HPA FUNCTIONS. For Self-Pay & Customer Service RCT079

Transcription

1 HPA FUNCTIONS For Self-Pay & Customer Service RCT079

2 Table of Contents CURRENT STATEMENT BALANCE HYPERLINK... 3 STATEMENT BALANCES... 5 LAST PATIENT PAYMENT... 7 BUDGET PLAN... 9 COMMENTS/NOTES ACTIONS BUTTON HPA BUDGET PLANS GENERAL RULES SETTING UP A NEW IN-HOUSE BUDGET PLAN ADDING VISITS TO EXISTING BUDGET PLANS ADDING TO IN-HOUSE BUDGET PLANS ADDING TO AGENCY BUDGET PLANS TE TRANSACTIONS SETTING UP THE HOSPITAL BATCH POSTING ADDITIONAL TRANSACTIONS FROM TE DELETING TRANSACTIONS FROM TE Manual.RCT079.HPA Functions for Self Pay Customer Service

3 CURRENT STATEMENT BALANCE HYPERLINK The Current Statement Balance hyperlink is the most common means to access a patient s account. If a patient has received a statement for outstanding balances, the user can access the Statement Overview screen from this link, which provides several tools in one location. Below are some of the features that can be accessed from the Current Statement Balance hyperlink with regards to Hospital Patient Accounts: 1. From Patient Services, the user can click on the Current Statement Balance hyperlink. Manual.RCT079.HPA Functions for Self Pay Customer Service

4 2. The user will then arrive at the Statement Overview screen. Below are details of the tools available from this screen: Manual.RCT079.HPA Functions for Self Pay Customer Service

5 STATEMENT BALANCES 1. Statement balances - are located at the top of the Statement Overview Screen. The current balances on both the Physician and Hospital accounts are reflected in this area. *NOTE the HPA balances are reflective of only balances that are currently on the AR. Any balances written off the AR (such as collection balances), will not be reflected. The patient s account needs to be reviewed further to determine if additional balances exist. Manual.RCT079.HPA Functions for Self Pay Customer Service

6 2. Statement Overview Grid provides more specific details regarding balances. The grid will only contain a billing group if a statement has been sent from that billing group in the past. The grid can be designed to the user s preference. Below is a table with descriptions of the default columns contained within this grid: Column Title Group Curr Stmt Bal Last Stmt Bal Run Date Printed Dun Acct Status Acct Status Dt Acct Status Initials Visit Description Billing group number associated with line Current AR balance (does not reflect balances written off the AR which are owed) Balance that appeared on the last statement sent to the patient Date the last statement was ran for mailing Indicates with Yes or No if the statement balance has been printed for statement Dunning level of the account Column not used by HPA Column not used by HPA Column not used by HPA Selected visit number, if it has been specified Manual.RCT079.HPA Functions for Self Pay Customer Service

7 LAST PATIENT PAYMENT 1. The user can view the last payment made to the patient s hospital account from the Statement Overview screen. The user should first ensure that the Group 2 line is highlighted in the Statement Overview Grid. The last payment on record for HPA will then appear to the right of Group 2, under Last Patient Payment. Manual.RCT079.HPA Functions for Self Pay Customer Service

8 2. The Last Patient Payment Detail button will allow the user to query the patient s account for transactions, including queries of personal payment transactions. Manual.RCT079.HPA Functions for Self Pay Customer Service

9 BUDGET PLAN 1. The user can view HPA budget plan details from the Statement Overview screen. The user should first ensure that the Group 2 line is highlighted in the Statement Overview Grid. If a HPA budget plan has ever been established on an account, the Budget Plan section would provide additional details. 2. The following information is provided if a HPA budget plan has been established in the past: a. Amount: i. Monthly budget plan amount; ii. Date the budget plan was established; iii. User initials of the person who created the budget plan. b. Budget Cancellation Date: i. Date the budget plan was cancelled, if applicable. Manual.RCT079.HPA Functions for Self Pay Customer Service

10 3. Budget Plan Detail button allows the user to establish/cancel a budget plan for a University Hospital account. See the SETTING UP BUDGET PLANS section of the manual for additional details. Manual.RCT079.HPA Functions for Self Pay Customer Service

