Patent Publication Number: US-2005125320-A1

Title: Point of service billing and records system

Description:
BACKGROUND OF THE INVENTION  
      1. Field of the Invention  
      The present invention relates generally to a billing and records system. More particularly, though not exclusively, the present invention relates to a code-driven computerized system for health care billing that places the responsibility for billing on the health care provider at the point of service. The present invention includes variations for other service industries in which it is desirable to place primary responsibility for billing and records keeping on the service provider. Other industries include, but are not limited to the fields of law, accounting, dentistry, architecture, and any other service-type industry where clients demand service providers be accountable for their time and services.  
      2. Problems in the Art  
      In 1966, the American Medical Association developed a system it calls Current Procedural Terminology (CPT). The CPT system is used by doctors and other health care providers to ensure uniformity in the description of services performed through the use of a common set of codes and descriptors. Unfortunately, the CPT is updated every year and in the year 2000 is expected to utilize 7,755 codes and descriptors. Such constant updating of so many codes requires care providers to spend countless hours ensuring the proper codes for services provided are being utilized correctly. With the passage of the Medicare Catastrophic Coverage Act of 1988, it became a mandatory requirement to use diagnostic coding of the International Classification of Diseases, 9 th  Revision, Clinical Modification, (ICD-9CM) published by the Practice Management Information Corporation with a new revision available approximately September 15 th  of each year. Proper coding is the essential component of billing systems in order to satisfy the needs of clients relative to insurance companies, health maintenance organizations, and federal government programs such as Medicare and Medicaid.  
      Currently, there are multiple medical billing systems in place in which a care provider, such as a doctor, nurse, or allied health care provider, must manually enter coded patient care data on paper sheets prior to placement into a computer system. A billing clerk or other non-care providing personnel is then required to convert codes into a patient specific bill. This procedure allows for too many errors and places the ultimate responsibility for proper billing of clients on clerks and other personnel instead of upon the provider of services. As the health care provider is legally responsible for their submitted codes, it is desirable to facilitate the proper coding and billing for the person performing the services, i.e. the care provider.  
      Prior art systems which have attempted to correct this situation have allowed care providers to input patient specific coding in various ways. One prior art method of properly coding patient services was to use a preprinted super bill, such as the DocuScan®. A super bill, as commonly known in the art, allows the care provider to simply select the appropriate codes for the services performed via a Scantron® type sheet. However, due to the great number of codes, the super bill only contains pre-selected codes. Any additional or supplemental codes must be entered and selected manually by the care provider or an assistant and manually transferred into the billing system. Further, the super bill requires the care provider to take time filling in circular indicators and finding exactly what codes should be marked for the services performed. Once completed by the care provider, the super bill is then submitted to other personnel and a patient specific bill is generated.  
      Still other prior art systems allow doctors to use a remote terminal and batch in, or download from a main terminal, all of the patient records for patients to be seen during the day. Upon download, the care provider can then input which services were performed for the patients on the remote terminal. At the end of the day, the care provider must then batch out, or upload to the main terminal, all the patient records in one action. Upon receiving the patient records, including the services performed, the main terminal can then be used to generate individual patient bills. This prior art system does not allow for the real-time generation of an individual bill or correction of erroneously selected codes prior to the patient&#39;s departure from the care provider&#39;s office. A further problem with such a prior art systems has been the inability to edit a patient&#39;s data once that data has been entered and before the data is transmitted or to input a new patient into the system at the point of care via the remote computer.  
      Still further yet, such systems do not allow the care provider to easily customize the diagnosis and procedure code screens with those codes most frequently used in the care provider&#39;s particular practice or field of specialty; such customization would require additional programming with great cost in terms of time and money. Nor do the prior art systems permit the care provider to research on-line for a particular code.  
      As on-line, or Internet based health-care information is becoming more and more prevalent, and more and more patients are on-line, it is desirable to have a system which is capable of having an on-line presence. Currently, WebMD.com provides information on physicians, diseases, and other medically related fields. However, the site does not allow patients to review their records or billing on-line. Further, the site does not allow care providers to provide such information.  
      Finally, remote computer systems are currently limited to laptop or desktop units which are then hardwired into the walls at the point of care and thereby wired to the main terminal. This prevents the care provider from entering data from any location other than where the computer has been placed. It is therefore desirable to provide a wireless, lightweight remote terminal system which allows the care provider to freely roam about and enter data anywhere at the point of care. It is further desirable to be able to access the host system even when out of the care provider&#39;s home office. In short, these prior art systems lack the functions and flexibility to be of significant assistance to the care provider. It is therefore desirable to have a system which overcomes the deficiencies found in the prior art, solving the aforementioned problems.  
      There is therefore a need to have a computer system that places responsibility for individual patient or client information, services provided, and billing records with the service provider at the point of service and allows the service provider to provide the patient or client with a bill upon the patient&#39;s or client&#39;s departure. In a medical application, there is a need to have a code driven computer system which accomplishes the above.  
