Hi All,
I have a question on handling the billing part on payments with insurance and patient.
This is the scenario:
Let me assume that the patient makes an encounter and a bill is processed for the patient for $100.
The patient makes the payment for $10 and the insurance pays $10.
Hence $20 is payed for the patient and $80 is to be payed again by the patient.
This is what I did:
I selected payments under fees, selected patient and made a payment for $10.
Then I selected insurance under payment and processed the invoice for another $10.
Later I checkout the patient with another $10 during the checkout process screen.
Observation 1:
After saving, the insurance payment is blank and no charge is observed under insurance but this reflects in patient payment.
Observation 2:
On trying to check out with the existing scenario, the checkout screen displays the cost that is applicable only for products and no procedures was observed.
But after saving and viewing the details, the procedures and applicable cost are also getting displayed.
Observation 3:
Once done, on viewing the checkout details, there is no way to differentiate the payments that is made by the insurance and the patients… (Screenshot attached)
Expectations:
Is ther a way, I could see amount that insurance has payed (with insurance name) and the amount patient has payed in the checkout screen.
Why is the isnsurance payment not reflecting in the payments screen with respective to insurance and shows up in the patient payment.
Any clue on how this could be handled or is this a bug to be checked on?
Attached screenshot and short description about the screenshot:
The_feesheet_after_the_payment_3.png : Feesheet of the encounter
Insurance_payment_blank_after_the_insurance_has_payed.png : The concern on why the payment on insurance is not reflecting under insurance
Checkout_screen_amount_display.png : Checkout shows only the product and no details on the procedures
Final_checkout_screen_4.png : Final checkout that shows the procedures and the payment that does not have any identification on what the patient has payed and what the insurance has payed.
Note: The codes and procedures shared in screenshot are sample used for interal purpose and not actual ones…
Be certain that there is data entered for insurer in Patient Summary. Can’t enter an insurance payment if the user doesn’t “tell” the Billing Manager the insurer must pay first.
Use EOB Posting - Invoice or Batch Payments to post insurance payments.
Checkout & Payment should only be used for patient payments, not insurance payments. These modules are not “built” to handle insurance payments.
Checkout does not have a column to reflect insurance payments.
For details on insurance payments, insurance adjustments, amounts applied to deductibles, non-covered service & other types of adjustments, the Patient Statement will have all this information. Checkout & Payment generated receipts are meant to be given to the patient, on the spot, with very limited information; while the Patient Statement is more complete, more detailed & will not be printed until all insurers have paid.
In Checkout, if there are enough payments against the first charge & thus paid in full; the module will assume any additional payments will be made against the second charge.
Thank you for your response and I really appreciate it…!
Will try out with the recommended suggestions…
Just another clarifications, will it be good if we remove the insurance tags from the payments screen if its not appicable to the current screen.
From users perspective, there are chances to get assumed with the payments related to insurance and perplexed about how it works.
We do welcome your suggestions and feedback on this, about how this could be made simple enough so that the end user is comfortable in using the billing section in Openemr.
Insurance billing is so complex in the US that we all get migraine headaches when we have to talk to insurers. If we are paid within 2 weeks, we are overjoyed. I hear in Australia physicans are paid within 24 hours. Billing Nirvana!
For your clients outside of the US, if their patients are mainly self-pay, Charges Panel is a wonderful little module. One-stop shopping.
Would suggest that the Insurance column remain, for those cases where patients have insurance. If the patient is self-pay, just use Checkout to generate receipts.