11 COMMENTS/NOTES 1. The user can View and Edit Comments of IDX from the fields provided at the bottom of the Statement Overview screen. The user should first ensure that the Group 2 line is highlighted in the Statement Overview Grid. Below are details of each of the notes, and how they are accessed, from the Statement Overview screen: Manual.RCT079.HPA Functions for Self Pay Customer Service

12 a. Accounts provides the user access to the patient s HPA account level notes. If the patients account contains account level notes, the parantheses to the right of Accounts will contain Yes. If there are no account level notes, the parantheses will contain No. i. To access these notes, the user would click on Accounts and then click on the Add/Edit button. The user would then arrive at the Account Notes screen, where the user can view and/or add notes to the patient s account. Manual.RCT079.HPA Functions for Self Pay Customer Service

13 b. General provides the user with access to the General Comments contained on the patient s account. If the patients account contains General Comments, the parantheses to the right of General will contain Yes. If there are no General Comments, the parantheses will contain No. i. To access these notes, the user would click on General and then click on the Add/Edit button. The user would then arrive at the General Comments, where the user can view and/or add notes. Manual.RCT079.HPA Functions for Self Pay Customer Service

14 c. Note A provides the user access to an NA note, or a note specific to one visit, on the patient s account. i. To access these notes, the user would click on Note A. If a visit has not previously been specified, in order to continue, the user must first specify a visit from which to view the Note A. The user will receive a pop-up message to indicate that a visit must be selected. ii. To specify a visit, the user would click the Select Visit button, which takes the user to the Visit Lookup screen. The user would then highlighted the desired visit and select OK. Manual.RCT079.HPA Functions for Self Pay Customer Service

15 iii. The user would then arrive back at the Statement Overview screen. The visit selected will appear in the Statement Overview Grid and directly above the comment box. If the visit contains NA notes, the parantheses to the right of Notes A will contain Yes. If there are no Notes A, the parantheses will contain No. *NOTE if visit number had already been specified, the user could have omitted the previous step. iv. To further view and/or add a NA note, the user would then click on the Add/Edit button. The user will arrive at the NA screen. Manual.RCT079.HPA Functions for Self Pay Customer Service

16 d. Note D provides the user access to the ND notes on a specific visit. The user would follow the same steps as specified above for Notes A, however clicking on Notes D instead. e. Note E users are not able to access Notes E (Notes Everything) from the Statement Overview screen. f. Note B - provides the user access to the NB notes on a specific visit. The user would follow the same steps as specified above for Notes A, however clicking on Notes B instead. g. Note C these notes are not currently used at the University. h. Note R these notes are not currently used at the University. Manual.RCT079.HPA Functions for Self Pay Customer Service

17 ACTIONS BUTTON 1. The Actions button is located at the bottom of the Statement Overview screen. These button provides the user with additional tools to further access the patient s HPA account. Below are details of the tools available: a. Account Work provides the user with access to the AW screen to access the patient s entire HPA account. Manual.RCT079.HPA Functions for Self Pay Customer Service

18 b. Statement History link that provides details of the patient s statement history. c. FIFO Payment Posting will not be used by this department. d. Transaction Posting currently not operational. Manual.RCT079.HPA Functions for Self Pay Customer Service

19 HPA BUDGET PLANS GENERAL RULES (Per Hospital Patient Accounts Budget Plan Policy): 1. Budget Plans can only be established on current balances. 2. The minimum monthly payment is $50/mo. 3. The maximum time frame for repayment is 12 months. 4. The patient is required to have the first payment made on the account within 10 days of setting up the budget plan. 5. If a patient needs to add balances to their budget plan, the patient must call once they receive new statements from the University to include those in the existing budget plan. SETTING UP A NEW IN-HOUSE BUDGET PLAN 1. The user will access the AW (Account Work) screen of the patient s account and determine the total balance on the patient s account that needs to be incorporated into a budget plan. Only balances in self-pay FSCs can be included in budget plans; collection balances cannot be included. a. Example - COPAY, TWO currently has $ in self-pay balances that are eligible to be set up on a budget plan. Manual.RCT079.HPA Functions for Self Pay Customer Service

20 2. The user will need to change the FSC of each visit being newly included in the budget plan to FSC 99. Below are the steps involved in changing the FSC: a. From the Visit Billing Overview (PB) screen, the user will enter CF (Change FSC) in the action code prompt and press tab. b. In the ARFSC field, the user will change the existing self-pay FSC to 99 and then press tab. The user will then click OK to save the change. Manual.RCT079.HPA Functions for Self Pay Customer Service