     FEATURES OF THE INVENTION  
      A general feature of the present invention is the provision of a billing and records system which overcomes the problems found in the prior art.  
      A further feature of the present invention is the provision of a billing and records system which is code driven.  
      Another feature of the present invention is the provision of a computer billing and records system which places responsibility for billing and record keeping on the service provider.  
      A further feature of the present invention is the provision of a wireless computer billing and records system.  
      A still further feature of the present invention is the provision of a billing and records computer system that allows the service provider to input data at the point of service.  
      A yet further feature of the present invention is the provision of a billing and records computer system that allows the service provider to input data through an integral on-screen keyboard, dedicated to the individual screens as necessary and useful.  
      Another feature of the present invention is the provision of a billing and records computer system which allows a service provider to generate a patient&#39;s or client&#39;s bill prior to the patient&#39;s or client&#39;s departure.  
      A still further feature of the present invention is the provision of a billing and records computer system that allows a service provider to download specified patient or client data to and from a back-end computer.  
      An additional feature of the present invention is the provision of selected lateral communication from one front-end system to another distinct front-end system.  
      An still further feature of the present invention is the provision of lateral communication from one terminal to another via a wireless linkage.  
      An additional feature of the present invention is the provision of lateral communication from one terminal to another via a hard wire linkage.  
      Another feature of the present invention is the provision of a computer billing and records system that uses a graphical user interface to interact with the service provider to provide a means for accessing patient or client record and billing information at the point of service.  
      An additional feature of the present invention is the provision of a billing and records computer system having time based or service based code screens which may be easily customized by the service provider.  
      A still further feature of the present invention is the provision of a billing and records computer system having diagnosis and procedure code screens easily customized by the service provider.  
      A yet further feature of the present invention is the provision of a billing and records computer system that permits a service provider to search on-line, by code number or code description, to identify and select a particular code.  
      A still further feature of the present invention is the provision of a billing and records computer system which provides access to service providers and patients or clients via the Internet.  
      These, as well as other features and advantages of the present invention, will become apparent from the following specification and claims.  
     SUMMARY OF THE INVENTION  
      The present invention generally comprises a computer billing and records system. In a preferred medical embodiment, the present invention includes a software application that is CPT and ICD-9CM code-driven and places responsibility for patient billing and record keeping on the care provider at the point of care. A software application residing on a remote computer is included which provides a graphical user interface for the care provider. The software application allows the care provider to input and edit individual patient data from the remote computer. Further, the software application allows the care provider to select the appropriate coding and allows the care provider to update the codes appropriately. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       FIG. 1  is a pictorial representation of the network connectivity set-up of the preferred embodiment of the present invention.  
       FIGS. 2A and 2B  (collectively referred to as “ FIG. 2 ”) are a flow chart of the back-end of the present invention.  
       FIGS. 3A, 3B ,  3 C, and  3 D (collectively referred to as “ FIG. 3 ”) are a flow chart of the front-end of the present invention.  
       FIG. 4  is a pictorial representation of the Splash screen.  
       FIG. 5  is a pictorial representation of the Log On screen.  
       FIG. 6  is a pictorial representation of the Edit Practice Data screen.  
       FIG. 7  is a pictorial representation of the Main Menu screen.  
       FIG. 8  is a pictorial representation of the Patient Selection screen.  
       FIG. 9  is a pictorial representation of the Facility Selection screen.  
       FIG. 10  is a pictorial representation of the Add A Patient screen.  
       FIG. 11  is a pictorial representation of the Edit A Patient screen.  
       FIG. 12  is a pictorial representation of the Patient Procedure and Diagnosis screen.  
       FIG. 13  is a pictorial representation of the Diagnosis Codes screen.  
       FIG. 14  is a pictorial representation of the Procedure Search Option screen.  
       FIG. 15  is a pictorial representation of the Diagnosis Codes Search screen.  
       FIG. 16  is a pictorial representation of the Ailment screen.  
       FIG. 17  is a pictorial representation of the Referring Provider List screen.  
       FIG. 18  is a pictorial representation of the Note screen.  
       FIG. 19  is a pictorial representation of the Modifier Option screen.  
       FIG. 20  is a pictorial representation of the Units Option screen.  
       FIG. 21  is a pictorial representation of the Summary screen.  
       FIG. 22  is a pictorial representation of the Import Data screen.  
       FIG. 23  is a pictorial representation of the Password Screen.  
       FIG. 24  is a pictorial representation of the Tools and Utilities screen.  
       FIG. 25  is a pictorial representation of the Full Tools and Utilities screen.  
       FIG. 26  is a pictorial representation of the View Practice Data screen.  
       FIG. 27  is a pictorial representation of the Color Preference screen.  
       FIG. 28  is a pictorial representation of the Setup screen.  
       FIG. 29  is a pictorial representation of the Procedure Code Setup screen.  
       FIG. 30  is a pictorial representation of the Diagnosis Code Setup screen.  
       FIG. 31  is a pictorial representation of the Abort Program screen. 
