Billed to insurance or patient

merlinsilk wrote on Friday, March 25, 2016:

The staff had been playing around when they first started to learn the system.
When I now had to clean up to prepare them for using the system for billing I found one of the dummy patients with an amount under Patient Balance Due and another one under Insurance Balance Due.
I can’t figure out how they got one to show up to be billed to the patient and the other to the insurance.
I even found another dummy patient that had no insurance data entered and he had an Insurance Balance Due.
How would I decide for a procedure performed who is to be billed for it?
Thanks - Merlin

fsgl wrote on Friday, March 25, 2016:

There is no simple way to set up for patients who are self-insured. There have been discussions about guarantors, but nothing concrete has been codified.

Be nice if there is a “No Insurance” button that can be clicked in the Insurance part of Patient Summary so that the Billing Manager will be bypassed & a statement will go directly to the patient.

A workaround would be, in EOB Posting - Invoice, pretend that Ins 1 did not pay & then the balance will go to the patient. See attachment.

The fake patient with amounts due in both patient/insurance balances probably had setup with features attributed to both. If you work backwards, you should be able to figure out how it happened.

Billing Manager assumes that all patients have insurance; hence if a charge had been entered, that amount will appear in Insurance Balance Due.

merlinsilk wrote on Tuesday, March 29, 2016:

Thanks fsgl!
That ‘no insurance’ button might become more and more important, as I get the impression that there are more providers who just want to bypass that whole mess of insureances and work for cash like the Surgery Center of Oklahoma.

fsgl wrote on Wednesday, March 30, 2016:

If the client has only self-pay patients, have them use the Charges Panel, which would save a lot of clicking.

If it’s mixture of self-pay & insurance, I suppose the practice can use both the Charges Panel & Billing Manager.

I think our colleagues abroad, who don’t deal with insurers, prefer the Charges Panel.

merlinsilk wrote on Tuesday, April 05, 2016:

yeah - I looked into the charges panel and actually have it enabled but this becomes useless if you don’t have fixed prices coded into your service codes, because there is no way to change the price for a procedure. It’s probably intended for those standard items that happen all the time and where never a rebate is given.
I am still bumbed by not being able to decide what goes to the insurance and what goes to the patients wallet when I enter a procedure in the fee sheet. Guess I have to do some serious tracing (now that I have Netbean up and running - and I can follow the old advise: use the source, Luke!).

fsgl wrote on Tuesday, April 05, 2016:

[[embed url=https://www.youtube.com/watch?v=Oo4OnQpwjkc]]

because help is on the way.