21 c. The user will receive a pop-up message to indicate that the FSC is being changed. The user will click OK to proceed. The visit s FSC has then successfully been changed. Manual.RCT079.HPA Functions for Self Pay Customer Service

22 3. The user will then set up the budget plan in IDX. There are two methods for completing this process. Below are details of each, including when it is appropriate to utilize each method: a. Statement Overview Screen - recording a budget plan when a statement has generated: i. If a patient has received a statement from University Hospital for outstanding balances, the user would begin at the Statement Overview screen. The user would highlight Group 2 in the Statement Overview Grid and then click on the Budget Plan Detail button. ii. The user would then arrive at the Account Level Budget Payment Control screen to record the details of the budget plan. Manual.RCT079.HPA Functions for Self Pay Customer Service

23 iii. The user would verify that the self-pay balances calculated previously match the selfpay balances recorded on the Account Level Budget Plan screen. The user will then complete only one field on this screen, either the Budget Payment Amount field or the Number of Payments field. 1. When the Budget Payment Amount field is populated with a dollar amount, the Number of Payments field will auto-populate with the number of months for repayment based upon that dollar amount and the account balance. 2. When the Number of Payments field is populated with the number of months for repayment, the Budget Payment Amount field is populated with the monthly dollar amount for repayment of the account balance. 3. Whichever field is utilized, the user MUST ensure that the budget plan falls within the policy criteria of no more than 12 months of repayment and a minimum payment of $50 per month. IDX will autopopulate these fields. The user should verify that the S/P Balances match the previously determined account balance. Users will complete only one of these two fields. By completing one of these fields, IDX auto-fills the other field based upon the criteria entered. Manual.RCT079.HPA Functions for Self Pay Customer Service

24 iv. When the user fills in either the Budget Payment Amount or the Number of Payments fields and presses tab, additional fields will auto-fill and/or update their data. Below are details of those fields that will auto-populate: 1. Last Budget Pymt Date contains the date of when the last payment would be made on the account to satisfy the budget plan agreement. 2. Last Budget Pymt Amount contains the dollar amount of the last budget plan payment (which might be less than the normal monthly payment amount). 3. Payment Due Date contains the date of when the first/next payment should be received by in order to keep the account from default. 4. Next Statement Date contains the date of when the patient s next statement will generate, which changes after the budget plan criteria has been entered. Manual.RCT079.HPA Functions for Self Pay Customer Service

25 v. The user will then confirm that the patient agrees to the terms, including mailing in the first payment within 10 days, before clicking OK to save the budget plan set-up in IDX. vi. The user can confirm that the budget plan has been set up by refreshing the Current Statement Balance screen. The budget plan details will then appear in the Budget Plan section when Group 2 is highlighted in the grid. vii. Once the user has clicked OK to save the budget plan details, two other actions automatically occur: 1. IDX automatically resets the patient s dunning level to 1. 1 Manual.RCT079.HPA Functions for Self Pay Customer Service

26 2. An account level (AW) note will automatically be generated on the patient s account. b. Account Work (AW) Screen - recording a budget plan when a statement has NOT generated: i. When a patient has requested to set up a budget plan on account that has not yet generated a statement, the user would not be able to complete the process from the Current Statement Overview screen. Instead, the user would begin the process from the Account Work (AW) screen. Manual.RCT079.HPA Functions for Self Pay Customer Service

27 ii. From the AW screen, the user would click on the Actions button and then select the Statement Detail link. iii. From the Statement Detail screen, the user would click on the Actions button and then select the Budget Plan link. Manual.RCT079.HPA Functions for Self Pay Customer Service

28 iv. The user would then arrive at the Account Budget Plan Control screen. Since a statement has not been mailed to the patient, the user must complete the Override S/P Acct Bal field. The user should enter the total self pay balance to be included in the budget plan in this field and press tab. v. The user will then arrive at the Statement Schematic field. The user should click the magnifying glass to auto-fill this field. This field, as well as, the Payment Due Date and Frequency fields will all auto-fill. These fields are required to complete the budget plan. Manual.RCT079.HPA Functions for Self Pay Customer Service

