Description
Use this page to define which practices' patients need billing (or DFT) events, how to schedule the delivery of billing event messages, the content of the billing messages, and CPT rules.
If desired, you may set your startup file to have the system populate DFT messages with an order's user defined fields' ZCF segment. Note that you must work with Orchard Software Technical Support to modify the startup file. When this option is enabled, the system creates a ZCF segment all billing messages generated in the system.
Access
AdminCenter > System Setup > Hosts > Interface Configuration > Outbound Interface > Outbound DFT
Technical Manual
Selecting Practices for Billing Events
In order to send DFT, or billing, event messages, you must select one or more practices as recipients for billing events sent to this host.
| Practice | To add a specific practice, enter one or more characters in the field. |
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| Search | Click to select the practice in the Practice Search page. See the Practice Search topic. Repeat this search for each practice you wish to add. If you select one or more practices, you cannot define a system event to create billing settings for all practices. |
| Add System Event | Click Add System Event to add an event for all practices. If you have selected one or more practices, then this button is disabled. If you add a system event, you cannot define billing settings for individual practices. If necessary, you may remove selected practices, and then click Add System Event. |
| Billing Event Trigger | For each practice, you may select what triggers a billing event by selecting an option from the drop-down list.
Note The DFT messages that the system will accept need to have an ORC and OBR segment for each FT1 segment. |
| Credit Cancelled Order Choices | For each practice, select or clear the option to define whether or not the system should create credit messages for cancelled order choices. |
| X | Click to remove the practice. If you remove a practice, the system will no longer send billing events for this practice to the host. |
| Cancel | Click to return to the Interface Configuration administration page without modifying the DFT event settings, if desired. |
| OK | Click to record all changes and return to the Interface Configuration administration page. Otherwise, complete the remaining sections, and then click OK. |
Defining Billing Event Message Delivery
Select when the system should deliver billing messages. the system will use the specified timing to send the billing event when the billing event trigger occurs.
| Immediate | Select this option to have the system queue the DFT message as soon as the billing event trigger occurs. |
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| Manual | Select this option to have the system hold the DFT message until you use the Billing administration page to manually designate the DFT messages to be delivered. |
| Scheduled | Select this option to have the system place the DFT message in the queue for the next scheduled delivery time. When you select this option, the system automatically displays one delivery time field. To add additional delivery times, click Add Delivery Time. You may then modify the hour, minute, and AM/PM values to create the appropriate delivery times. To remove a delivery time, click the X button that corresponds to the time you wish to delete. Using these settings, when a billing event trigger occurs, the system finds the next scheduled time for delivery and queues the message to be delivered at that time. Note that the system displays the hosts' time zone next to the time. This is the time zone that the system uses to determine the scheduling for billing events. |
| Delay DFT Messages for | Select to delay DFT messages from being sent by a specified amount of time. The user can adjust the setting between seconds, minutes, and hours. The default is set to zero seconds. |
| Cancel | Click to return to the Interface Configuration administration page without modifying the DFT event settings, if desired. |
| OK | Click to record all changes and return to the Interface Configuration administration page. Otherwise, complete the remaining sections, and then click OK. |
Defining the Content of Billing Messages
Use the Billing Message Content section of the page to define what information the system sends in billing messages.
| Message content type | Select an option to define the HL7 segments that should be sent in DFT messages to this host. There are three schemes: One FT1 and one PR1 segment per procedure code, One FT1 and no PR1 per procedure code, and One FT1 per order choice and a distinct PR1 for each procedure code in that order choice. |
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| Message host code usage | Select an option to define where the system will obtain the host codes for the order choices when this host is receiving DFT messages. You may select one of the following: to use the billing interface's order choice host code, to use the testing location's order choice host code, or to use the billing interface's order choice host code if it exists, but if it doesn't exist, then to use the testing location's host code. |
| If no insurance, send this as billing status | Enter the value that will act as an override for the billing status of orders with no associated insurance. |
| Signed ABN CPT code modifier | Enter the value the system should use as the Signed ABN CPT code modifier. |
| Signed Don't Bill CPT code modifier | Enter the value the system should use as the Signed/Don't Bill ABN CPT code modifier. The default value is GA. Note that when both Signed and Signed/Don't Bill use the same code, Signed takes precedence. |
| Unsigned ABN CPT code modifier | Enter the value the system should use as the Unsigned ABN CPT code modifier. |
| Repeat CPT code modifier | Enter the value the system should use as the repeat CPT code modifier. If there is more than one billing event for the order choice for the host within the number of hours specified for the billing frequency in the Order Choices administration page (see the Order Choices topic), then the system considers it a repeat billing event, and, when sending the HL7 message, it appends the Repeat CPT code modifier to the Signed ABN CPT code modifier. |
| Send one FT1 segment per message | Select this option to force outbound DFT messages to be split so that a single DFT message will only contain a single FT1 segment. |
| Send result segments | Select this option to populate DFT HL7 messages with ORC, OBR, and OBX segments. Note To include embedded PDF results in the DFT message, ensure this option is enabled and enable the Send Lab Report in OBX setting located on the Hosts page. Both options must be enabled. |
| Send any placer order number to this host regardless of the number's origin | Select this checkbox to cause ORC-2 and OBR-2 to be populated with the HostSpecimen.ID field's value if a value is not already found in the HostSpecimen.hostKeyPlacerIDArray for the host. |
| Suppress EVN segment | Select this option to prevent the EVN segment from being in the DFT message. The system does not currently support this segment. |
| Suppress sending encounter information | Select this option to prevent encounter information from being in the DFT message. |
| Suppress sending insurance information | Select this option to prevent insurance information from being in the DFT message. |
| Send duplicate CPT codes | Select this option to send duplicate CPT codes in a DFT message for an order choice that has the same CPT code assigned to it more than once. |
| Send profile host code instead of individual order choice host codes | Select this option to allow the system to send the profile host code for a profile to the billing destination rather than the CPT codes for the individual components of the profile. |
| Create billing message at billing event time instead of at the time of sending the message | Select this option to determine and store the billing message at the time of the billing trigger event instead of at the time of the DFT message generation. When this setting is turned on, the billing message will be created and stored at the time of the billing trigger event. When the setting is turned off (previous behavior), the billing message is not created and stored until the time the DFT message is sent out. |
| Per Order Choice | Select an option from the Per Order Choice drop-down list to define DFT message generation. For each order, generate one DFT message (per Order Choice, per Sample ID, or per Order). This only applies when the billing event trigger is when order is complete and if billing messages are not created at billing event time. |
Select this option to populate a flag in the FT1-28 section of the billing message to indicate that a previous billing message in a calendar day has been created for that order. Any part of the order that's been completed and a billing message sent on the first day will have a flag of N. Any part of the order that's been completed and a billing message sent for the following days will have a flag of E. If there are no prior billing messages for the order, it will be considered the same day and populate an N in FT1-28. | |
| Cancel | Click to return to the Interface Configuration administration page without modifying the DFT event settings, if desired. |
| OK | Click to record all changes and return to the Interface Configuration administration page. Otherwise, complete the remaining sections, and then click OK. |
