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Order Maintenance

I. PRINCIPLE:

Order Maintenance provides a mechanism to modify billing information on orders placed in the Laboratory Information System (LIS) but not yet billed. All security levels have access to this screen.

II. PROCEDURE:

  1. Open Order Maintenance screen:
    Click on the Order Maintenance button located on the Lab Palette or choose “Order Maintenance” from the Screens menu on the menu bar under Maintenance.
      
  2. Patient Search:
    1. Patient search using ID number:
      1. Type in the patient’s unique ID number into the Patient ID field and press ENTER.
      2. If information exists in the LIS database under this number, it will fill the "Order Maintenance" screen. If no patient is found, a message displays telling the operator to check the search criteria and try again, click [OK] to return to the refreshed patient search screen.
    2. Patient search by name:
      1. TAB to the Last Name field and type in the patient's last name (for common last names also type in the first name and date of birth to further restrict the search) then press ENTER. If no patient is found, a message displays telling the operator to check the search criteria and try again, click [OK] to return to the refreshed patient search screen.
        Note: If the correct spelling of the patient's last name is in question, type in only the first few letters. Example Schmidt vs. Schmit or Schmitt; type in only “Schmi” to display all.
      2. A listing of all patients in the LIS database who match the search criteria will display.
        Note: If the same patient is listed, inappropriately, under more than one ID number, print the screen. Highlight the names, indicate that the patient records are possible candidates for merge and send the screen print to the LIS Project Coordinator.
      3. Select the desired patient. Using the mouse, double-click on the correct patient name. The scroll window will disappear and the selected patient order information will fill the Order Maintenance screen.
        Note: If the wrong patient is selected, return to the list of names based on the search criteria entered, by selecting Function on the menu bar and “Last Name Search” from the drop-down menu.
  3. Order Maintenance screen:

    Using the mouse move the pointer arrow directly over the desired order and click the left mouse button once. The following information about that order will display:
    1. Billed to Location: the insurance company or the account to be billed Bill To is an editable field.
      Note: When editing this field, the Patient Insurance screen will display. Make any insurance information change on the Patient Insurance screen and be sure all required fields in the insurance information section of the Patient Insurance screen are completed; and save the changes/additions (ctrl+s). If the “Bill To” should be an account, select the correct account from the drop-down list of accounts and insurance companies in the “Bill To” field on the Order Maintenance screen and save the change (ctrl+s).
      1. When the Bill To field is changed from an account or a non-Medicare insurance to Medicare and the ICD field is completed, the compliance checker will perform a check for medical necessity at the time the changes are saved.
      2. If the code entered does not pass the compliance checker, a message will display.
    2. Order By Location: the account ordering the test This is an editable field.
      Note: If the “Bill To” is an account, the “Order By Loc” must be the same account.
    3. Order Entered By: the laboratory staff member who entered the order or the interfaced system from which the order was received.
    4. Entry Location: the laboratory site where the order was placed.
    5. Resulted By Location: the laboratory site where the test was resulted; this is an editable field.
    6. Released On: the date/time the results were released.
    7. Released By: the user name of the person who released the results last.
    8. Client Order No:
      This number is entered at time of order for specific accounts that receive results through one of the interfaced systems (e.g. Cascade Medical Clinic-CMC). The client order number is the number that appears on the client’s requisitions as the “requisition number”. The Client Order No is only an editable field for accounts that require the entry of this number to receive results from a system interfaced with CLICS.
      Note: The Client Order No will be visible and editable only if the order by and/or bill to account is Cascade Medical Clinic-CMC.
    9. Quantity:
      The default quantity is 1. There is a 2 digit limit to this field. Test charges (crossmatch, unit screen, histology charges, microbiology charges, etc…) may, appropriately, be ordered with quantities greater than 1. The program will multiply the unit price by the quantity entered. Quantity is an editable field.
      Warning: Tests that require results entry are not to be ordered in a quantity greater than 1.
      If a quantity greater than 1 is entered a message box will appear when the screen is saved to alert the operator and asks for verification that the quantity entered is correct.
      1. If the quantity was entered in error, click [No] the quantity will be reset to 1 and the screen saved. (No is the default.)
      2. If the quantity entered is correct, click [Yes] and the save will occur.
    10. ABN: This field allows the operator to change the ABN indicator entered at time of order placement. ABN is an editable field that displays only for those test orders that are covered by a medical necessity rule.
    11. Workarea: This field displays the workarea of the test ordered if the assigned workarea is in either the Referrals (Outside UCL) or Mayo Medical Lab workareas. In these two instances this field is editable.
    12. Ordering Physician: the physician that ordered the test Ordering Physician is an editable field.
    13. Price Override: Pricing is not in the CLICS database so typically this field will appear blank. If a price override was performed then a dollar amount will appear ($0.00 is considered a dollar amount and represents an override).
      1. To perform a price override, click on the Price Override button.
      2. The Price Override screen will display. Enter the price in the Price field.
      3. A comment is required whenever a price override is performed; type in an explanation of why the price override was necessary. The date of override and user id of the person performing the override will append to the comment.
      4. If a price override was performed during order entry, the billing comment explaining the price override is viewable and can be edited by clicking on the Price Override button and opening the Price Override screen; the billing comment is editable by staff with security level defined for this function.
      5. Click OK to save the override, Cancel to leave the Price Override screen or Delete to remove the price override.
    14. ICD Code: the ICD codes are typically entered at time of order. ICD Code is an editable field. If a noncompliant code is entered, the field will be backlit in yellow.
      Note: An ICD code checker is used to verify that codes entered are valid (i.e. in the ICD database table) and medically necessary when the selected patient insurance has medical necessity rules.

