Classic Fee Slip Retirement, and New Fee Slip Transition

1. Understand the announcement and what is changing 0:04

• ChiroSpring is retiring the classic/old fee slip.

• The new fee slip has already been available for about a year and a half.

  The webinar includes:

  • Why the change is happening
  • What improves in the new fee slip
  • A live demo
  • Q&A at the end

2. Know why the new fee slip was built 1:18

• The old fee slip had a less smooth workflow for:
  • Adding diagnoses
  • Adding services

  • Pointing diagnoses to procedures

    The new fee slip was designed to be:

  • Faster
  • More flexible
  • More accurate for claims
• It supports favorite lists so users do not need to search the full ICD-10 or procedure library every time.
• It also improves data consistency because the fee slip and claim now stay synchronized.

3. Understand the key technical improvement: fee slip and claim are now connected 2:02

• In the old workflow, the fee slip created the claim, but changes to the claim did not flow back to the fee slip.

• That could create mismatches and headaches later.

  In the new workflow:

  • The fee slip is the claim behind the scenes
  • Both use the same database
  • Changes in one reflect in the other
• This reduces errors and keeps billing data aligned.

4. Recognize the compliance and documentation benefit 3:19

• The new fee slip makes it easier to see whether treatment notes are linked to charges.

• This matters for compliance and audits.

  ChiroSpring uses a compliance report to identify visits where:

  • A note exists but no fee slip/claim exists
  • A fee slip exists but no note exists
• The new fee slip makes attachment easier with a paperclip icon.
• More improvements to this workflow are coming soon.

5. Know the future-proofing reason: billing cases 4:14

• The old fee slip will not support upcoming billing cases.

  Billing cases will allow practices to organize billing by case, including:

  • Primary insurance
  • Secondary insurance
  • Start and end dates
  • Filtering treatment notes and claims by case
• This helps avoid messy workarounds like creating duplicate patients.
• Because of this, the old fee slip must be retired.

6. Mark the retirement date 5:10

• May 31st is the retirement date for the classic fee slip.

  After that date:

  • The old fee slip will not be accessible
  • There are no workarounds
• Users should transition to the new fee slip before then.

7. Learn the main improvements in the new fee slip 5:34

• Diagnosis display options now include:
  • Full diagnosis list
  • Clinic favorite diagnosis list
  • Patient diagnosis history

  • Classic fee slip favorite list

    Procedure display options now include:

  • Full procedure list
  • Service favorites

  • Provider favorites

    Benefits include:

  • Faster diagnosis selection
  • Better consistency across providers
  • Easier workflow for recurring patients
  • Less scrolling and better default visibility

8. Use the smart diagnosis-pointing tools 6:50

• The new fee slip includes a magic wand tool.
• This automatically points diagnoses to CPT codes.
• You can then tweak the results manually if needed.

• You can also set default procedure modifiers at the payer level.

  Example:

  • Medicare + 98941 can automatically add an AT modifier
• This reduces manual billing work and improves consistency.

9. Take advantage of expanded fee slip controls 7:49

• The updated fee slip lets users manage more directly inside the workflow:
  • Reorder procedures
  • Reorder modifiers
  • Reorder diagnosis codes
  • Add onset dates and qualifiers
  • Add NDC numbers
  • Adjust timing permits
  • Set the earning provider
  • Create product sales on the fly
• This reduces disconnected workflows and improves claim preparation.

10. Use fee schedules more flexibly 9:16

• Fee schedules can be selected directly in the fee slip.

  They can apply to:

  • Non-insurance procedures

  • Insurance procedures as well

    Fee schedules can work as:

  • Discounts on a procedure level
  • Discounts at the top level affecting all procedures
• This gives clinics more pricing flexibility and control.

11. Follow the connected workflow from note to fee slip to claim 10:09

• Typical flow:
  1. Start a treatment note
  2. Save the note
  3. The fee slip opens
  4. Add diagnoses and procedures
  5. Save
  6. Sign the note if needed

  7. The claim is created and sent to pending claims

     Alternate flow:

• You can start with the fee slip first
• But then you must manually attach it to the note later
• Recommended flow is note first, then fee slip.

12. Compare the classic fee slip to the new fee slip 11:11

• Classic fee slip:

  • Relies on dropdowns and searching through codes

    New fee slip:

  • Uses tabs and folders for easier navigation
  • Shows insurance and treatment plan details more clearly
  • Includes the magic wand for diagnosis pointing
• The new layout is more visual and easier to work with.

13. Set up diagnosis favorites before using the new fee slip 14:22

• Go to:
  • Settings → Clinic → Diagnosis Favorites
• Use the master diagnosis list to pin codes into favorite folders.
• These folders then appear in the fee slip for quick access.
• This is one of the most important setup steps before switching.

14. Set up service favorites before using the new fee slip 14:43

• Go to:

  • Settings → Clinic → Favorite Service Lists

    You can:

  • Create a new list
  • Copy a list from another user
  • Add codes with plus signs
  • Reorder codes up or down
  • Remove codes with the minus sign
• This helps create fast-access procedure folders in the fee slip.

15. Walk through the live setup for diagnosis favorites 15:33

• In the live demo, a diagnosis code is searched and added to a category such as cervical.
• The code then appears in the diagnosis favorites folder.
• Codes can be removed easily with the minus icon.
• The category names themselves are not editable in the current version.

16. Walk through the live setup for service favorites 16:52

• A new service list can be created and named.
• Codes can be added into that list.
• Multiple lists can be created for different workflows.
• Codes can be reordered so the most-used items appear first.
• Lists can also be copied from another user.