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT(S)  
      The present invention will be described as it applies to its preferred medical embodiment. It is not intended that the present invention be limited to the described embodiment. It is intended that the invention cover all modifications and alternatives which may be included within the spirit and scope of the invention.  
      As shown in  FIG. 1 , the billing and records system  10  of the present invention is a front-end-back-end system, with an open standards-based software architecture as is commonly known in the art. A new trend in such architecture is “multi-tiered solutions.” A tier is simply a layer, usually consisting of a particular piece of software. For instance, in a typical front-end/back-end relationship, the front-end is one tier and the back-end is another tier. The front-end performs user interface services such as entering, editing, validating, and displaying information on the front-end computer  14  as shown in  FIG. 1 . The user interface preferred for use by the care provider is a graphical user interface, running for example in Microsoft Windows 98® via Microsoft Visual Basic 6.0, that interacts with the care provider as the front-end.  
      The front-end computer  14  is preferably a pen based computer such as the Fujitsu Model Point 1600, including a radio frequency based Proxim connection system. The use of a wireless, pen based computer allows a care provider to enter all necessary data from the point of care with minimal equipment interference. The back-end computer  12  is preferably a Hewlett Packard computer running a UNIX operating system, though any operating system compatible with the front-end computer  14  is acceptable. Both the front-end computer  14  and the back-end computer  12  are preferably Internet capable. Internet capable means each computer is connected to and may be accessed from the Internet  16 . Connection to the Internet  16  is accomplished using Transfer Control Protocol/Internet Protocol (TCP/IP), and an internet service provider such as U.S. West, Iowa Network Services, or any other provider.  
      The front-end computer  14  is linked to the back-end computer  12  through either the Internet  16  or a direct linkage. This linkage may be either a wired or wireless linkage, such as the Proxim connection system mentioned above. Further, any other computer  18  may be connected to or accessed from either the front-end computer  14  or the back-end computer  12  through the Internet  16 .  
      On a web page, not shown, information about healthcare related issues is presented along with an access area in which patients would be able to enter an access code and user identification so as to access and view their records and billing information. The care provider would have a separate access code and user identification which would allow the care provider to provide, edit, review, and download patient records and billing information. Should any questions arise, patients are able to click on the e-mail address provided to ask a care provider to address their concerns. The web page is preferably created in hyper text markup language (HTML).  
      To provide patient records and billing information over the Internet  16  requires a high level of security in order to ensure no access is given to non-patients. This form of Internet security can be provided for by implementing the measures as stated in U.S. Pat. No. 5,898,830 to Wesinger, Jr., et al., hereby incorporated by reference. Of course, the front-end computer  14  may also be internet capable.  
      As shown in  FIG. 2 , a linking computer program  300  is located on the back-end computer  12 . The linking computer program  300  uses a patient database to create a patient work file on the back-end computer  12 . The patient work file is a text file which contains a list of all patients, and their necessary accompanying records, to be seen for a specific day such as the current day.  
      The linking computer program  300  initially presents the care provider, system administrator, or user, with a main menu  302 . The main menu  302  screen, presents the care provider with several options, including a port for program option  304 , a summary report option  306 , a detail report option  308 , a enter no shows/cancels option  310 , a daily archive maintenance option  312 , a control file maintenance option  314 , a create modifier code file option  316 , a create service code file option  318 , a create diagnosis code file option  320 , a create referring provider file option  322 , a create facility code file option  324 , a create patient encounters option  328  and a create program files option  326 .  
      The control file maintenance option  314  governs information regarding the front-end program described below and its interaction with the back-end computer  12 . The control file maintenance option  314  segregates the location of the front-end program data files, in relationship to the back-end system.  
      A reference database may be maintained on the back-end computer  12  or any other system  18  to which the back-end computer  12  may connect either through hard wire linkage or wireless linkage. The reference database may be accessed from or over the Internet  16 . The reference data base contains all procedure codes, modifier codes and diagnosis codes needed, as well as a complete patient/client list. The present invention uses and obtains the latest electronic versions of the American Medical Associations CPT as well as International Classification of Disease 9 th  Edition (ICD-9CM) terminology. These codes may be downloaded from the Internet  16  or from disks. Additionally, if necessary, these codes may be input by a system administrator.  
      Using the reference database, the create modifier code files option  316  creates the modifier code file for export to the front-end computer  14  containing all modifier codes residing on the back-end system. Again using the reference database, the create service code file option  318  creates a file for export to the front-end computer  14  containing all procedure or service codes, residing on the back-end system. Using the reference database again, the create diagnosis code file option  320  creates a file for export to the front-end computer  14  containing new or updated diagnosis codes.  
      The create referring provider file option  322  creates a file for export to the front-end computer  14  containing all referring provider information and codes, residing on the back-end system. The create facility code file  324  creates a file for export to the front-end computer  14  containing all current facility information residing on the back-end system.  
      The create program code file option  326  creates a file for export to the front-end computer  14  containing all of the current information listed above for transmission in batch mode. The use of create program code file option  326  alleviates the need to run each option separately.  