      If the code entered does not pass the compliance checker, a message will display.

    15. Updated By: (This field is automatically filled if changes are made to any of the editable fields.)
    16. [Billed]: This date/time, if present, indicates that the test was previously billed (posting time), if no posting time is present, the test has not been billed yet.
    17. Status: The Status is the numeric value that indicates the test status in the system; the possible status values are:
      1. 100: Ordered
      2. 200: Requisition Printed
      3. 250: Specimen in Transit
      4. 300: Specimen in Lab
      5. 350: On Worklist
      6. 400: Results Entered; Not Released
      7. 500: Released
      8. 550: Throwaway Report Printed
      9. 600: Cumulative Reported
      10. 700: Billed
        Note: Any change made to the billing information when the status is ≥ 700 will not affect the patient billing since billing has already occurred. If any changes are necessary call or e-mail (see
        5. Rebill) the Business Office at Cathedral Square so they can rectify the incorrect billing by issuing a credit(s) and rebilling.
      11. 750: Discharge Printed
      12. 800: Ready for Archive
    18. Lab Comment: This field is editable by inserting the cursor, typing the desired text and saving (ctrl+s).
    19. Workarea: The Workarea assigned to the Miscellaneous Test (950) is defaulted to Mayo Medical Laboratories (MML). This field was added so the operator can change the workarea for a Miscellaneous Test to be sent to a reference lab other than MML. The workarea should be changed to “Referrals (Outside UCL)” before results are released so results will transmit properly to other interfaced systems.
    20. FAX: The FAX to Doctor, Account and Custom check boxes/fields allow the operator to set up an autoFAX after the test order(s) is placed and before results are released. The message “Auto Fax Selected” will display in Lab Comment.
  4. Editing an order:
    1. Using the mouse, move the pointer arrow directly over the field to be updated and either make a selection from the drop-down list (Order by Loc, Billed to Loc and Ordering Dr.) or type in the correction if the field does not support a drop-down list (ICD9 Code and Total Charge). Lab Comments may be updated as well, if a Canned Comment is to be inserted, insert the cursor in the Lab Comment field and right click on the mouse to access the Canned Comment selections.
    2. When all necessary updates are made to the order, save the changes by pressing the Ctrl+s keys or using the mouse, select “Save” from the "File" drop-down menu on the menu bar. The changes will be saved along with the name of the staff member affecting the change(s).
  5. Rebill a test already billed: (Security Level 3 or Above ONLY)
    Note: A test can only be rebilled if it has previously billed and the person initiating the rebill has a security level of 3 or above (Cathedral Square Business Office staff). The existence of a posting date following the [Billed] button is indicative of a test that has already billed.
    1. Click on the [Billed] button and a message will display:
    2. Click [Yes] to rebill the test.
      1. If the person initiating the rebill has a security level of 3 or higher the test status will change to 600 and the posting date will be removed so that the test will rebill but not produce a second report. Save (ctrl+s) any changes before closing the screen.
      2. If the person initiating the rebill has a security level <3, a message will display with the option to e-mail the insurance department.

        Click [Yes] to display the billing comments e-mail to Insurance Dept, click [No] to return to the Order Maintenance screen.
      3. Enter a BRIEF explanation under Patient Comments and the correct information necessary to accomplish the rebilling. Click [OK] to send the billing comments to the Cathedral Square Business Office staff. Click [Cancel] to return to the Order Maintenance screen.
    3. Click [No] on the rebill to return to the Order Maintenance screen and no changes will occur.
  6. Exit the "Order Maintenance" screen:
    Press the Ctrl+F4 keys or using the mouse, click once on “File" on the menu bar to open the drop down menu and then click once on "Close" to close the screen.
    1. September 2008 M. English (Revised: II.3.H. added Client Order No)
    2. June 2009 M. English (Revised: II.3.I & J. added)
    3. September 2009 M. English (Revised: II.3. Q-R.)
    4. May 2010 M. English (Revised: for Telcor; price override)
    5. June 2010 M. English (Revised: billing comments added)

Comprehensive Review:

Interim Review:
November 2010 M. English (Revised: for additional custom fax fields)
December 2011 S. White (no changes)
January 2012 M. English (Revised: screen updates)

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