Nopali Help Nopali HelpInsurance billing in the U.S. can be very daunting. In order to create an insurance bill with Nopali, there are several steps that you need to follow: prepare physician information, prepare patient information, create an insurance claim, export claim in paper or electronic format, perform reconciliation.
Physician information is completed using both the Nopali and Nopali Administrator Application.
Physician Information need only be entered once. Sequential insurance bills will reuse this information.
Patient information is completed using the Patient Info view. The date of birth, doctor, address, ID Numbers and Insurance 1 and Insurance 2 areas should be filled as best possible to avoid rejected claims. (If a patient is not their own guarantor, then the guarantor must also have their own chart with the same information filled out.)
The Patient U.S. Insurance View is used to create insurance claims. If you don't see the Patient U.S. Insurance icon in the toolbar, then you can modify your toolbar by selecting 'Window>Customize Toolbar' at the top of the screen. Press the Patient US Insurance icon in the toolbar:
After pressing, you will see the Patient U.S. Insurance View. The view consists of a top table, showing the claims, and a bottom table, showing the charges associated for a claim selected in the top table:
Double-clicking on a row in the top table will bring down a panel allowing you to edit claim information. A similar panel for claim charges appears when double-clicking on a row in the lower table. You can delete a claim or a charge by selecting a row and pressing the 'delete' key on your keyboard. For deleting to work, the interface must be placed in edit-mode by clicking on the lock icon in the lower-right corner.
To create a new insurance claim, select a patient chart in the search drawer and press the 'New Claim' button in the Patient US Insurance view. A sheet will come down and walk you through the steps you need to create a claim for the currently selected patient.
As you type information into the fields, the step 'arrow' button will become disabled. After completing a field, press 'Return' (or press the tab key) to allow Nopali to check for data consistency and enable the 'arrow' button if all the data checks out. Note that fields prefixed with an asterix (*) are obligatory ones that need to be filled before the next 'step' can proceed.
Once you reach step 3, you may enter the actual charges to the claim. You may enter multiple charges for a claim by pressing the '+' button to the right of the charge row:
In order to maintain compatibility with paper claims, a maximum of 6 charges may be entered for each claim. Press 'Accept' to create the claim.
As a convenience, you can duplicate a claim by selecting an existing claim an pressing the 'Duplicate Claim' button. You can also duplicate a claim by dragging a claim to the last row in the claim table. Charges can be copied or moved between claims by dragging from the bottom table into a different claim in the top table.
You can add charges to an existing claim by pressing the 'Add Charge To Claim' button.
Once claims are made, they may be exported in 2 ways: export as a paper claim, and export as an electronic claim. Note that a claim cannot be exported simultaneously in both formats.
A paper claim is easily created by pressing the 'Generate HCFA Form' button in the Patient U.S. Insurance Claim view:
A preview window is shown for the claim. If you are satisfied with the information, pressing print will simultaneously print and save a PDF copy of the claim in the database, as indicated by the 'paper' icon under the print column in the insurance claim table:
Pressing the paper icon will bring up a panel showing the saved PDF file.
The Office U.S. Insurance view is used to combine multiple claims for batch exporting to a HIPAA file:
The Office U.S. Insurance view is divided into multiple tables. The search drawer is used to fine-tune searches in this view:
Search results will show up on the top table in the main view:
Claims are made by dragging rows from the top table into one of the tables lower down in the window. You may generate a paper claim by dragging a row from the top table into the HCFA table:
Alternatively, you can add a claim to an electronic batch file by doing the following in the HIPAA tab:
For an export to work, you must designate which insurance companies or clearinghouses in the Insurance Company table (see Insurance Company setup here) can receive Nopali eclaims. Nopali has been tested with 'The Consult Inc' clearinghouse and pressing the button in the panel will take you to their website where you can setup an account. Pressing 'Export' will export a HIPAA file to your desktop.
Depending on your clearinghouse, you may prefer to use their web interface to reconcile claims, since it is probably fairly automated. You may also manually enter claim payment information into Nopali. Once Payment information is received, go to the Office U.S. Insurance view and double-click on the relevant claim. This will take you directly to the patient chart:
In the patient chart, single click the relevant claim to see the associated charges in the lower table. At this point you can double-click on each charge to see the charge panel:
Fill in the date and amount values, as well as any adjustments.
If a claim has not been completely paid by the insurance company, you may choose to accept the loss (by entering an adjustment) or charge the balance to the patient or a secondary insurance company. You may transfer an outstanding balance to the Patient Billing section in order to collect directly from the patient. This is done by pressing the 'Transfer Balance To Patient Billing' button at the bottom of the main window. If you prefer to bill the balance to the secondary insurance company, then press the 'Claim Balance From 2ary Carrier' button.
You may also duplicate claims by pressing the 'Duplicate Claim' button. This becomes useful for very repetetive claims. The dates can be adjusted for the new duplicate.