Starting Physician Billing Database

[freemind]

Hello,

I am brand new to Access--I've been working at it now for 2 weeks and sure
can use some help! My father, nearing 70, contracted bone cancer and had to
take 2 years off from his physician career for treatment. Upon returning to
work, he found out the hospital replaced his position, so if he wants to
continue doing his outpatient hospital procedures, he has to do his own
billing. Since his cancer treatment has cost him dearly financially, he has
asked me to do the billing for free (in all my spare time!!) This is a
description of the situation:

1. Each patient is seen only once for one kind of procedure, always at the
same cost.

2. Through a separate online program, I bill the insurance.

3. When the insurance payments come in, I need a database to track how much
the insurance pays, how much the physician is expected to "write-off", and
how much the insurance "withholds" for their security (which will be repaid).

4. After the insurance pays, I need to bill the patient the remaining
balance. The invoice needs to include the starting amount, the amount the
insurance pays (or doesn't pay), and the balance.

5. Some patients are unable to pay the total amount, so will need to make
monthly payments.

6. The database needs to keep track of all payments made to the patient's
account and make a monthly invoice to bill the patient.

I am having trouble getting a final monthly balance to work for the patient!
I have put the database here for someone to view and offer and advice you
can! http://www.sawyersweb.com/ForHelp.mdb

I'd appreciate any advice you can give!
Thanks so much,
Freemind

 

[mscertified]

I'm sure your father made a very very good living for many years and I'd be
surprised if he did not have much better than average medical insurance.
Personally, I think you should be paid for the work you are doing, that is,
unless your father gives you free medical treatment.
As for your system, I'd suggest buying an off the shelf program to do
medical billing. Its not a trivial process to handle insurance claims, there
are many complications. You have to comply with HIPAA regulations on personal
medical information otherwise both you and your father could face a crippling
lawsuit.

Dorian

 

[freemind]

Hi, Dorian

Thanks for your response. As I mentioned, I do all the insurance claim
filing through a separate online billing program. What I'm left with is just
billing the patients for whatever the insurance didn't pay. So, the database
is just for that. I thought it wouldn't be too complicated, but since I'm a
newbie, I've been having trouble getting a monthly balance to show up for
each patient after their insurance pays a portion and after they make any
programmed payments.

I know this is not the place to discuss my father's physician career, but
please don't assume that all physicians are the same.

Thanks for your help,
Freemind

 

[Ed Warren]

At least you are ambitious!

As you must be aware medical billing is one of the most complex issues
around.

It is almost as complex as an Italian Restaurant Inprobability Space Drive
(see Douglas Adams -- Restaurant at the End of the Universe). The real
question is why the software you are currently using to submit to the rest
of the world does not also provide the functionality you want to develop?
Frequently, this type of software will provide additional functionality for
a reasonable additional cost or there may be commerical software already
developed that will provide the fuctionality you desire. There are hidden
costs in building your own, free isn't always free. Specifically, if you
application fails to recover even a small percent of what a competing
commerical product would, it will quickly add up to 'real money'.



consider:

HIPAA

HL7

RHIIO

CPT

ICD9

LOINC

SNOMED

E-prescribing



Best of luck.



Ed Warren.

 

[freemind]

I appreciate the concern you've shown on my doing the patient billing myself.
In this case, the billing will not be very complicated, and there is a need
for me to do this without expensive programs.

Can someone please take a look at what I've got so far. Are there any
suggestions as to how I can get the monthlyl patient balance after insurance
and patient payments have been made? Again, it's here:
http://www.sawyersweb.com/ForHelp.mdb

I'd really appreciate any suggestions!

 

[Ed Warren]

1. Your use of the nz function to calculate the totalpayment is incorrect:
=nz([PaymentAmount]+[WriteOff]+[Inswithhold])
First you don't have a 'default' value, second what you really want is:
=nz(paymentamount,0)+nz(writeoff,0)+nz(inswithhold,0)

2. Your reference to the TotalPayment field in the subform is incorrect.
You are trying to sum a field in the master form (a field that does not
exist). Take a look at the help files to find out how to properly reference
a field in a subform.

Best of luck

Ed Warren.

 

[freemind]

Ed,

Thanks a lot for your help! Things are coming together now for this database!

I really appreciate your taking the time to help me.

Nancy