This article should help you understand patient invoices so that you can make sure they are 100% accurate.
Before we dig into Patient Invoices/Statements we’d like to remind you that if you are trying to invoice insurers and only getting patient invoices, this is because there is no active insurance timeframe for the patient that matches the treatment date. Without insurance timeframes ChiroPulse uses the logic… “this patient has no insurance to invoice so all invoices for that patient will be sent to the patient”.
It is important to setup your default office invoice in Preferred Options “Your Office” Tab. We recommend Patient Invoice-3 for typical use, see below for more details. For each patient, you can specify their default invoice per claim in Claim Wizard page-1. This allows you to automatically invoice patients with a specific invoice per claim.
In Preferred Options… INVOICE SETUP tab you can setup your “typical” invoices. These can be changed “on-the-fly” when using Billing Invoice Wizard also! (see pictures below
Patient Invoice-3 & Walkout Receipt ~ See screen shot example below.
For the most part you would want to use Patient Invoice-3 as it is the most detailed, yet easy for the patient to understand. You can set Preferred Options using the Invoice Setup tab to customize the report. You can toggle the options on-the-fly while printing also.
(sample invoice-3 screenshot)
Patient Invoice-1 ~ See screen shot example below.
Patient Invoice-1 is useful as the various totals can be hidden to meet the needs if going to lawyers, etc. Some offices & patients like it’s format, others find it overwhelming. You decide for yourself. You can set Preferred Options using the Invoice Setup tab to customize the report. You can toggle the options on-the-fly while printing also.
(sample invoice-1 screenshot)
The only reasons why the Patient Amount Due might appear incorrect:
- Timeframe: if Deductible is wrong (primary, secondary or tertiary)
- Timeframe: if Outside Met Deductible is wrong (primary, secondary or tertiary)
- Timeframe: if coverage % is wrong (primary, secondary or tertiary)
- Timeframe: if Copay entered is wrong
- Timeframe: if Visit total is wrong. For example if you have a visit cap set to 5 visits then the 6th visit will be calculated to the patient share.
- When using non-collectable fees WITHOUT the fee schedule, an adjustment must be made if coverage is not 100% (note – fee schedule is exclusive to ChiroPulse365)
If the “patient amount due / Pay This amount” is incorrect in the reports then it will also be incorrect in your ledger (since both of these are calculated totals based on the insurance timeframe). In this case a transfer of the balance needs to be performed in Ledger to correct the “patient amount due / patient share” (vs the insurance share).
A balance transfer ALWAYS will keep the total payments due the same but transfer the responsibility for the amount to the patient or the insurer . Please do this as follows:
- Go to the patient’s ledger.
- Click on the transfer balances pulldown menu
- Select adjust patient share and/or copay due
- Enter the transfer date
- Enter the amount that would correct the estimated patient share in the ledger in the patient share box.
- Press OK
When correcting mistakes, the transfer must be billed in the billing invoice wizard to guarantee the patient invoice to be correct and reflect the transfer & ledger totals.
for example: in this case the patient amount due really is $677.03 but what really happened is you had the timeframe wrong and when you entered payments from the EOB you entered more payments (from the insurer) than the invoice expected the insurer to be responsible for. This is easily fixed as explained below. If you correct the timeframes future visit/charges entered should be correct going forward!
In this example the Ledger would be showing Estimated Patient Share of $1204.98 since that is the “Please remit this amount total” . So in the Ledger you must get the Est Patient Share to matches the “please remit total $677.03” which is correct. In Leger select Transfer Balance menu & enter a balance transfer “Patient Share” of -$527.95 to zero out the patient amount due and get the “pay this amount” correct” at $677.03. (sample invoice-1 screenshot)
Copays & Timeframes with Insurance coverage not 100%
ChiroPulse365: has IMPROVED LOGIC which allows and calculates timeframes with any scenario of insurance percent coverage AND copays AND allowed amounts. (i.e $20 copay with 80:20 coverage and set allowed amounts non-collectible fee schedule)