How do I bill patient co-pays?

Transcription

1 How do I bill patient co-pays? To bill patient co-pays, the Patient Pay (Self Pay) insurance must be first entered in the Patient insurance file or the System File must have the default Self Pay insurance selected. The patient co-pay amount can be set up to deduct automatically from the primary payer s billed amount at the time of the Bill Audit posting, it can be transferred to the Patient pay insurance after the primary payer has been billed, or if the primary payer is PPS a co-pay charge can be used. To Transfer to the Patient Pay insurance after billing the primary payer: 1. Go to AR>Payments\Transfers 2. Find the outstanding receivable record you wish to transfer from and highlight it: 3. Go to the Detail tab at the top of the page located between the Summary and Preferences Tabs. 4. Check Allow Transfer and choose the "Bill Date" (this will default to Today's Date) and select the Patient Pay insurance as the "Transfer To" insurance. 5. Go to the individual charge record s Transfer field and enter the co-pay amount to be transferred (if wish to transfer the Net amount for all charges check XFer All Chgs then click Xfer button). 716 Newman Springs Road Lincroft, NJ Tel Page 1 of 6

2 Note: In some cases the co-pay amount to be transferred may be more than an individual charge. We suggest you break the charge out evenly among multiple charges. Transfers cannot be more than the net amount. 6. Press Save, and Confirm. 7. After transferring to the Patient or Payer generate patient pay claims (Billing>Printed Claims>Custom Invoices) or patient statements (AR>AR Reporting>Report Type = Statements) following your usual process. Note: If billing the patient and wish to show prior payments, use the A/R Patient Statement. To Transfer to the Patient Pay insurance at the time of posting the primary payer s Billing Audit: 1. Go to File>File Maintenance>System Settings and in the Reporting tab in the Other Billing Options section select Auto Post CoPays to Self Pay : 716 Newman Springs Road Lincroft, NJ Tel Page 2 of 6

3 2. Confirm the Co-Pay Amount is entered in the Co-Pay field of the primary insurance. 3. When running the Billing Audit for the primary payer, confirm the co-pay amount is posting to the Patient Pay Insurance. 716 Newman Springs Road Lincroft, NJ Tel Page 3 of 6

4 4. After posting the Primary Payer Billing Audit that has co-pay amounts posted to the Patient Pay insurance, generate patient pay claims (Billing>Printed Claims>Custom Invoices) or patient statements (AR>AR Reporting>Report Type = Statements) following your usual process. Note: If billing the patient and wish to show prior payments, use the A/R Patient Statement. To enter Patient Co-Pay charges when the Primary payer is PPS. Note: Dollar amounts greater than zero cannot be transferred to or from a PPS payer. If the co-pay is for a PPS insurance you can follow these steps: 1. Go to File>File Maintenance>Charge Code and create a patient pay charge code. (Note if a Co-Pay modality isn t available from the dropdown, go to File>File Maintenance>System Settings, Modality tab, pick an unused Modality and change the Description to Co-Pay). Example: 716 Newman Springs Road Lincroft, NJ Tel Page 4 of 6

5 2. Then set up the Co-pay charge to not be covered by the primary payer. Example: 3. In the Patient>Insurance tab, the co-pay amount can be added in the Patient Pay insurance Bill Rates tab: 716 Newman Springs Road Lincroft, NJ Tel Page 5 of 6

6 4. The Co-Pay charge must be added in Charge Entry. If NOT entering rates in the Patient s Patient Pay>Bill Rates tab as shown above, the co-pay amount can instead be entered in the charge override field: 5. After posting the Patient Pay Billing Audit generate patient pay claims (Billing>Printed Claims>Custom Invoices) or patient statements (AR>AR Reporting>Report Type = Statements) following your usual process Note: If billing the patient and wish to show prior payments, use the A/R Patient Statement. 716 Newman Springs Road Lincroft, NJ Tel Page 6 of 6