that contains icons for all of the NDS modules.

Note:  The NDS desktop is the window area that includes the Start button, Task Bar and optional icons for programs.  It is usually the area displayed after your computer starts up.

 

See also:  Desktop

Non-participating Provider/Facility

A provider or facility that is not under contract with an insurance carrier and is free to collect the full fee for services.

On Account

To pay a portion of an account balance as opposed to paying a specific charge.  For example, a patient might pay $500 per month on account until the balance is paid off.

Note:  To enter payments on account, you can use Payment Method 2; see Payment Entry - Transaction Detail Entry By Automatic Oldest First.

Participating Provider/Facility

A provider or facility that is under contract with an insurance carrier to accept the allowable charge as the full fee for services.  The agreement also stipulates that the patient is not responsible for the difference between the standard fee and the allowable amount.

Patient Account

Identifies master information relating to a patient including their demographic information, guarantor information, and diagnoses.  The key field that identifies the Patient Account is the Patient Account Number.

Also called:  Patient, Account Number

Piggyback Insurance

A secondary insurance plan by an insurance carrier that accepts any outstanding charges forwarded directly by the patient's primary insurance carrier.

Example:  If the insurance plan is a companion plan, like a Blue Cross Companion Plan, then it is piggybacked.  Claims are submitted directly from the primary insurer directly to the piggybacked insurer.

See also:  Insurance Maintenance

Policy Holder

The person designated as the authorized signatory of an insurance policy.  

Also called:  Subscriber, Policyholder

Pop-up

A pop-up is a help topic that appears in a smaller window on top of an existing topic, when you click the hyperlink for the pop-up.  It is usually used for additional information, such as a field definition.

Also called:  Popup

Tip:  To close a pop-up, simply click once anywhere on the screen.

POS

Point-of-Service Plan.  A type of insurance plan that usually offers a smaller network of doctors and hospitals than PPO plans. Often, the POS plan is similar to an HMO network plan. Employees who are insured must select medical care from the POS network for maximum benefits. Going out of network means lower benefits. Discount arrangements tend to be about the same as a HMO plan, but POS plans are more expensive than HMOs.

See also:  HMO, PPO

Position

To move the pointer to a particular location on the screen.

Post

An INSight routine that updates fields within the file maintenance records with the daily services and payments.  Although some practices refer to Charge and Payment Entry as posting, INSight files are not updated until Charge/Payment Post Initialize is performed.

Post Date

The date that services are posted to the Live Service Date file.

PPO

Preferred Provider Organization.  A health benefit plan with contracts between the sponsor and healthcare providers to treat plan members.  A PPO can also be a group of healthcare providers who contract with an insurer to treat policyholders according to a predetermined fee schedule.

PPOs can range from one hospital and its practicing physicians that contract with a large employer to a national network of physicians, hospitals and labs that contract with insurers or employer groups.  PPO contracts typically provide discounts from standard fees, incentives for plan enrollees to use the contracting providers, and other managed care cost containment methods.

See also:  Managed Care

Prior Authorization Number

Medicare and other insurance carriers may require prior authorization for payment of specified procedures.  Claims for procedures requiring authorization must include the authorization number for reimbursement to occur.  Workers' compensation billing may also require prior authorization numbers.

Private Responsibility

Charges not covered by a patient's health insurance plan.

Procedure

A medical service provided to a patient by a physician, healthcare provider, hospital, or other facility.

See also: CPT Codes, Procedure Maintenance

Process

A program function that performs operations that require only minimal interaction with the user.  A process may take several minutes when accessing large files.

Note:  You can monitor the progress of a process using Process Control Options.

Profiling

A technique in Payment Entry used to pay more than one ticket at a time.  By entering P after the Line Number, you can select up to eight tickets to pay at once.

Note:  This method is available only in Method 3: By Ticket (Auto Transfer and Adjustments by Percentage (%) Method).

Prompt

The statements or questions that appear on the screen as the system runs.

Example:  The Printing Options dialog box prompts for the printer identification number.

See also:  Dialog Box

Provider ID

The number issued by an insurance carrier to a provider under contract for services.

See also:  Provider Maintenance

Rebill Transaction

A Rebill Transaction generates a claim to rebill an insurance company.  Rebill transactions do not affect the balance of a charge ticket.

Tip:  For more information, see the Payment Entry - Entering a Rebill Transaction procedure.

Record

A group of related fields within a file.

Note:  Spreadsheet programs, such as Microsoft Excel™, often refer to records as rows.