      The create patient encounters option  328  creates a patient work file which contains all of the patients with their corresponding appointment times for the current day. The patient work file created by the patient encounters option incorporates the current information compiled by the create program code file option  326  or any of the separately run options. The current information is incorporated with each patient&#39;s information such that should the care provider choose, the care provider may select only one patient at a time and still be presented with all of the current information at the time of the patient&#39;s appointment.  
      The daily archive maintenance option  312  moves the contents of the patient work file to a file entitled using the work file name as the prefix and the current day&#39;s date as the suffix. Th daily archive maintenance option  312  clears out and stores the previous day&#39;s work file.  
      The summary report option  306  provides the care provider with a summary report of general data regarding the procedure charges which may be viewed and/or printed. The detail report option  306  provides the care provider with a printed detailed report regarding the procedure charges with related diagnosis codes for the day which may be viewed and printed.  
      The enter no shows/cancels option  310  updates the patient work file for those patients that have not shown up for their appointments or have canceled their appointments. The updated work file is then transmitted to the front-end computer  14  via the program link  106  described below, or transmitted from the front-end system to the back-end system via the program link.  
      The port for program option  304  opens the program link  106  described below. All files, including either the batch file created by the create program code file option  326  or the individual files by the create options above, the updated or current patient work file are transmitted to the front-end computer  14  via the program link  106  as described below.  
      Further, the back-end computer  12  contains a billing program capable of receiving individual patient data and forming a Health Care Financing Administration (HCFA) Form 1500 statement for billing based on services performed and treatments given as shown in the patient work file. Using the appropriate information from the patient work file including the codes representing the services performed, the billing program determines the proper amount of charges due for services rendered on each particular visit for each particular patient. Additionally, the billing program may be adapted to transfer patient data from the patient work file to electronic versions of other insurance and governmental forms.  
      The core of the billing and records keeping system  10  of the present invention is a computer program which makes it possible to place all the responsibility for billing and record keeping on the care provider while ensuring the care provider has the latest up-to-date codes available from the back-end computer  12  as described above.  
      The graphical user interface and object-logic tiers of the present invention are programmed for a front-end computer, preferably the Fujitsu Model 1600 running on a Microsoft Windows 98® platform. The preferred programming languages are Microsoft Visual Basic and C+.  
       FIG. 3  shows a flowchart of a computer program which resides on the front-end computer  14  of  FIG. 1 . The computer program is capable of communicating with the back-end computer  12 , and is therefore designed for use over networks or the Internet. Communication preferably takes place over a Proxim radio frequency based system, but may also use hard wired connections, such as telephone lines or Ethernet lines, or a radio frequency modem and accompanying antenna and system. The back-end computer  12  may be a single computer or other system, including existing hospital information support systems, or remote Internet access servers.  
      As shown in  FIG. 3 , upon start up, a care provider is presented with a splash screen  20 , shown in  FIG. 4 , which welcomes the care provider to the system  10  and gives general information regarding the software licensing and title. After this brief welcome, the logon screen  22 , shown in  FIG. 5 , appears. The logon screen  22  requires the care provider to enter a proper user identification  24  and password  26  in the appropriate text fields shown in  FIG. 5 , and select the OK option  28  push button. At initial startup, a general user identification  24  and password  26  may be used. As is further shown in  FIG. 5 , an on-screen keyboard  200  may be used to enter in the identification  24  and password  26 . The on-screen keyboard is integral to the screen and remains screen specific. Additionally, software capable of recognizing handwriting may be installed onto the front-end computer  14  allowing the care provider to simply write the identification  24  and password  26  into the appropriate text fields via pen input.  
      The identification  24  and password  26  may be changed to a care provider specified identification  24  and password  26  through the Edit Practice Data Screen of the Tools and Utilities Sub Menu, shown in  FIG. 6 , as discussed further below. This ensures patient data will only be accessed by authorized personnel, further ensuring patient record privacy. Should the care provider fail to enter a proper identification  24  and password  26  or choose to cancel the logon operation by selecting the cancel option  30 , such care provider will be directed to the exit  32  of the computer program.  
      Once access has been obtained, the main menu  34  of the computer program is displayed as shown in  FIG. 7 . The main menu  34  of the computer program consists of a screen which presents the care provider with several options. From the main menu  34 , the care provider may choose an option, by simply pressing the pen of the pen based computer on the appropriate push button on the screen representing that option. The options available on the main menu  34  include an option for opening today&#39;s clinic database  36 , an option for evaluating patient summaries  38 , an option to import data  40  from the back-end computer  12 , a tools and utilities option  42 , an option to evaluate the program source data  44 , and a log off option  46 .  
      As shown in  FIG. 8 , upon pressing the push button for the option for opening today&#39;s clinic database  36 , the patient selection screen  48  is displayed, showing a list of the current day&#39;s patients compiled from the transmitted patient work file discussed above, with the first patient highlighted in the patient list box  49  along with the current place of service for that patient. Along with the name of the patient, the patient&#39;s date of birth, provider, encounter number, the date of current encounter, the time for the appointment, the back system account number, the action status and the result of actions taken status is displayed.  