29 vi. The user will then complete the budget plan as described in the above steps. Once all details have been recorded, the user would click OK to save the budget plan in the system. vii. Once the budget plan has been saved in this method, the dunning level will automatically be reset to 1 and the system will also record an AW note, just as with the other budget plan process. 4. The user will need to advise the patient to call back to add any additional balances to the budget plan, as this is not an automated process. Manual.RCT079.HPA Functions for Self Pay Customer Service

30 ADDING VISITS TO EXISTING BUDGET PLANS ADDING TO IN-HOUSE BUDGET PLANS 1. If a patient requests to add a new visit balance to an existing in-house budget plan, the user would need to review the patient s account for the new total balance. a. The addition of the new visit balances must be incorporated into the current budget plan. The patient s number of payments should NOT be changed. The user would need to increase the Budget Payment Amount to accomadate the additional visit balances. The user would make the appropriate changes on the Account Budget Plan Control screen and click OK to save the changes. b. The user would also then change the FSC of the new visit(s) to FSC 99 to complete the process. Please reference the SETTING UP NEW BUDGET PLANS section of the manual for additional instructions. 2. Important the user would NOT delete the previous budget plan to create a new budget plan. The user should only modify the existing budget plan data. Manual.RCT079.HPA Functions for Self Pay Customer Service

31 ADDING TO AGENCY BUDGET PLANS 1. HPA had been using Budget Monitoring companies when patients requested budget plans until February Some patients continue to have existing budget plans established with these companies. If a patient currently has a budget plan established with a budget monitoring company, that patient can choose to add new balances to that budget plan. To add the new visits to the budget plan, the user would need to complete different steps. Below are details of adding a new visit to a budget plan established with an agency: a. The user will access the AW (Account Work) screen of the patient s account and determine the total balance on the patient s account that needs to be incorporated into the budget plan. Once the new total balance is determined, the user would need to confirm the new monthly payment amount with the patient. The patient s number of payments should NOT be changed. The user would need to increase the monthly payment amount to accomadate the additional visit balances. Manual.RCT079.HPA Functions for Self Pay Customer Service

32 b. The user will need to change the FSC of each visit that is being added to the budget plan. The user would change the FSC to 2. Below are the steps involved in changing the FSC: i. From the Visit Billing Overview (PB) screen, the user will enter CF in the action code prompt and press tab. CF ii. In the ARFSC field, the user will change the existing self-pay FSC to 2 and then press tab. The user will then click OK to save the change. Manual.RCT079.HPA Functions for Self Pay Customer Service

33 iii. The user will receive a pop-up message to indicate that the FSC is being changed. The user will click OK to proceed. The visit s FSC has then successfully been changed. Manual.RCT079.HPA Functions for Self Pay Customer Service

34 c. The user will then need to leave an visit (NA) note on each visit that is being included in the budget plan that will be handled by the budget monitoring company. i. The note should contain the following information: the visit numbers included in the budget plan, the total balance of the budget plan, the monthly payment amount, the duration of the budget plan, and finally that the patient is aware that the budget monitoring company will be handling the budget plan for the patient. d. The user will also need to leave a note on the account level (AW) of the patient s account regarding the budget plan arrangements. Manual.RCT079.HPA Functions for Self Pay Customer Service

35 e. If a user encounters a visit that has already been placed in a Budget Monitoring FSC (823, 821, 830, 923, 921, 930), the user should NOT change the FSC to 2 as the agency already has that visit. The user will need to contact the budget monitoring agency to advise of the new budget plans details. This can be done either via or by phone call. Manual.RCT079.HPA Functions for Self Pay Customer Service

36 TE TRANSACTIONS HPA uses Transaction Entry to post adjustments to patient s accounts. Below is a list of the most commonly used TE adjustment types and the corresponding adjustment codes: *Denotes that the adjustment is only used by the Self-Pay team. Type of Adjustment Adjustment Code Small Balance Financial Assistance* Lien Settlements* Bankruptcy* Customer Service Negotiated Discounts Self Pay Discounts Catastrophic* SETTING UP THE HOSPITAL BATCH 1. Type the action code for Transaction Entry (TE) at any action code prompt and press Tab. The TE transaction can be used at the Patient Services action prompt or from the Patient Billing (PB) screen on the visit level action prompt. Manual.RCT079.HPA Functions for Self Pay Customer Service

