Makers of Practice Magic Psychotherapy Billing Software
Instructions for Using the New CMS-1500 Templates
Or the New Version of MAGIC Designed for NPI# and the CMS-1500 form
New Practice MAGIC Program: We have written an upgrade to Practice MAGIC that is specifically designed to have the capability to correctly fill our or print and fill our the new CMS-1500 insurance form (8/06). ALL NEWLY PURCHASED PRACTICE MAGIC PROGRAMS Automatically INCLUDE THIS UPGRADE. If you purchased the program in the past, you will know if you have the upgrade installed because the Calendar Menu that used to read, "HCFA-1500" will now read "CMS-1500." Despite the fact that it says it is for the CMS-1500 and the on-screen insurance form says "CMS-1500," it can be used for both HCFA-1500 and CMS-1500. The cost is $39.95 (free to people who ordered Practice MAGIC after June 1, 2006) and can be ordered only from the order page. It can still be used to fill out either a HCFA-1500 form or a CMS-1500, depending on how lines #101 and #102 are filled out in each client's information file. If you want to change the form that is filled out for a specific client, you can change lines 101 and 102 from HCFA1500 to CMS1500 or you can edit the client's information on the on-screen insurance form (accessed using the second entry in either the EDIT or CMS-1500 menu on the Calendar screen.) On the on-screen insurance form, you will need to scroll down nearly to the bottom and look on the right side for the box an inch or two up from the bottom of the form that reads, "Insurance Form Template," click on it, and enter the name of the form you would like to fill out. NOTE THAT CHANGING THE INSURANCE FORM TEMPLATE TO CMS-1500 DOES NOT CHANGE THE ON-SCREEN INSURANCE FORM. PLEASE DO NOT EMAIL OR CALL US TO TELL US THAT CHANGING THE TEMPLATE DOES NOT CHANGE THE FORM UNTIL YOU HAVE TRIED PRINTING A FORM. In addition lines 50, 51, 109 and possibly 110 of each client file should be edited as well as line 40 and 41 of the USERDATA file. As an alternative to opening each client file and editing it, Cornucopia has developed a utility that will modify all your client files automatically; this utility (Windows only) is available to download for $29.95, and can be ordered only from the order page. People currently purchasing Practice MAGIC do not need this utility, since there will be no changes required in the client files.
IMPORTANT: (This note applies only to upgrades and does not apply to current purchasers of Practice MAGIC.) After upgrading to the CMS-1500 version, for each pre-existing client, you will need to replace "HCFA1500.frm" as your "Insurance Form Template" with either CMS1500 or CMSALT; these CMS-1500 templates will format your output to conform to the new CMS-1500 form. NOTE THAT CHANGING THE INSURANCE FORM TEMPLATE TO CMS1500 DOES NOT CHANGE THE ON-SCREEN INSURANCE FORM. PLEASE DO NOT EMAIL OR CALL US TO TELL US THAT CHANGING THE TEMPLATE DOES NOT CHANGE THE FORM UNTIL YOU HAVE TRIED PRINTING A FORM. In addition lines 50, 51 and 109 of each client file should be edited as well as line 40 and 41 of the USERDATA file. Line 110 of the client file now fills in box 33b, Line 50 now fills in 24j (top) and line 51 fills in box 19 which is commonly designated for the therapist's taxonomy number. Line 109 fills in box 32a and 32b and line 61 fills in box 17 a&b. Lines 40 and 41 of the USERDATA file in the NPI number (33a) and the default for the NPI number of the place of service for new clients (which is placed on line 109 of the client info file and fills out boxes 32a and 32b).
WE HAVE RECEIVED MANY SUPPORT CALLS BY PEOPLE WHO ARE FINDING BOX 24J (lower portion) IS BEING FILLED OUT WITH THE INFORMATION FROM BOX 33A. If the NPI of the Billing Provider(agency) is different from the NPI of the Rendering Provider (therapist), both NPI numbers should be placed on line #40 of userdata AND IN BOX 33A OF THE ON-SCREEN INSURANCE FORM separated by a forward slash ("/"). If you do not want anything to print in lower 24J, just begin Box 33A (AND LINE 40 OF USERDATA) with a forward slash ("/") followed by your NPI#. In general all entries on the on-screen insurance form that ask for two possible pieces of data. Although rarely required, two situations in which you might need to use a forward slash, for instance, are box 17a&b (on line 61), which asks the name and NPI number of the referring physician, and 32a&b (on line 110), which gives the NPI number of the place of service (different from your own provider NPI number) and the insurance company's ID# for the place of service (if you have one); these can be filled out with both pieces of data separated by a forward slash. If no forward slash is included, the entire entry will be printed in both places. If nothing follows the slash, the place on the form that is filled out by that second piece of data will be left blank. If nothing precedes the slash, the place on the form that is filled out by that first piece of data will be left blank. The new form template will place the therapist's name in box 31 one line higher than the therapist name was printed on the old HCFA-1500. This will be important information for you to supply to your clearing house, if you use one, and also the fact that you are switching from HCFA to CMS; unless you let them know of the switch, they will start kicking back your claims. IF YOUR COPY OF MAGIC WAS PURCHASED OR DOWNLOADED PRIOR TO APRIL in 2007, you may need to download an updated copy in order to for the instructions in this paragraph to work (order "CMS upgrade" from the order page of our website.)