Example:  Account Number, Last Name, and First Name, Init are fields within the Patient Master record.  There is a unique Patient Master record for each patient in the Patient Master file.

See also:  Field, File, Key

Referring Provider

A physician that refers a patient to another provider, such as a specialist.

See also:  Referral Maintenance

Responsible Party

The person accepting responsibility for a patient's private charges.

Also called:  Guarantor

Right-Click

To press the right mouse button once, usually to display a shortcut menu.

See also:  Click and Double-Click

RVS

Relative Value Scale.  A Medicare system where payments for services are determined by the resource costs needed to provide them.

The following calculations determine the RVS for any procedure.  

  1. First, the value of each CPT procedure is established relative to all other procedures.  This value is a mathematical quotient, rather than a dollar value.  

  2. A procedure's dollar value is then determined by multiplying the relative value by the conversion factor set by a particular insurance.  Insurance carriers adjust their respective conversion factors annually for inflation and other factors.  

  3. A procedure's calculated dollar value is then multiplied by a geographical adjustment factor to determine the allowed amount for a procedure.

Also called:  RBRVS: Resource-Based Relative Value Scale

Schedule Console

The Schedule Console displays a list of the Schedule IDs, which contain groups of jobs that run in the background.  From here you can launch the Schedule Manager to maintain the jobs on a schedule.

Tip:  You can not use the Schedule Console within EMS.  It is only available in an NDS application module.

See also:  Console

Schedule Manager

Schedules jobs to automatically run in the background at specified times - daily, weekly, or monthly.

Tip:  You can not use the Schedule Manager within EMS.  It is only available in an NDS application module.

Script

A type of program that consists of a set of instructions for another application or utility to use.

A high-level programming language that is interpreted (translated on the fly) rather than compiled ahead of time. A scripting language may be a general-purpose programming language or it may be limited to specific functions used to augment the running of an application or system program. For example, JavaScript is widely used on Web pages for calculations as well as for displaying messages, drop-down menus and other user interface elements.

Scroll

To view information that does not currently fit in the displayed window by rolling up, down, left, or right.

Methods:

  • Click on the arrow at either end of the vertical or horizontal scroll bar.

  • Or, drag the scroll button on the scroll bar.

  • Or, rotate the scroll wheel on a specially equipped mouse device.

Search

INSight utilities used to located records within a file.

Select

To position the pointer over an item and click it by pressing the mouse button.

Service Date

The date that services are rendered.

Session

The time you work in the software between signing on and signing off.  Each time you sign on, a new session begins.

Shortcut Menu

Displays a pop-up menu when you click the right mouse button (right-click).

Single-payer System

A centralized healthcare payment system funded by a government.

Example:  Canadian Healthcare System

Sliding Scale Fees

Adjustment of fees based on a patient's income.  For additional information, see the Remarks 1 field in Patient Entry.

Split Tickets

A feature allowing you to bill co-pay amounts prior to payment by the insurance carrier.  The split ticket feature automatically generates two tickets, one for the insurance amount, and one for the patient responsible amount.  For additional information, see Charge Entry - Work Window.

Status Bar

Displays informational and error messages about the current function.  The Status Bar appears at the bottom of the module window.

See also:  INSight Toolbar, Menu Bar, Task Bar, Title Bar, Toolbar

Subscriber

See:  Policy Holder

Superbill

See:  Encounter Form, Scheduling - Print Appointment Forms Instructions

System Parameters

Fields that can be set to customize the operation of the module for your office.  System parameters are set during installation; however, these features can be changed by your System Administrator as required.

Task Bar

Displays buttons that represent windows for programs that are currently running.

Notes:

  • Usually appears at the bottom of the  NDS desktop, next to the Windows® Start Button.

  • Your computer may be configured to hide the Task Bar when not in use.

See also:  INSight Toolbar, Menu Bar, Status Bar, Title Bar, Toolbar

Ticket

The means by which services are tracked for a patient.  The Ticket Number serves as the key for tracking tickets from Charge Entry through Payment Entry.

Title Bar

Appears at the top of a window and usually displays the program or function name.

Note:  In the main module window, the Menu Bar and INSight Toolbar appear below the Title Bar.

See also:  INSight Toolbar, Menu Bar, Status Bar, Task Bar, Toolbar

Toolbar

Contains one or more rows of buttons for commonly used tasks.  There are several Toolbars in INSight including the INSight Toolbar and the Scheduling Window - Toolbar.

See also:  Menu Bar, Status Bar, Task Bar, Title Bar

Tool Tips

A level of help that displays a single-line description when the pointer hovers over a field or button.

