Billing Patient Statements

After creating your statements, you are now ready to bill them. When a statement is first created, it is not marked as either a paper statement, or an electronic statement. This gives you the option of sending the statement either way.

Printing Paper Statements

In order to print your paper statements, take the following steps:

  1. Create your statements using the process outlined previously.
  2. Click the Print/Send button.


  3. The following window will appear. Select Paper. You will also see a field labeled Exclude Billed Paid Entries. This field will cause the statements to ignore any transactions that have a balance of zero, regardless of whether the entire statement has been paid or not. We recommend that you check this. Once you have made your selections, click OK.


  4. You will now be asked to select a format for your patient statements. Medisoft comes standard with the formats listed. You also have the ability to modify these formats in order to create your own. If the statements you have created are remainder statements, you MUST select a remainder statement format. If the statements you have created are standard statements, you MUST select one of the other formats. After making your selection, press OK.


  5. The program will now prompt you to select where you would like to output your statements. In order for the statement to be marked as billed, you must select either the option to Print the report on the printer or Export the report to a file. Make your selection and click Start.


  6. You will see the Data Selection Questions screen. This screen will allow you to filter your statements. The Statement Total Range will default to 0.01 to 99999. This means that you will only get statements with a total between 1 cent and $99,999. If you want zero or negative balance statements, you will need to modify this value. You will also see a Statement Number Range. This filter will default to a range including the entire range of statements in statement management. Do not change this filter. Make any other selections you wish to filter on and click OK.


  1. The statements will be sent to the output device previously specified.

You will note that Statement Management works in a much different manner than Claim Management. The statements printed are NOT limited to those statements with a status of Ready to Send and a batch set to 0. You will get any statements that have charges with outstanding balances on them.

Additionally, if the same patient or guarantor has multiple statements created in statement management, those statements will NOT print out on separate forms. They will be combined into one statement when printed. There is one exception to this condition. If you have created statements in both the standard and remainder formats, the statements will not merge with other statements with a different type.

Tips and Tricks:

It is possible that charges appear on a remainder statement prior to being paid by the insurance carrier. This has to do with the allowed amount settings. See the Allowed Amount handout for more information.

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Billing Patient Statements

After creating your statements, you are now ready to bill them. When a statement is first created, it is not marked as either a paper statement, or an electronic statement. This gives you the option of sending the statement either way.

Printing Paper Statements

In order to print your paper statements, take the following steps:

  1. Create your statements using the process outlined previously.
  2. Click the Print/Send button.


  3. The following window will appear. Select Paper. You will also see a field labeled Exclude Billed Paid Entries. This field will cause the statements to ignore any transactions that have a balance of zero, regardless of whether the entire statement has been paid or not. We recommend that you check this. Once you have made your selections, click OK.


  4. You will now be asked to select a format for your patient statements. Medisoft comes standard with the formats listed. You also have the ability to modify these formats in order to create your own. If the statements you have created are remainder statements, you MUST select a remainder statement format. If the statements you have created are standard statements, you MUST select one of the other formats. After making your selection, press OK.


  5. The program will now prompt you to select where you would like to output your statements. In order for the statement to be marked as billed, you must select either the option to Print the report on the printer or Export the report to a file. Make your selection and click Start.


  6. You will see the Data Selection Questions screen. This screen will allow you to filter your statements. The Statement Total Range will default to 0.01 to 99999. This means that you will only get statements with a total between 1 cent and $99,999. If you want zero or negative balance statements, you will need to modify this value. You will also see a Statement Number Range. This filter will default to a range including the entire range of statements in statement management. Do not change this filter. Make any other selections you wish to filter on and click OK.


  1. The statements will be sent to the output device previously specified.

You will note that Statement Management works in a much different manner than Claim Management. The statements printed are NOT limited to those statements with a status of Ready to Send and a batch set to 0. You will get any statements that have charges with outstanding balances on them.

Additionally, if the same patient or guarantor has multiple statements created in statement management, those statements will NOT print out on separate forms. They will be combined into one statement when printed. There is one exception to this condition. If you have created statements in both the standard and remainder formats, the statements will not merge with other statements with a different type.

