2015 User Conference The Ins and Outs of Patient Accounts April 23 and 25, 2015 Presented by: Kim Gingras EHR Training Specialist PM Session

2015 Office Practicum User Conference Objectives 1. Understand Charges vs Claims 2. Create and manage claims 3. Identify the use of Payments vs Credits tabs 4. Use Messages & Tasks to notate Patient Accounts 5. Learn how to print demand Statements and CMS Identify the items found in the Consents & Disclosures tab

2015 Office Practicum User Conference Accessing the Patient’s Account = F12

2015 Office Practicum User Conference Overview

2015 Office Practicum User Conference Insurance Once an insurance is attached to a claim you cannot delete/edit it.

2015 Office Practicum User Conference Charges vs Claims Charges Claims ●Current/ not Daysheeted ●No audit trail ●Not editable on the claims tab ●Current/Daysheeted ●Can View Claims Status History ●Archived claims are not editable in the charges tab

2015 Office Practicum User Conference Create/ Review Charges ●Patient not seen in office ○Hospital ●Miscellaneous charge (ex: form, interest, ROI, etc) ●Posting superbill charges ○Best practice What are some of the reasons for creating charges from the Patient Account?

2015 Office Practicum User Conference Posting Charges Basic Information Tab

2015 Office Practicum User Conference Posting Charges Other Items Tab

2015 Office Practicum User Conference Let’s Try It! #1

2015 Office Practicum User Conference Claims Lets review what Actions can be taken: ●Task: use this to create a reminder for claims follow up. ●Edit: use this to make claims corrections to error edits for rejected claims, i.e cpt/icd9, modifiers, ndc etc. ●Void: use this to remove or adjust a line item/claim, if voiding payments, it will place the payment amount into the Credits tab for future use. ●Recoup: use this when an insurance payer takes back (recoups) a payment previous made on a claim or line item.

2015 Office Practicum User Conference Claims Lets review what Actions can be taken: ●Revert Pat Resp: this button will transfer money on account that is in patient responsibility to the insurance responsibility. ●Change Payer: this button allows users to change the insurance payer on a claim ●Rebuild/Proof: use these buttons to correct that are out of proof when too much adjustments or excessive voidings have caused the account to go out of balance. ●Q Prim/Q Sec: use this to send the claim back to the Transmit queue to be sent to the clearinghouse.

2015 Office Practicum User Conference Let’s Try It! #2 & #3

2015 Office Practicum User Conference Payments What is the Payments tab used for? ●Posting payment for patient responsibility ○Copays, co-insurance, deductible ○Direct payments ○Apply unapplied credits ●Posting adjustments for patients, move money to patient responsibility. ●Posting patient’s insurance payments/adjustments

2015 Office Practicum User Conference Payments Remember Insurance payments are in Green, Patient Payments in Orange

2015 Office Practicum User Conference Credits How are Credits different from Payments? ●Credits are payments collected through the Schedule or the Credits tab on the Patient Account ○They are Copays, Pre-payments, Overpayments ○They sit in an unapplied state ●Payments is the area where the credits are applied to a line item. How do I ensure my Credits balance? ●Applying credits at time of posting ●Current Credits Report

2015 Office Practicum User Conference Current Credits Report Match this report to your daily posting!

2015 Office Practicum User Conference Common mistakes with Credits Common mistakes made when applying credits to charges ●Posted to incorrect DOS ●Posted to wrong line item ●Posted as actual method of payment instead of patient credit (PC)

2015 Office Practicum User Conference Let’s Try It! #5

2015 Office Practicum User Conference Methods to Notate a Patient Account No more... What are the different ways to notate a Patient Account?

2015 Office Practicum User Conference Methods to Notate a Patient Account Tasks

2015 Office Practicum User Conference Methods to Notate a Patient Account Messages What can messages be used for?

2015 Office Practicum User Conference Statements What can we do in the Statements tab?? ●Print a statement ○Insurance or patient ●Queue a statement ●Drop a claim to paper (CMS 1500) ●Print a ledger ●Save a PDF Copy ●Create custom statement labels

2015 Office Practicum User Conference Let’s Take a Look #6

2015 Office Practicum User Conference Consents A list of standard consent forms that patients have signed in OP.

2015 Office Practicum User Conference Disclosures What does the Disclosures tab display?

2015 Office Practicum User Conference Disclosures ●Claim file ●HCFA ●Statement

2015 Office Practicum User Conference Questions ?

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