      The patient selection screen  48  allows the care provider to select which patient is being cared for. Selection is accomplished by pushing on the patient name with the pen and thereby highlighting the patient. Once the correct patient has been highlighted, the OK option  50  push button is selected. If the care provider no longer wishes to select any patient, the care provider may return to the main menu  34  by selecting the cancel option  52  push button.  
      The patient selection screen  48  further allows the care provider to edit the location at which services are performed by selecting the change place of service option  62  push button. Selecting the change place of service option  62  directs the care provider to the Facility Selection screen  78 , as shown in  FIG. 9 . The Facility Selection screen  78  displays a place of service box  80  and a facility list box  82 . By highlighting the place of service and the facility of service, no facility selection need be made for the care provider&#39;s office, and then selecting the OK option  84  push button, the care provider can change the place of service. Clicking the cancel option  88  push button will keep the current place of service information. A help option  90  push button can be selected and will display helpful information on the screen. Selection of the place of service allows the care provider to quickly indicate whether services are to be performed as an in-patient, out-patient, clinic or other service.  
      As shown, the select a patient screen of  FIG. 8  further allows the care provider to add, as shown in  FIG. 10 , or edit, as shown in  FIG. 11 , individual patient data. Therefore, the responsibility for patient record keeping falls on the care provider rather than a non-care providing person who must interpret the care provider&#39;s notes and/or dictation to arrive at the data in question.  
      The care provider may add patient profiles for the current day&#39;s processing. From the patient selection screen, shown in  FIG. 8 , the care provider can select the add a patient option  54 . This directs the care provider to the add a patient option  54  screen, as shown in  FIG. 10 .  
      The add a patient option  54  screen includes several text boxes which allow the care provider to input data concerning the patient, including the account number, the appointment time, the patient&#39;s last name, the patient&#39;s first name, the patient&#39;s middle initial, the patient&#39;s date of birth, and the care provider&#39;s provider number. Other information can be added by adding additional text boxes and customizing the add a patient option  54  screen to include desired information relevant to the type of services provided.  
      Here again the care provider may use the on-screen keyboard  200  or the pen input to add an individual patient profile. Selecting the OK option  94  push button enters the patient information. Upon selecting the OK option  94 , the patient profile is immediately available for use with the rest of the billing and records system  10 . Selecting the cancel option  96  push button will return the care provider to the select a patient screen  48 . Additionally, a help option  98  push button is provided to provide helpful information to the care provider upon request.  
      Similar to the add a patient option  54  is the edit a patient option  56 . Unlike the add a patient option  54 , the edit a patient option  56  screen, shown in  FIG. 11 , presents the care provider with text boxes already completed with patient information of the highlighted patient to be edited. This patient information may be edited through the use of either the pen or the on-screen keyboard  200 . The OK option  100 , the cancel option  102 , and the help option  104  push buttons work similar to those in the add a patient option  54 .  
      The patient selection screen  48  also includes a send/receive option  58 . After a patient has been cared for, the patient data is ported to the back system through the program link, with a result code shown in  FIG. 8  indicating successful porting to the back-end computer or an error message. The services performed action code appears on the select a patient screen  48  as an asterisk in the action column of the patient list before sending the data to the back-end system. Once the updated patient data has been sent, an “S” is shown in the Action Section. Once data has been received by the back-end system  12 , the back-end system  12  transmits data to the front-end system  14  indicating the latest data has been received, indicating the result of successful transmission of code data with an “x” in the result column and, thereby changing the action code to an “S” as shown in  FIG. 8 .  
      The send/receive option  58  screen uses the program link  106  to send and receive patient or coding data between a front-end computer  14  and a back-end computer  12 . Simultaneously, all patient data with an asterisk action code is transmitted. This allows for single batch or multiple batch transfer of patient data capabilities. By selecting the receive data option  164 , data for new patients to be seen, cancellations, no shows, updates, or similar information is transmitted from the back-end computer  12  to the front-end computer  14  with each activation of the Send/Receive link. This capability to send and receive individual patient data allows the care provider to properly bill a patient upon the patient&#39;s departure from the care provider&#39;s office and is responsive to the burdens placed upon the typical operations of a clinic, namely add-on patients, such as “walk-ins” or “work-ins.” 
      All transmission between the front-end computer  14  and the back-end computer  12  or vice-versa occur via the program link  106  as described below. Such importing/exporting of data may take place immediately, updating the care provider while viewing the patient selection screen  32 .  
      The patient selection screen  48  further allows the care provider to ask for help by selecting the help option  60  push button. Help is provided in all of its applications in the present invention internally, via the front-end computer  14 , or the Internet  16  to which the front-end computer  14  are connected. Help is routed through the program link  106  if necessary.  