Tips and Tricks:

It is possible that charges appear on a remainder statement prior to being paid by the insurance carrier. This has to do with the allowed amount settings. See the Allowed Amount handout for more information.

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Transactions

The Transactions tab will show you which charges are attached to this statement.

You will also have the same options on this tab as you did on the corresponding tab within Claim Management.

Add: Clicking the Add button will allow you to add eligible transactions to this statement. In order for a transaction to be eligible for addition, it must meet the criteria required for the type of statement you are editing. This means that all conditions discussed during the Troubleshooting Creating Statements must be met.

Split: If you click the Split button, you will be able to split transactions off of the existing statement and onto a new statement.

Remove: Clicking the Remove button will take the highlighted transaction off the statement. That transaction will then be subject to addition to another statement if it remains eligible.

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There are two types of patient statements.

  1. Standard Statement: This type of statement will show all charges that have a balance on them. The balance shown on this statement is the Patient Reference Balance. If you print or send standard statements, your patients will get statements showing a balance that may not reflect the amount the patient will need to pay. For this reason, we recommend that you do not use standard statements for patient billing purposes.
  2. Remainder Statement: Patient remainder statements will show the charges that make up the patient remainder balance. This means that charges that have not yet been paid by responsible insurance carriers will not appear on these statements. We recommend that you use remainder statements for patient billing purposes.
  3. Missed Co-pay Remainder Statement: The only difference between this and the Remainder Statements is that this statement will include missed copays in the total amount due. In order for this statement to work properly you must turn this function on in Program Options by checking the Add Copays to Remainder Statements field in the Billing tab. This statement function is only available using Statement Management.
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Comment

The comment tab will allow you to enter various comments regarding this statement. These comments will not be included on any printed or sent statements. They are for internal use only.

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  1. The Show Unpaid Only field does not have any effect on patient payments.
  2. The Payment Procedure Code fields will automatically populate with the codes that were entered during the creation of the deposit. These are the codes that will be listed on the line item entries within the patient ledger after the applicable charges and adjustments are applied. You do not need to change these fields.
  3. At the top of the screen you will see a field labeled For. This field is used to designate the patient for whom the payment(s) and adjustment(s) are being entered. This field will default to the same chart number that was entered when creating the deposit. You do have the ability to change the chart number. If you select a patient that does not have the person making the payment listed as the guarantor, you will see the following message. Clicking Yes will allow you to apply the payment anyways. Clicking No will force you to select a different patient before proceeding.


  4. Once you have selected the chart number of the patient to whom the payment will be applied, you are ready to actually apply the payment. The first step in applying the payments (and adjustments) is to identify which charges are being paid or adjusted. You can identify the specific charges by using the Date, Procedure, Charge, and Remainder fields. The remainder field tells you the balance on each charge.


  5. Once you have identified the charges you wish to pay or adjust, enter the amount of the payment that will be applied to each charge in the column labeled Payment, and the amount (if any) that you wish to adjust off each charge in the Adjustment column.


Tips and Tricks:

If you apply a payment amount greater than the remainder amount, you are indicating that an overpayment was made on that charge. The patient is usually due a refund in this instance. The refund should be entered as a positive adjustment.

  1. After entering your payment and adjustment amounts, click Save Transactions. At this point, we are making line item entries into both the mwtrn.adt and the mwpax.adt tables.


  2. If the payment was made for multiple patient accounts, you can now change the chart number in the For field to the next patient to whom you wish to apply the payment.
Tips and Tricks:

Normally you would want to apply the entire payment before leaving the payment application screen. If you do this, the unapplied amount field will show 0.00.

If you do not apply a payment completely, the balance and AR totals will only be affected by the amount you apply.

  1. After applying and saving the payments and adjustments, click Close.

Following this process will allow you to enter and apply patient payments from the deposit list. It is important to note that copays entered through Office Hours into the deposit list will be listed as unapplied payments until you go through and manually apply them to the charges.

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Insurance Payments

To enter an insurance payment from an EOB, take the following steps from within the Deposit List.