See also:  WebHelp, Cue Cards, Field-Level Help, Form-Level Help, Context-Sensitive Help

Tracers

An inquiry form that a provider sends to an insurer to follow up on unpaid claims.

Transaction Code

A code entered with a payment to identify the type of transaction it is, such as, adjustment, payment, or refund.

Transfer of Responsibility

The transfer of a patient's remaining balance during Payment Entry from one party to another.  The transfer is often from the patient's primary insurance to their secondary insurance plan.  However, if no secondary insurance plan exists, you can transfer the balance to the patient or adjust it off.

See also:  Payment Entry

Type

  1. To press a key or series of keys on the keyboard.

  2. To enter data.

Type of Service Code

Codes issued by insurance carriers to distinguish between multiple types of a particular procedure.  Type of Service Codes are assigned within the procedure records, and display during Charge Entry.

Example:  Medicare usually assigns Type of Service Code 01 as General Medical Care.  During Procedure Maintenance, Procedures Codes that are classified as General Medical Care are assigned Type of Service Code 01.

See Also:  Procedure, Procedure Maintenance, and Type of Service Maintenance

UB04 Claim Form

A medical insurance claim form used for institutional billing that accommodates the National Provider Identifier (NPI).

Also called:  CMS - 1450 Form

UB-92 Claim Form

A medical insurance claim form used when you are submitting insurance claims for a facility such as, a hospital or drug rehab facility.  It is similar to the HCFA 1500 form, but it contains different fields.

Units of Service

The number of units rendered for a procedure.

See also:  Charge Entry

UPIN

Universal Provider Identification Number.  Pronounced You-pin.

The Identification Number is issued to providers by Medicare.

URL

Uniform Resource Locator.

Also called:  Internet address or web site address

User Console

A console that provides access to your favorite files, such as word documents, spreadsheets, data bases, Crystal Reports, and application reports.

Tips:

  • The User Console only shows items from the open module.  In contrast, the Executive Console shows items from all application modules, including the General Ledger.

  • To add items to the console, use the Console Item Wizards for favorite files and the Job Console for application reports and processes.

  • You can not use the User Console within EMS.  It is only available in an NDS application module.

See also:  Console

User ID

The identification assigned to the person who is using a computer or workstation.  The User ID is defined in the User Profile.

Also called:  Operator ID

Tips:

  • Do not confuse the User ID with the Scheduling Operator ID.  They are different identification numbers.

  • You can see your User ID displayed at the bottom of the Side Panel.

User Number

A unique number automatically associated with each User ID.  The User Number is stored in some files, displayed in some windows, and printed on some reports.

See also:  User ID, Operator Number

User Profile

A special file that contains several preset parameters for a user, including their NDS User ID, default printers, passwords, and other module-specific information.

Tip:  For more information, contact NDS Technical Support.

Viewing Pane

The right side of the WebHelp window containing the topic of information.

See also:  Navigation Pane

WebHelp

An online Help system that operates within an Internet browser application such as Internet Explorer.

Also called:  Web Manual, Web Help (two words)

See also:  Help, Cue Cards, Tool Tips, Field-Level Help, Form-Level Help, Context-Sensitive Help

Window

A bordered area within a screen that can be resized and closed independently of other windows on the screen.

Windows®

A Microsoft operating system.

Wizard

An interactive assistance routine that guides the user through a complex task. Wizards are often implemented as a sequence of prompts through which the user can move forward and backward, filling in the details required.

Example: Wizard Button

Work File

A temporary file updated whenever you build the Work file with information from the live service date and service procedure files to date.  You can generate claims and statements for all qualifying tickets from the Work file.  For more information, see Billing Overview.

Workflow Console

Keeps track of tasks assigned to users.  Distributes documents to users, who can sign off on the documents to acknowledge receipt.

Tip:  You can not use the Workflow Console within an NDS application.  It is only available in EMS.

See also:  Console

Work Window

A window operating in conjunction with the Batch window within Charge Entry, used to enter individual patient charges.  Default values set during Batch Entry display in the Work window.

See also:  Batch Window

Workers' Compensation

A type of healthcare insurance provided to employees for injuries or disabilities that occur within the context of their jobs.

Write-off Flags

A field set when entering a patient charge to alert you that the patient balance can be written off.  This means the provider removes the charge from receivables, assuming it will never be paid.  For additional information, see Accept Assignment within Charge Entry.

See also:  Accept Assignment, Charge Entry

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