      Preferably, the front-end computer  14  and back-end computer  12  are linked wirelessly via the program link  106 . The program link  106  is preferably a wireless linkage using a radio frequency (RF) local area network (LAN) such as Proxim or BreezeCom. Other forms of communication between the front-end computer  14  and the back-end computer  12  may be used such as cellular, time modulated ultra wide band radio frequency, infrared, or any type of conventional hard wiring which is commonly known in the art.  
      Once a patient has been selected from the patient selection screen  48 , the care provider is directed towards the Patient Procedure and Diagnosis Codes  104  screen as shown in  FIG. 12 . From here, the care provider can select the proper procedure and diagnosis codes from the American Medical Associations CPT. The patient procedures codes and a description of the procedure appear at the bottom of the screen shown in  FIG. 12 . Upon selecting the appropriate procedure code, the care provider is directed to the diagnosis screen  106  as shown in  FIG. 13 .  
      If the proper procedure code is not shown, the care provider may select the procedure search option  132 . Clicking on the procedure search option  132  push button directs the care provider to the procedure search option  132  screen as shown in  FIG. 14 . Here the care provider can search by number or by description for the procedures not previously found using either the pen or the on-screen keyboard  200 . Selecting the OK option  134 , or the cancel option  136  returns the care provider back to the patient procedures and diagnosis codes screen  104  with or without the selected codes respectively. The care provider may also select a help option  138  which will present the care provider with helpful information.  
      In the diagnosis screen  106 , the care provider can select the proper diagnosis code(s). Up to four diagnosis codes can be selected, however, if more are required by the Health Care Financing Administration (HCFA) in the future, this number can easily be expanded. The selected diagnosis code appears in the upper left corner of the diagnosis screen  106  as shown in  FIG. 13  and the order of codes may be changed by highlighting the desired code and then moving the highlighted code either up or down, to the top or to the bottom by selecting the appropriate push button. Additionally, either the highlighted code or all of the codes selected may be deleted by pushing the appropriate push button. When the care provider is done selecting diagnosis codes, the OK option  108  push button is selected directing the care provider back to the Patient Procedure and Diagnosis Codes Screen  104 . Additionally, if the care provider does not wish to select a diagnosis code at this time, the care provider may select the cancel option  110  push button, thereby returning the care provider to the Patient Procedure and Diagnosis Codes Screen  104 . Upon pressing the cancel option push button, the care provider will be prompted to determine whether the intention to leave the screen without updating is correct. Only upon affirmation will the care provider be returned to the patient procedure and diagnosis codes screen  104 , canceling the diagnosis code(s) and specific related procedure code.  
      If the care provider does not see the proper diagnosis present, the care provider may select the search option  112  from the diagnosis screen  106 . Selecting the search option  112  push button directs the care provider to the diagnosis search screen  116  as shown in  FIG. 15 . Here, the care provider may scan the vast amounts of data representing different possible diagnoses. The care provider may search by number or by description for the diagnosis codes desired. The care provider then selects the proper code using either the pen or the on-screen keyboard  200 . Selecting the OK option push button returns the care provider to the patient procedure and diagnosis screen  104  with the desired input. Selecting the cancel option push button discards all input and simply returns the care-provider to the procedure and diagnosis screen  104 . A help push button is also provided should the care provider need assistance.  
      From the procedure and diagnosis screen  104 , the care provider may select the ailment option. This directs the care provider to the ailment screen  118  as shown in  FIG. 16 . Here the ailment may be documented through the use of various text boxes labeled to show all the required fields for insurance processing including when symptoms first appeared, when the first consultation was sought, etc. The dates will default to the current day&#39;s date unless changed.  
      Further, the doctor who referred the patient with the respective ailment is shown including the doctor&#39;s name and referring provider number. These may be edited by using the change referring provider option  120 . Upon selecting the change referring provider option  120  push button, the care provider is directed to the referring provider list screen, as shown in  FIG. 17 . This allows the care provider to select the referring provider from the list or type in the first letter of the name to narrow the search using the on-screen keyboard  200 . Additionally, if the referring provider information is to be left blank, the care provider can delete any name listed in the text boxes by selecting the delete referring provider option  122  push button, which simply clears all text boxes relating to the referring provider. Selecting the OK option sends the care provider back to the patient procedures and diagnosis codes screen  104 . A cancel option push button returns the care provider to the patient selection screen  48 . Additionally, a help option push button provides help if the care provider needs assistance.  
      The patient procedures and diagnosis codes screen  104  also includes a note option  124 . By selecting this note option  124  push button, the care provider is directed to a note option  124  screen as shown in  FIG. 18 . Here the care provider may use the built in on-screen keyboard  200  or the pen via handwriting recognition software to enter notes for this particular patient into the text box. Again, the on screen keyboard  200  is always present on any screen where it is necessary for the care provider to enter or edit. After entering a note into the text box, the care provider may select the OK option  126 , the cancel option  128 , or the help option  130 . Selecting either the OK option  126  or the cancel option  128  will return the care provider to the patient procedures and diagnosis codes screen  104 . Selecting the help option  130  will offer help to the care provider.  
