Important Content Update Message
We are currently updating the OP Help Center content for the release of OP 20. OP 20 (official version 20.0.x) is the certified, 2015 Edition, version of the Office Practicum software. This is displayed in your software (Help tab > About) and in the Help Center tab labeled Version 20.0. We appreciate your patience as we continue to update all of our content.

Entering a Capitation Payment

Version 14.19

Creating a Generic Patient Account

When entering Capitation payments into Office Practicum, you create a generic Patient Chart called Capitation Payments. As Capitation Payments come into the practice for Office Practicum claims, create a Capitation charge to that Generic Account and then pay the balance in full.

  1. Click the Register button .
  2. Click in the Patient Search field .
  3. Click the +New Patient button.
  4. Enter in the following information highlighted in red:
  • Patient Last Name: Payments.
  • Patient First Name: Capitation.
  • Date of Birth: 01/01/2016 (or any date).
  • Gender: Unknown (or any gender).
  • Address: Enter in any address or if you wish the address of your office.
  • Phone: Enter in any phone number or the phone number of the office.
  • Primary Provider: Click on the search field and enter in one of your providers.
  1. Click the Green Checkmark button to save.  

Posting a Generic Cap Charge

  1. Click the Account button to open the Patient Account.
  2. Use the Patient Search box to locate the patient.
  3. Click the Charges tab.
  4. Click the Claim button. The Add/ Edit Charges window is displayed. 
  5. Enter the follow information noting that an item highlighted in RED is a mandatory field that must be filled out.
  • Rendering Provider: Select a Provider from your staff list. 
  • Insurance or Self-pay: Generally there is not an insurance record associated with the Capitation Payment Account
  • Date: The system default is the current date. To backdate if necessary, click the drop-down menu to change to the desired date. 
  • ICD code: Click the Green Plus sign and enter the Numeric Code or Description to search under the ICD Desc field. Then, click the Green Checkmark button to save the diagnosis code. Any DX code is acceptable to use, there is no claim going out to a payer. You may create a new miscellaneous ICD code for the purpose of capitation.
  • CPT: Enter the numeric CPT Code or click the Ellipsis button to search for the code CAP for Capitation. 

If a capitation CPT code is not added to your system please see: Adding in CPT codes
  • Select a Diagnosis Code from the drop-down menu. Diagnosis codes must be assigned to each CPT code line. 
  • Click the Unit Charge field to enter the value of the Capitation Payment.
  • Click the Green Checkmark button to save.
  1. Once all charges have been entered, click the Save button in the bottom right hand of the Add/Edit Charges screen.
  2. Once your capitation charge is entered, post the insurance's capitation payment to the charge that you just posted. Note: This is posted as an insurance payment for reporting and tracking purposes.
Version 14.10

Creating a Generic Patient Account

When entering in a Capitation payments into Office Practicum, create a Generic Patient account called Capitation Payments. Then as Capitation Payments come into the practice for Office Practicum claims, the end user creates a Capitation charge to that Generic Account and then pay the balance in full.

  1. Click the Register button .
  2. Click the Patient Search field .
  3. Click on +New Patient button.
  4. Enter in the following information highlighted in red:
  • Patient Last Name: Payments.
  • Patient First Name: Capitation.
  • Date of Birth: 01/01/2016 (or any date).
  • Gender: Unknown (or any gender).
  • Address: Enter any Address or if you wish the address of your office.
  • Phone: Enter any Phone Number or the phone number of the office.
  • Primary Provider: Click the Search field and enter a Provider.
  1. Click the Green Checkmark button to Save.  

Posting a Generic Cap Charge

  1. Click the Account button to open the Patient Account.
  2. Use the Patient Search box to locate the patient.
  3. Click the Charges  tab.
  4. Click the Claim button.
  5. The Add/ Edit Charges window is displayed. From here, enter the follow information noting that an item highlighted in RED is a mandatory field that must be filled out.
  • Rendering Provider: Select a Provider from your staff list. 
  • Insurance or Self-pay: Generally there is an insurance record associated with the Capitation Payment Account
  • Date: The system default is the current date. To backdate if necessary, click the drop-down menu to change to the desired date. 
  • ICD code: Click the Green Plus sign and enter the Numeric Code or Description to search under the ICD Desc field. Then, click the Green Checkmark button to save the diagnosis code. Any DX code is acceptable to use, there is no claim going out to a payer. You may create a new miscellaneous ICD code for the purpose of capitation if you wish.
  • CPT: Enter the numeric CPT code or click the Ellipsis button to search for the code CAP for Capitation. 

If a capitation CPT code is not added to your system please see: Adding in CPT codes
  • Diagnosis codes must be assigned to each CPT code line. Use the drop-down menu to select the Diagnosis Code.
  • Click the Unit Charge field and enter the Value of the Capitation Payment.
  • Click the Green Checkmark button to save.
  1. Once all charges have been entered, click on the Save button in the bottom right hand of the Add/Edit Charges screen.
  2. Once your capitation charge is entered, post the insurance's capitation payment to the charge that you just posted. Note: This is posted as an insurance payment for reporting and tracking purposes.