Add a New Consumer

The Consumer Master allows you to track a wide variety of demographic information on your consumers. There is specific information needed to process billing. Please review the list below carefully.

 If you process billing in the system, the information listed below is REQUIRED and must be entered in the Client Master for the billing file to generate with the correct information needed.

Add New Consumer

NAVIGATION: TRANSACTIONS menu > Add Consumer

  1. Enter search information
    1. First name, last name, date of birth
    2. Select an intake target from the drop down list
    3. Today's date and the default payor will already be populated
  2. CLICK SEARCH to determine if this consumer already exists in your database.
  3. No Duplicates
    1. If no duplicates consumers are found, you will see the following message, "There were no duplicates found. Would you like to create a new consumer ID?"
    2. Select YES.
    3. The new consumer will open in the Consumer Master.
  4. Potential Duplicates
    1. If one or more potential duplicate is found, they will be populated in the Duplicate List.
    2. Select any of the potential duplicates to open that consumer in the Consumer Master.
    3. Review the data in the Consumer Master to determine if this consumer is in fact a duplicate entry.
    4. If the entry is a duplicate, make any necessary changes directly in the Consumer Master.
    5. If not a duplicate, click ADD CONSUMER.  
  5. When you are creating a new consumer, the name and date of birth will automatically be populated with the information entered on the Add Consumer screen.

Update Consumer Information

From the Consumer Master, select the consumer.

NAVIGATION: MAINTAIN menu > Consumers

  1. Add the basic information  
    1. Recipient number
    2. Date of Birth
    3. MCI number
    4. Social Security number
  2. REGISTRATION section, enter a complete address.
  3. PAYOR/INCOME: enter the individual's insurance (typically PROMISe)
  4. Click SAVE.
  5. OPTIONAL INFORMATION: Review Add Consumer Information for a list of all the information that can be tracked in the Consumer Master.

Open to a Facility (Program)

From the Consumer Master, select the consumer.

NAVIGATION: MAINTAIN menu > Consumers > Program Status

  1. Click ADD NEW
  2. Select the facility (the facility name will appear).
  3. OPEN date: enter the date the person was admitted to the program
  4. Status: select OPEN
  5. ID Diagnosis tab: select a primary diagnosis (the name will appear)
  6. Click SAVE
  7. The program will appear in the Program Status grid.

Review Service Code Master

If the service(s) for the new consumer are entirely new for your agency, setup the new service code. If the service code it not setup, you will not be able to enter services or complete notes.

NAVIGATION: MAINTAIN menu > Master Tables > Service/Procedure Codes > Service Codes

  1. CODES field: browse to find the service code.
  2. If the service code is not in the listing, refer to Service Code Master for details on how to setup a service code.
  3. If the service code is in the listing, move to the next step.

Review Procedure Code Master

If you had to add a new service code in the previous step, refer to Procedure Code Master to setup the new code. If the code it not setup, you will not be able to enter services or complete notes.

Add Service Auths

From the Consumer Master, select the consumer.

NAVIGATION: MAINTAIN menu > Consumers > Service Auth

  1. Click ADD NEW
  2. Payor Code: select the payor (typically PROMISe)
  3. Facility: Select the facility (the facility name will appear)
  4. Start Date/End Date: select the authorization dates
    1. Make sure the start date is the first day services will be provided.
    2. Start/end date should always match the HCSIS authorization.
  5. Service: select the authorized service
  6. Status: select ACTIVE
  7. Units Authorized: enter the number of units authorized (the units posted will update as you process billing)
  8. Click SAVE
  9. OPTIONAL INFORMATION: fields are available for funding, frequency, and duration. 

Review Facility Master

Make sure the authorized services for the new consumer are listed on the Facility Master Fee For Service tab. If the service code is not on the tab or missing information, there may be issues entering services, notes, and processing billing.

NAVIGATION: MAINTAIN menu > Master Tables > Facility Tables > Facility Master

  1. Click on the Fee for Service tab.
  2. Review the list to make sure the service code(s) for the new consumer are in the grid.
  3. If the service code(s) are not listed, add a line with the service and make sure to enter all the information, i.e., rate, unit type, status, begin date, procedure, etc.
    1. Refer to Setup New Facility

Forms/Documentation

Form setup is not required for billing, but if you have staff completing service notes and documentation, this step must be completed.

From the Consumer Master, select the consumer.

NAVIGATION: MAINTAIN menu > Consumers > Assign Forms

  1. Form Code: select the form (the name will populate)
  2. Begin Date: enter the start date of the service authorization
  3. End Date: do not add an end date.
  4. Note For: click the browse to see the list of authorized services for the individual. select the service code for the form selected.
    1. Residential notes: If the person has both a with and without day residential code, link the form to the HI code.

VIDEO: How to Add a New Consumer

7/2023

NEED MORE HELP?  Submit a ticket to the Help Desk or call (814) 535-7810 or (800) 889-3388