37 2. The Transaction Entry Batch Creation screen appears. Type a G to generate a new batch of transactions. Then tab to the Description field and type in a description of the transactions that will occur for the batch (such as Financial Assistance). Then click OK. 3. On the next screen, the user should tab down to the Batch Duplication Fields. In the Transaction Date field, the user should enter today s date. Skip these fields Manual.RCT079.HPA Functions for Self Pay Customer Service

38 4. The user should establish a new batch for each Transaction Code (adjustment reason). The user should next specify a transaction code in the Batch Duplication Fields. The user can either choose the Transaction Code from the magnifying glass options or can type in the number associated with the Transaction Code. The user should then select OK. 5. At the next screen, the user will choose E Enter Transactions in the Action prompt. The user can either select Enter Transactions from the magnifying glass options or can type E into the field and then tab. Manual.RCT079.HPA Functions for Self Pay Customer Service

39 6. In the Patient field, the patient s name will auto-fill, however the user will type over the patient s name with the visit number associated with the transaction. Once the visit number appears in the Patient field, the user should tab. NOTE - To prevent creating AR counter issues, the user should NOT put the visit number directly in the Vis # field. 7. IDX will auto-fill the Vis# field and the user will arrive in the ARCTR field. The user should select the magnifying glass from this field to choose the correct AR counter. The user will highlight the correct ARCTR and select OK. The user will almost always choose the Z99 ARCTR, unless Z11 is the only payer. ARCTR options box will appear when using the dictionary in the ARCTR field. Manual.RCT079.HPA Functions for Self Pay Customer Service

40 8. The user will then arrive at the Date field. The user can tab through the Date field and the Code field as both of the fields should be auto-filled. The user can also tab past the Comment field and arrive at the Amount field. 9. In the Amount field, the user should type in the amount of money to be adjusted from the visit and tab. The amount should be listed in decimal format without a $. Manual.RCT079.HPA Functions for Self Pay Customer Service

41 10. Once the user arrives in the SA field, the balance on the visit should change and the user should select OK to save the transaction. NOTE If the user creates multiple ARCTRs on the visit, the user should HPA Appliers to resolve. 11. Once the user selects OK, the user can then use the Up Arrow to move back to the Patient field to complete another transaction. If another transaction in that batch is not required, then the user would select OK again. Manual.RCT079.HPA Functions for Self Pay Customer Service

42 12. The user would then arrive at the Batch Proof screen. The user would select OK. 13. The user will then arrive back at the screen from which the transaction began (in this case, the PB screen). The user can verify the transaction on the TI screen of the visit. Manual.RCT079.HPA Functions for Self Pay Customer Service

43 POSTING ADDITIONAL TRANSACTIONS FROM TE 1. Once the user enters their first transaction in Transaction Entry, a batch is created and can be accessed throughout the day by entering TE in any action code prompt. The user should click on the magnifying glass by the Batch # field to find the batch. 2. The following screen will appear. The user should select the appropriate established batch to complete an additional transaction. The user should highlight the correct batch and then click OK. NOTE If there is not a batch established for the type of transaction that is required, the user should generate a new batch instead of adding to an existing batch. Manual.RCT079.HPA Functions for Self Pay Customer Service

44 DELETING TRANSACTIONS FROM TE 1. To delete transactions, the user should enter TE into any action prompt. The user will need to select the Batch that contains the transaction that needs to be deleted. The user will bypass both the Batch Description and the Batch Duplication screens by clicking OK at each screen. At the Transaction Entry screen, the user should type a D in the Action field and then press the tab key. 2. The user will then arrive at the Transaction Batch Detail screen. This screen lists all transactions that have occurred in that batch. The user should click the check mark under the Seq Column next to the transaction to be deleted. Manual.RCT079.HPA Functions for Self Pay Customer Service

45 3. The user should then select the Delete Transaction hyperlink (or press D on the keyboard). Once this has been done, a pop-up box will appear to question if the user wants to delete all selected transactions. Select Yes. NOTE - Never click on the Delete All Txns hyperlink or press the T key on the keyboard. This will delete every transaction in the batch. 4. The Batch Detail screen will then confirm that the transaction has been deleted as **Deleted** will appear in the Description column. 5. If the user is done with deleting transactions, then select the OK button until the user returns to the Patient Services screen. Manual.RCT079.HPA Functions for Self Pay Customer Service