17. Open a patient note and launch the fee slip 18:47

• In the demo, a patient is checked in and a note is opened.
• Saving the note opens the fee slip.
• The note can be cleared if needed, but note content often copies from visit to visit.
• This demonstrates the normal note-first workflow.

18. Review the top section of the new fee slip 20:09

• The top of the fee slip shows billing details such as:
  • Insurance
  • Treatment plans
  • Memberships
  • Rendering provider
  • Earning provider
  • Onset date
  • Qualifier
• Memberships are currently a bit more complex because they are cash-only and handled differently from insurance.
• Future billing cases will improve this workflow.

19. Use the diagnosis tab inside the fee slip 22:12

• Diagnosis tabs include:
  • Regions
  • Favorites
  • Patient history

  • Full list

    Recommended workflow:

  • Use Favorites after setting them up

    You can:

  • Add codes
  • Reorder them
  • Delete them
  • Clear all if needed
• The magic wand can later point diagnoses to procedures.

20. Use the procedures tab and point diagnoses 23:27

• Procedure folders appear by billing groups, favorites, or master lists.
• Add procedures such as 98940.

• Then use the magic wand to point diagnoses automatically.

  You can:

  • Remove or add diagnosis links
  • Reorder them
  • Add modifiers
• Diagnosis pointing can also be done on the claim, but the fee slip is easier.

21. Review the summary tab before saving 25:29

• The summary tab becomes the default view on later visits.

  It shows everything in one place:

  • Diagnoses
  • Procedures
  • Modifiers
  • Pointing
  • Fee schedule
  • Earning provider
• This makes it easy to confirm the visit is correct before saving.

22. Understand charge toggles and the classic ditto behavior 27:22

• You can toggle line items to:
  • No charge
  • Cash/no insurance bill
• A very important feature is the classic fee slip ditto option.
• When switching to the new fee slip, the first one may appear blank.
• Click Ditto Classic Fee Slip once to copy over the prior setup.
• After that, the new fee slip will ditto from the previous one automatically.

23. Add NDC details when needed 28:44

• Click the plus sign next to NDC to expand the fields.

  You can then enter:

  • NDC number
  • Quantity
  • Units
• This is useful for practices that need NDC coding.

24. Check the compliance report for missing notes or fee slips 29:31

• Go to:

  • Reports → Visit Compliance

    The report identifies mismatches such as:

  • Note without fee slip
  • Fee slip without note
  • Missing documentation relationships
• A future update will allow users to mark a note as intentionally not needing a fee slip, which will keep it off the report.

25. Turn on the new fee slip in settings 31:09

• Go to:
  • Settings → Treatment Notes → Notes and Fee Slips

• Open the Note Settings tab.

  Under Template Usage, switch from:

  • Use old fee slip
  • to Use new fee slip
• Save changes to activate the new workflow.

26. Configure automatic modifiers for procedure codes 32:01

• Go to:
  • Billing Settings → Third Party Payers
• Open the payer record.

• Under Procedure Allowances, click Configure.

  Search for a procedure code and add modifiers such as:

  • AT
  • GA
• You can add multiple modifiers.
• This also lets you set allowed amounts for the payer.

27. Understand the upcoming billing cases rollout 33:46

• Billing cases are targeted for end of Q2 / end of June.

• Cases will be optional, not forced on every patient.

  Users will create a case when needed and assign:

  • Primary insurance
  • Secondary insurance
  • Start/end dates
  • Other case details like attorney or box 10 fields
• Cases can also be used for self-pay patients.

28. Use earning providers correctly on procedures 35:23

• Yes, one claim can have two earning providers.
• Set the earning provider at the procedure level.
• This is useful when different procedures on the same visit should credit different providers.

29. Understand how multiple notes relate to one visit and one claim 35:56

• Today, a note generally requires a fee slip.
• That creates a one-to-one relationship.
• Future updates will allow users to say a note does not need a fee slip.
• This will help when multiple notes are written for one visit but only one claim is needed.

30. Know how attached notes work for claims 44:43

• If multiple notes exist for the same date of service, and the claim is submitted through the integrated clearinghouse:
  • All notes for that date of service are attached
• This applies to insurance and other claim types as well.
• The system does not only attach insurance notes.

31. Use fee schedules and write-off rules for discounts 39:15

• A patient can have a fee schedule such as a military discount.

  Go to:

  • Settings → Clinic → Customization → Write-Off Rules

    You can choose whether the system:

  • Writes off the difference between the general fee and the fee schedule amount
  • Or simply uses the fee schedule amount directly
• This works for both insurance and non-insurance scenarios depending on settings.

32. Handle procedure allowances and visit limits manually when needed 41:27

• If a payer allows a code up to a certain number of visits, but then coverage changes after that:
  • Set the allowed amount in procedure allowances
  • Track the visit count manually or with insurance max tracking
  • After the limit, switch the charge to non-insurance/cash if needed
• This is currently a manual process, but there are tools to help flag maxed-out visits.

33. Work around missing diagnosis codes for new patients if needed 43:16

• The new fee slip currently requires diagnosis codes before saving.
• If a patient is not yet fully coded, a workaround is to use a temporary or Z-code encounter code.
• Then the provider can go back and update the diagnosis later.

34. Understand how front desk and scheduler status indicators work 52:02

• The scheduler/front desk indicators show visit status with colors:
  • Red: nothing started
  • Black: fee slip and claim created
  • Green with checkmark: note, fee slip, and claim created
• This helps staff quickly see what has been completed.

35. Final recommendation and wrap-up 55:05

• Users should start using the new fee slip as soon as possible.
• If you are still on the classic fee slip, transition before the retirement date.
• The webinar ends with a reminder to send unanswered questions to the team.