We have also received a half dozen support calls from clinicians whose local medicare manager has rejected claims because the year-length of the dates on the claims are inconsistent. They can no longer require service years to be consistent to other date years. The service dates MUST by two digit years by CMS stipulation. The rest of the dates should have four digit years, because the date in box 31 automatically has a four digit year. If any claims in this format are rejected by Medicare, the company is in violation of federal guidelines; you should ask to talk to a supervisor at Medicare if necessary to get them to straighten out their misunderstanding.
For people purchasing upgrades (not new purchasers), as an alternative to opening each client file and editing it, Cornucopia has developed a utility that will modify all your client files automatically; this utility (Windows only) is available to download for $29.95, and can be ordered only from the order page.The MAGIC on-Screen insurance form will look the same. The "CMS1500.FRM" template will automatically place a zero in box 29, as our HCFA-1500 template has been doing for years. You can alternatively select "CMSALT", which will cause MAGIC to calculate the copay for the visits being billed and place that number in box 29. In the case of MAC, you will need to copy the two files, "CMS1500.FRM" and "CMSALT.FRM" from the folder created when you unstuff the downloaded file to the INFO subfolder in your MAGIC folder residing on your desktop. (The files will be copied automatically for Windows, although NO PROMPT WILL BE DISPLAYED THAT THE TEMPLATES ARE NOW SUCCESSFULLY INSTALLED).
NPI#: For people purchasing upgrades and new purchasers, before using the CMS-1500 forms, you will need to enter your and National Provider Identification ("NPI") number. Do this by selecting "User data" from the EDIT menu. Scroll down and click on line 40 and enter your NPI on that line (see above if your Billing NPI is not the same as your Rendering NPI). Many Medicare licensees have rejected claims that have 24J top filled out with the provider's NPI number, even though the billing NPI may be the same as the rendering NPI. If you need 24J to be blank, precede the NPI number with a forward slash. e.g. "/123456789") If you have a separate National Provider Identification number for your place of service, you can enter that on line 41.
PINs: If an insurance company requires that you use a specific provider number, like a PIN, authorized by that company and distinct from the NPI, input that number on line 50 and line 110 of the CLIENT information file for that particular client (also accessed from the edit menu). (see above if your Billing PIN is not the same as your Rendering PIN) Information for both Primary and Secondary insurance can be entered on line 50, separated by a backslash. Line 51 should be empty unless you want something to print into box 19 (some insurance companies are asking for the taxonomy number to go there) The "ID Qualifier" number that is required for non-NPI identification numbers should come before the actual identification number, and be followed by several spaces. Some examples of "ID Qualifier" numbers can be found in the user manual connected to this website. Simply click on "online manuals" on the left side of this web-page, and then utilize the "find" or "search" function of your web browser to locate the first instance of "ID Qualifier" in the manual. The "find" or "search" function is usually accessed by control-F or control-S. On line #109 of the client information file, if required, you should enter the NPI of the Place of Service; this is not the same as the Provider NPI! 109 can also handle the other I.D. of the place of service by putting both on line 109 separated by a forward slash. If you want 32a and 32b to be blank, you will need to delete the information on line 109. If you do not want 32b filled out, be sure that line 109 ends with a forward slash.
Switching from HCFA-1500 to CMS-1500: For people purchasing upgrades (not new purchasers), to fill out a CMS-1500 form, for any given client, highlight an appointment of that client on the MAGIC calendar, or click on an open appointment slot, and select "Client Info on HCFA" (or "Client Info on CMS-1500" if you have a later version of MAGIC) from the Edit Menu, scroll to the bottom of the on-screen insurance form, and then change the letters "HCFA" in the box labeled "MAGIC Insurance Form Template" to "CMS" so that instead of reading "HCFA1500," for instance, it would read "CMS1500". NOTE THAT CHANGING THE INSURANCE FORM TEMPLATE TO CMS1500 DOES NOT CHANGE THE ON-SCREEN INSURANCE FORM. PLEASE DO NOT EMAIL OR CALL US COMPLAINING THAT CHANGING THE TEMPLATE DOES NOT CHANGE THE FORM UNTIL YOU HAVE TRIED PRINTING A FORM. It has been brought to our attention that, if you switch to CMS-1500, and you have been useing a clearing house for electronic billing with the HCFA-1500, you must notify the clearing house that you have switched forms, or your electronic claims will be rejected.
Box 29: With the old HCFA-1500, box 29 was obsolete and unused for years. With the CMS-1500, for reasons beyond our abilities to comprehend, this box has been reactivated. Since Practice MAGIC keeps a running balance of charges and payments, and does not associate each payment with a specific service, the program can not calculate box 29 accurately. Those practitioners who feel compelled to place an accurate number in box 29, will need to settle for the calculated copay on the relevant visits to be placed in box #29 as "amount paid." For newer versions of Practice Magic, by clicking "no" to the question in box 29 on the on-screen cms-1500, you will instruct MAGIC to change the insurance template from "CMS1500" to "CMSALT" which will calculate the copay for the visits being billed and place that number in box 29. For older versions, you will need to change the name of the insurance form template yourself. Note that neither we nor any of our customers have ever encountered an insurance company that had any interest in knowing how much of the client's copay had been collected to date.
Signature: With the new CMS-1500 form, rather than sign the form the program prints your name in box 31. You can place your signature over it if you wish.
More Information: For more information about handling the CMS-1500 form using practice magic, go to our on-line manual; simply click on "online manuals" on the left side of this web-page, and then utilize the "find" or "search" function of your web browser to locate the first instance of "CMS-1500" or whatever you are looking for in the manual. The "find" or "search" function is usually accessed by control-F or control-S.