Work with Guarantor Accounts

Transcription

1 Work with Guarantor Accounts Update guarantor information... 2 Demand a statement for a guarantor... 2 Change the guarantor for a hospital account... 2 Change the guarantor for a minor's hospital account... 3 Change the guarantor on subsequent hospital accounts... 3 Remove or deactivate an invalid guarantor account... 3 Add a primary coverage to a billed hospital account... 4 Add a non-primary coverage to a billed hospital account... 5 End (terminate) a coverage for a patient... 6 Remove a coverage from the hospital account... 7 Send a letter to a guarantor... 7 Send a balance to bad debt... 7 Manually update an account's self-pay follow-up level... 8 Page 1

2 Update guarantor information If you find that the guarantor's contact information is incorrect (for example, the guarantor moved), you can update the information from Registration. 1. In Account Maintenance, click Go To and select Registration. 2. In the Guarantors & Coverages section of the Interactive Face Sheet, click Guarantor Demographics. 3. Update any incorrect information, such as the address or phone number. 4. Click Accept to save your changes. Close Registration. 5. If needed, demand a statement to send it to the updated guarantor address. Page 2 Refer to p. 2 for instructions on demanding a statement for a guarantor. 6. Document your actions by clicking Acct Activities and selecting the appropriate activity, such as Update Guarantor Information. 7. Add any extra information in the Add Account Note field. 8. Click Accept to save the note to the account. Demand a statement for a guarantor If a guarantor says that she never received a statement, or requests a new copy, you can create one manually. 1. In Account Maintenance, go to the Account Contact tab. 2. Select the Statement History tab, and then click Demand Statement. 3. Verify that the statement template is appropriate, or enter a new one. 4. Verify that the default printer selection is appropriate or update as needed, and then click Print. Change the guarantor for a hospital account If you need to completely remove the guarantor account from the patient (likely due to an error), refer to p. 3 for instructions. Removing a guarantor account completely breaks the link between that account and the patient. 1. In Account Maintenance, click Go To > Registration.

3 2. Go to the hospital account, indicated by a green folder icon and labeled with the type of hospital account and the patient's name. 3. Click Change Guarantor, and then select and deactivate the existing guarantor account. This guarantor account becomes unavailable for future encounters, but it remains connected to the patient for historical purposes. The guarantor account also remains active for other patients currently using it. 4. Click Add New Guarantor, and then select or verify the guarantor account type, such as Personal/Family. 5. Select the responsible party for the new guarantor account, and then create the account. 6. Optional: If there is coverage associated with the new guarantor account, associate or create the coverage. 7. Click Finish to return to Registration, and then click Finish again to return to Account Maintenance. 8. Document your actions by clicking Acct Activities and selecting the Change Guarantor activity. 9. Write a brief note to explain what you did for this account and why. 10. Click Accept to save the note on the account. Change the guarantor for a minor's hospital account Sometimes you might need to change the guarantor of a minor's hospital account from one parent to the other parent. 1. In Account Maintenance, click Acct Actions > Change Guarantor. 2. Select the new guarantor and click Accept. Change the guarantor on subsequent hospital accounts After you change the guarantor for a hospital account, you might need to change the guarantor account for the patient's other hospital accounts. 1. In Account Maintenance, go to the Enterprise Guarantor Summary tab and select the patient's next hospital account. 2. Click Acct Actions > Change Guarantor. 3. Select the new guarantor and click Accept. Remove or deactivate an invalid guarantor account After you change a patient's guarantor, you need to decide whether the previous guarantor information was incorrect or outdated. If it was incorrect, remove the guarantor account. If it was outdated, deactivate that account. 1. In Account Maintenance, click Go To > Registration. 2. Click Detailed View. Page 3

4 3. Select the Guarantor Accounts form. If the guarantor was never valid for this patient (entered in error), click the Remove link. If the guarantor account used to be valid, but is no longer, clear the Active? check box. 4. Click Finish. To see inactive guarantor accounts on the Guarantor Accounts form, select the Include Inactive Guarantor Accounts check box. Add a primary coverage to a billed hospital account 1. In Account Maintenance, go to Liability Buckets, click the Bucket Action button for the self-pay bucket, and select Undo Billing. You can't add a primary coverage to a hospital account with a status of Billed. Undo billing to change the hospital account's status from Billed to DNB and move the financial liability back to the prebilled bucket. 2. Click Go To > Registration. 3. In the Guarantors & Coverages section of the Interactive Face Sheet, click Add Coverage, and then search for and add the plan. 4. Enter as much information as possible. For coverages that aren't electronically verifiable, enter the coverage details on the Subscriber Info form and verify the coverage by phone or fax. When you've entered all the coverage information, click Finish to add coverage. Then skip the rest of this topic. If a payor can verify the coverage electronically, the Eligibility Query form opens when you select the coverage. 5. Click Send. The Response Notification button at the bottom of the screen changes to Awaiting Response. 6. When the Awaiting Response button changes to Response Received, click it. 7. Review the information to ensure it is accurate for the patient and that there are no warnings, and then create the coverage. 8. Select the correct plan, and then click Accept. Page 4