      Also on the patient procedures and diagnosis codes screen  104 , is a summary area  140 . The summary area  140  contains all procedures selected along with the modifiers, units, and diagnosis codes selected which correspond to each procedure. Selected procedures and their accompanying information may be deleted by using the delete option  150  push button. A Help button (not shown) is also provided.  
      Modifiers, adding further clarification to the procedures performed, may be added by clicking on the modifier option  142  push button. Upon clicking on the modifier option  142  push button, the care provider is directed to the modifier option  142  screen, as shown in  FIG. 19 . On the modifier option  142  screen, the care provider is presented with a list of possible modifiers relevant to the selected procedure. From this list, the care provider selects any and all necessary modifiers (up to three, as allowed by the Health Care Financing Administration). The care provider may move the selected modifier up, down, to the top or bottom using the corresponding option push buttons. Additionally, the care provider may delete either the selected modifier or all of the modifiers using the delete push button or the delete all push button respectively. Upon conclusion, the care provider clicks on the OK option push button or the cancel option push button and returns to the patient procedures and diagnosis codes screen  104  with or without the desired modifier(s) selected respectively. Further, a help option is available to the care provider in the need of assistance.  
      By selecting the units option  144  and clicking on the units option  144  push button, the care provider is directed to the units option  144  screen as shown in  FIG. 20 . On the units option  144  screen, the care provider may enter the number of units desired in the corresponding text box. The default number of units is one. Further, the care provider may enter other information, such as the start time, end time, actual minutes, supervisor reduction percentage, etc. in corresponding text boxes through either the pen or the on-screen keyboard  200 . Upon conclusion, the care provider clicks on the OK option push button or the cancel option push button and returns to the patient procedures and diagnosis codes screen  104  with or without the desired units selected respectively. Further, a help option is available to the care provider in the need of assistance.  
      Finally, the summary area  140  also includes a send beam option  146  and an accept beam option  148 . The send beam option will transmit only the data in the summary area  140  to only another computer which is waiting for the data. Any other computer capable of accepting data is capable of receiving data from the send beam option  146  and must be “Accept beam” mode, waiting for data transmission. As only the data in the summary area  140 , which includes no patient names nor identifying information will be transmitted, total patient privacy is ensured. Only another computer which is specifically waiting for data regarding a particular patient will be able to make use of the data. This situation occurs often between doctors who must rely on the work done just previously by another care provider. To comply with insurance and governmental regulations, doctors must include all coding for all prior procedures performed on a particular patient.  
      In order to be waiting for data from another computer, or if another computer is transmitting the data, the front-end computer  14  of the present invention, must click on the accept beam option  148 . This allows the front-end computer  14  to receive data from another front-end computer using a non similar back-end link system. Should an error occur, an error message appears indicating the error.  
      Both the send beam option  146  and the accept beam option  148  use a wireless linkage, such as the Proxim RangeLAN2 system. Other wireless linkage are possible, such as an Infra red laser diode system, such as currently found in the art. Further, the linkage may be hardwired to transmit data between two corresponding ports on the front-end computers  14 .  
      If the transmission is successful, an “OK” message will appear indicating to the care provider that data has been transmitted. At any point in the process, the care provider may wish to terminate transmission and may exit the beam data option. If the transmission encounters errors, an appropriate error message is noted. Upon exiting or encountering an error message, the care provider will be passed back to the summary area  140 .  
      From the main menu screen  34 , the care provider may also view today&#39;s patient summary  38 . This directs the care provider to the patient summary  64  screen which may be printed, stored, or downloaded from the back-end computer  12 . The patient summary  64  screen as shown in  FIG. 21 , shows a list of all patients seen and processed for the current day. The list displays the account number, the patient name, the date of service, all codes that have been posted, the procedure code with modifiers and units, the first diagnosis code, the care provider number and the dollar amount of charges due per procedure performed.  
      From the main menu  34 , a care provider can select the import data option  40 . The care provider is directed to the import data screen  166  as shown in  FIG. 22 . The import data screen  166  includes several check boxes allowing the care provider to decide which files to import. The care provider may import the patient files, the procedure code files, the diagnosis codes files, the modifiers files, the referring providers files, or the facility files, or all of the above. By pressing the pen or using a mouse, the care provider may select or check the appropriate boxes. Upon pressing the import option  168  push button and using the program link  106 , the care provider can import all of the desired files for the day. Only the patient files corresponding to the patients the care provider plans on seeing that day are available. Should the care provider wish to cancel the import process at any time, the care provider may click on or press the cancel option  170  push button which will cancel the operation. Should the import option  168  fail for any reason, an error message appears. The care provider is also provided with a help option  172  to provide assistance if needed.  
      The main menu screen  34  also allows the user to select the tools and utilities option  42 . Upon clicking the tools and utilities option  42  push button, the user is directed to re-enter their password as shown in  FIG. 23 . After confirmation by the system  10 , the user is directed to the tools and utilities  42  screen, as shown in  FIG. 24  or a full Tools and Utilities screen  FIG. 25  by entering a special password. The care provider is presented with the options to view the practice data or the set-up screen or, if password allowed, edit the practice data, select the color preferences, or enter the setup screens. One can exit with corresponding push buttons.  
