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SET-UP

For new clients you will enter this data when you enroll and admit them into WITS and

your program. For existing clients you will just need to update the sections listed below.

DIAGNOSIS

Each Client must have a diagnosis attached to each encounter that you bill for. The easy

way to add this is to add the diagnosis to the Admission. It will then auto populate on

each encounter. The Diagnosis is available in the Admission after the ASAM. You can

either click through the pages using the next button or select diagnosis from the left

navigation bar.

From the dropdown list, select the diagnosis that was indicated by the clinician. The

wording may be slightly different so use the numbers to select the appropriate diagnosis.

You will also need to enroll the client in a program. This is the next section of the

admission and can be accessed by clicking on the NEXT arrow.

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Once you are on the Program Enrollment page select ADD Enrollment.

Select a program from the drop down list and make sure that the start date corresponds

with their actual start date and not the data entry date.

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Next you will need to add a Payor Group Enrollment for each funding source you wish to

bill this client to. There is no limit to the number of enrollment plans a client can be

enrolled in, however, duplicate plans (ie: 2 DMC plans) with overlapping dates may

cause bills to be denied.

To add a Payor Group Enrollment select Profile and then Payor Group Enrollment from

the left hand navigation bar.

Select Add Benefit Plan Enrollment.

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Fill in the enrollment information based on the sources you wish to bill.

You need to fill in the following Fields:

Payor Type = Medicaid (any medi-cal program), Self-pay (non-county funding), Group

Insurance (private insurance- i.e. Kaiser, Blue Cross) and Other (County),

Plan Group = Plan Group will populate choices based on Payor Type. If you do not see a

plan type that seems appropriate review your Payor Type Selection.

Coverage Start Date = Date insurance coverage started on.

Relationship to Subscriber/ Responsible Party = Self unless private insurance is through a

family member such as parents or spouse.

First Name = Name on Admission Form

Last Name = Name on Admission Form

Birth date and Gender = information on Admission Form

Address = Client address on file with insurance company

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Select SAVE when you are finished.

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The first step in adding an encounter is to look-up the client via the CLIENT LIST.

Select the client’s Activity List.

The first time you add encounters (individual or group counseling sessions, dosing, or

bed days) you will need to access the Encounter Summary via the left navigation bar.

On subsequent months you can access the Encounters from the Main Activity list

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To enter a new encounter (counseling session record) select Add Encounter Record.

A new Encounter will look like the below screenshot.

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Begin by selecting the Note Type. For most Medi-Cal services the only option is

PROGRESS NOTES. (Only methadone clinics will also bill for MEDICATION

ADMINISTRATION notes). County billing will access note types related to their funding

source such as Detox, JDC or County.

Next select the service code. For individual therapy sessions select H0004 ODF-

Individual Counseling. ODF stands for Outpatient Drug Free. (Methadone clinics should

select H0004 NTP- Individual Counseling. NTP = narcotic treatment program).

Likewise group sessions should be H0005- ODF group counseling. A complete list of

Services and codes is at the end of this chapter.

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The page will reset after you make this selection. Next enter the start date and time of

the counseling session. Make sure to change the start date as this field auto populates

with today’s date.

The screen will refresh after you have entered the start time. Enter the End time. The

screen will refresh again and populate the duration.

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Next you will select the visit type. Acceptable codes for individual units are: AS-

Assessment, CL-Collateral, CS-Crisis, IT-Intake, DP-Discharge Planning, or TP-

Treatment Planning. If you select CS-Crisis you must also mark the encounter as an

emergency. (Unless you are a methadone clinic DO NOT select IN-Individual NTP.)

For Medi-Cal Group Counseling units, the only option will be GR-group. After you

select a Visit Type the Medi-Cal billable box should auto populate to YES. If you are

billing the county this should not be selected.

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The Rendering Staff field automatically populates with your name. If you are not the

clinician you must be sure to select the appropriate rendering staff from the drop down

list

.

Once you have completed this page you may enter the Encounter Progress note on the

next page by clicking the NEXT button. This page is not currently required for billing.

Once you complete this page you can return to the previous page. If you are not entering

this data, remain on the previous page. Review the completed data and ensure that it is

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correct. If it is, SAVE your data and then click on the Release to Billing link in the

Administrative Actions box.

Review the Group and Plan Enrollment. If they are correct. Select Finish.

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You may also CLONE encounters if you only have to change minimal data. This is

especially useful for group encounters where the group meets at the same time every

session.

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A Cloned encounter is completely filled out except that the START DATE and

RENDERING STAFF Fields need to be updated as they both reset to the current date and

data entry staff.

Once you have updated these fields you can SAVE and RELEASE to BILLING as you

would with an original encounter.

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Summary of Terminology and Frequently Asked Questions

Required item What is it FAQ Where is it

Payor Group Enrollment insurance information Clients may have more than one active insurance card.

Under Profile

Authorization Place to keep track of how many units rendered

Required private insurance

Under Profile

Program Enroll You can now enroll clients without admitting them to tx. This is useful for pretreatment readiness groups or services rendered to residential clients at OP facility.

Under Activity List

Diagnosis Place to enter Diagnosis so that it pre-populates billing encounters and Tx plan

Under Admission

Encounters Place to enter Tx notes and the place to create billing units

Under Activity List

Notes Place to print a list of client specific notes

Under Activity List

Encounter Report Review all encounters provided within a specific time period

Data is exported to excel so it can be reviewed by client, clinician, service, etc.

Reports

Other Items:

Treatment Team Associates staff with clients so that you can look for clients based on their assigned staff

Under Admission

Treatment Plan Syncs with encounter notes so can track progress toward treatment goals

Under Activity List

Group List A convenient way to create encounters for groups.

Can create encounters straight from this list. Can also print sign-in sheet and track attendance.

Above Client List on Main menu

Absences Place to track client absences

Under Treatment