5 Add a non-primary coverage to a billed hospital account Don't use the undo billing account action on an account if the primary payor has already been billed. Rejected buckets can cause problems for future or existing payments. 1. In Account Maintenance, go to Liability Buckets, click the Bucket Action button for the self-pay bucket, and select Undo Transfer to Self-pay/Next Responsible. This transfers the remaining balance back into the primary payor's bucket but doesn't reject any payments already made. 2. Click Go To > Registration. 3. Click Detailed View. Because you can't use Registration to add coverages to a hospital account with a status of Billed, you need to use Detailed View to add the coverage at the guarantor level and then manually attach it to the hospital account. 4. Go to the Cvg & Add'l Info form and click Add Coverage. 5. Search for and add the plan. 6. Enter as much info as possible. Page 5 a. For coverages that aren't electronically verifiable, enter the coverage details on the Subscriber Info form and verify the coverage by phone or fax. When you've entered all the coverage information, click Finish to add the coverage. Then skip to step 11.

6 b. If a payor can verify the coverage electronically, the Eligibility Query form opens when you select the coverage. 7. Click Send. The Response Notification button at the bottom of the screen changes to Awaiting Response. 8. When the Awaiting Response button changes to Response Received, click it. 9. Review the information to ensure it is accurate for the patient and that there are no warnings, and then create the coverage. 10. Select the correct plan, and then click Accept. 11. Click Finish to return to Account Maintenance. Now that you've created the secondary coverage, you need to attach it to the hospital account. 12. Go to Coverage Info and add the coverage you just created to the hospital account. 13. Go to Liability Buckets, select the Bucket Action button for the primary payor, and select NRP Remaining Balance. End (terminate) a coverage for a patient Terminate a coverage when it is no longer effective for the patient. When you terminate a coverage, first remove it from the hospital account if you also know that it isn't valid for the current visit. Refer to p. 7 for instructions on removing a coverage from a hospital account. 1. From Account Maintenance, click Go To > Registration. 2. On the Interactive Face Sheet, find the coverage you want to terminate. Click the Coverage Info link. 3. Enter the last date that the coverage was effective in the Member eff to field. 4. Click Accept. The coverage is grayed out on the Interactive Face Sheet. You can see terminated coverages on the All Coverages. Coverages form in Registration by selecting Show Page 6

7 Remove a coverage from the hospital account Remove a coverage when it isn't valid for the current visit. You might remove a coverage if a patient comes in for a service that she knows her insurance doesn't cover. If the coverage isn't valid for the patient at all, remove it from the hospital account and terminate it. Refer to p. 6 to learn how to terminate a coverage. 1. In Account Maintenance, click Go To > Registration. 2. Go to the Coverage Info form for the hospital account. 3. Select the invalid coverage and then click Remove. The coverage is still available for the patient's other visits, but it will not be billed for this one. You can't remove the coverage if the hospital account has a status of Billed. 4. If the coverage you removed was the only one listed for the hospital account, select the Do not bill insurance check box. Selecting this check box indicates that you confirmed with the patient that her insurance should not apply to the visit. Send a letter to a guarantor 1. In Account Maintenance, click Acct Activities and select the type of letter you want to send, such as Denied Fin Assist App. 2. If necessary, edit the letter. 3. Enter any extra information about your interaction with the guarantor in the Add Account Note field. This becomes a permanent note on the guarantor's account. 4. Click Accept. The letter is queued for printing. Send a balance to bad debt When a guarantor fails to pay her balance, her accounts can be sent to a collection agency and the account balance can be reclassified as bad debt. Bad debt balances do not affect your active accounts receivable. When an account's balance is sent to bad debt, the system performs several actions automatically. The system: Removes any existing payment plans. Changes the account status to Billed (Bad Debt). Logs an account note. If a payment is made towards a bad debt account, the bad debt balance can be recovered so the payment can be matched to it. 1. From a self-pay follow-up workqueue, select the account to be sent to bad debt. Page 7

8 2. Click Acct Activities in the activity toolbar, and then search for and open the Send to Bad Debt activity. When you send an account to bad debt, the system also sends a letter to the guarantor. 3. Enter any extra information about sending the balance to bad debt in the Add Account Note field. 4. Click Accept. For information on sending letters to guarantors, refer to p. 7. Manually update an account's self-pay follow-up level When you take actions on an account, such as placing the account on a payment plan or resubmitting a claim to insurance, the system can automatically update the self-pay follow-up level on the account. Other actions you perform, such as changing a guarantor's address, do not automatically update the self-pay follow-up level, and as a result, you must change the self-pay follow-up level manually. 1. Click Acct Activities, and then search for and open the Change Self-Pay Follow-Up Level activity. 2. Enter any additional information about the account. 3. Click Accept. The account's self-pay follow-up level is updated. 8