      Clicking on the view practice data option  68  push button directs the care provider to the view practice data option  68  screen, as shown in  FIG. 26 . This presents the care provider with filled in text boxes allowing the care provider to see the practice name, address, city, state, serial number, license information, type of practice, provider number, password, identification, and view the selections made concerning various options such as repeatability of diagnosis on procedures, whether to show the start/end times and whether to use the supervisor reduction percentage. Once the care provider is done viewing the practice data, the care provider may return to the main menu by selecting the cancel option  176 .  
      Clicking on the edit practice data option  70  push button directs the care provider to the edit practice data option  70  screen, as shown in  FIG. 6 . This screen allows the care provider to change any of the information listed in the view practice data option  68  screen. After the appropriate information is entered via the keyboard  200  or the pen, the care provider selects the OK option  178 . If the care provider does not want to keep any changes made, the care provider may select the cancel option  180  and return to the main menu  34 .  
      Clicking on the color preferences option  72  directs the care provider to the color preferences option  72  screen, as shown in  FIG. 27 . Here the care provider may alter the colors used on the screen displays to suit the individual care provider&#39;s preferences. The color preferences may be saved by selecting the save colors option  182 , or any changes may be cancelled by selecting the cancel option  184 . The care provider may return to their previously established colors by selecting the user defaults option  186  or return to the pre-programmed colors by selecting the program defaults  190 . Here the aesthetics of the front-end computer  14  screen may be adjusted to fit the individual care provider&#39;s preferences, fully taking into account human abilities or inabilities to differentiate between colors—e.g. red and green in red/green colorblind users. A help option  192  is also provided should the care provider need assistance.  
      Again referring to  FIG. 24 , clicking on the setup screens option  74  push button directs the user to the set up screens option  74  screen, as shown in  FIG. 28 . Here the care provider may alter the setup of the procedure codes via the procedure code setup option  194  or the diagnosis code setup option  210 .  
      Clicking on the procedure code setup option  194  push button directs the care provider to the procedure code screen builder screen as shown in  FIG. 29 . Here, the care provider may search for codes by number or description, select the appropriate code, delete a current code, or add a new code. To import the current CPT/EM codes into the editing area, the care provider may click on the load CPTs option push button. After any and all modifications are done, the care provider can click on the save CPTs option push button. When all modifications are done the care provider may exit by clicking on the exit option  196  push button. This gives the care provider the ability to customize the procedure codes used most frequently for their individual practice. Additionally, help is available to the care provider via the help option  198 .  
      The diagnosis code setup option  210  and screen, as shown in  FIG. 30 , works exactly like the procedure code setup option  194 , except, of course, with diagnosis codes.  
      Again referring to  FIG. 25 , the care provider may exit the tools and utilities option  42  screen by selecting the exit option  76 . This returns the care provider to the main menu  34 .  
      Now referring to  FIG. 3  from the main menu  34 , the care provider may select the about program option  44 . Upon clicking on the about program option  54  push button, the about program option  54  screen is displayed as shown in  FIG. 31 . The screen displays the author of the program, the author&#39;s address and phone number, as well as the current version of the program. Once the care provider is done viewing this information, the care provider may return to the main menu  34  by selecting the OK option  218 .  
      Once the care provider is finished using the front-end system  10 , the care provider may log off using the log off option  46  from the main menu  34  as shown in  FIG. 7 . After logging off, the care provider exits the system  10  via exit  32 .  
      The system  10  and program described above may be easily modified to work in other health care fields, such as dentistry and non-health care related fields such as accounting, law, architecture and others. Anyone in the multiple service industries could use the present invention for their billing and records system  10 . For example, a law office, which bases its billing typically on a time standard, could easily use such a system  10 . Instead of diagnosis codes, the law office would be able to use or codify commonly performed task categories, such as “telephone conversation,” “briefing,” “motion,” “letter,” “trial,” etc. These categories could then have more specific sub categories. For instance, the category “motion” could have subcategories such as “summary judgment,” “bifurcation,” “compel,” or as many others as should be desirable.  
      Much like the health care industry, more and more legal fees, such as court fees, administrative practice fees, etc. are constantly changing. Through the use of this billing/records system  10 , a law office may have one person which can update all appropriate fees for the entire office. Simple modifications would be all that is required. Instead of patients, clients would be selected. Instead of referring physician, reference attorney or referring entity would be used. These and many other substitutions could be made to tailor the program to fit the needs of a law office. Similar modifications could be made to the program for use in an accounting office, insurance company, brokerage firm, or any other member of the multiple service industries doing business.  
      A general description of the present invention as well as a preferred embodiment of the present invention has been set forth above. Those skilled in the art to which the present invention pertains will recognize and be able to practice additional variations in the methods and systems described which fall within the teachings of this invention. Accordingly, all such modifications and additions are deemed to be within the scope of the invention which is to be limited only by the claims appended hereto.