  1. Click the New button.


  2. The following screen will appear.


  3. The Deposit Date field specifies the date of payment and adjustment that will be listed in the patient ledgers. This date will default to the computer’s system date. You can manually change this date in order to enter payments that were received on previous dates.
  4. The Payor Type field will default to Insurance. This is the value you want here for a non-capitation insurance payment.
  5. Enter the entire amount listed on the check in the field labeled Payment Amount.
  6. In the field labeled Insurance, enter the insurance code for the carrier making the payment.
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Deposit List

The Deposit List is a feature that is only available in Medisoft Advanced and Medisoft Network Professional. This feature will allow you to quickly apply an EOB to multiple patients. It will also track payments that have been entered into Transaction Entry. Any payments entered into Transaction Entry will be automatically entered into the Deposit List and will be listed in the Deposit List as applied payments.

Navigation of the Deposit List

Prior to utilizing the Deposit List, it is important to know the different functions it can perform.

It is important to note that items entered into the Deposit List WILL NOT affect accounts receivable totals until they have been applied to specific charges. This is important to note because it has implications on reports. Reports based on the Deposit List will not match reports based on the Transaction Entry file. This is because the accounting reports are based on the mwtrn.adt table. The Deposit List does not update this table until payments have been applied.

When you first open the Deposit List, you will see the following screen:

We will now discuss some of the fields available to you and explain what they are used for.

Deposit Date: When you first open the deposit list, the Deposit Date field in the upper left corner of the screen will default to the system date. Selecting a date in this field will allow you to see all payments made on that particular date. By default, you will see all payments made today.

Show All Deposits: If you want to see all payments regardless of date, place a check mark in this field.

Show Unapplied Only: This option will allow you to only view deposits that have not been applied, or deposits that have only been partially applied. This is useful in determining which deposits still require work.

Sort and Search: The sort and search functions work in the same manner as the sort and search functions discussed in previous chapters.

Detail: In the upper right corner of the deposit list you will see a button labeled Detail. This button will only be available if you have selected an existing patient or insurance payment that has been applied. Clicking this button will show you the patient accounts to which the deposit has been applied.


 

The Deposit List Detail window can be printed by clicking on the Print Grid button on the right side of the window. This can be helpful for finding discrepancies between an EOB and what has been posted by allowing users to print the detail and compare. Additionally, the printed version will show the dates of service and procedures for the charges to which the payment was applied.

Tips and Tricks:
Because you do not apply capitation payments, you will not have access to the Detail button when a capitation payment is highlited.

 

Export: Clicking the Export button will allow you to export your deposit list to either Quicken or Quickbooks.

Through the deposit list you can apply three types of payments.

  1. Patient Payments: Patient payments entered through the deposit list can be applied to any charges regardless of case, document, or superbill number. These payments can also be made to different patient accounts. This allows you to enter payments that come from a guarantor for one of the patients for whom they are responsible. You will be able to quickly enter up to 2 types of transactions into the patient ledgers. (Patient Payment, and Adjustment
  2. Insurance Payments: Insurance payments entered into the deposit list can be entered for any patient. You will receive a warning message if you try to apply a payment to a patient who does not have that insurance carrier listed in their case information. Additionally, you will be able to quickly enter up to 5 types of transactions into the patient ledgers. (Insurance Payment, Disallowed Amount Adjustment, Withhold Adjustment, Takeback Adjustment, and Deductible)
  3. Capitation Payments: Capitation payments entered into the deposit list are not applied. Therefore they will not affect the practices AR totals. They will ONLY be reflected in your Deposit List reports. You will not see these payments on any other major accounting reports.

We will discuss the process for entering and applying all three of these types of payments. We will focus on the fields that have the biggest effect on the process. For information regarding fields not discussed, refer to the Medisoft Help Files.

 

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ERA Adjustment Posting

ERA (Electronic Remittance Advice) Adjustment Posting is an option that works in conjunction with Revenue Management. Revenue Management automatically reads the electronic EOB format returned by the insurance carrier, and applies the payments to the appropriate charges. This is the most efficient way to post payments. The process for posting an electronic EOB will be discussed in the blog posts covering EDI.

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Transaction Entry Buttons

Transaction Entry has various buttons at the bottom of the screen.


These buttons perform the following functions:

Update All: The Update All button is used to update the displayed transactions to include changes made to either the Case setup or the Procedure Code setup. These changes would affect which payors are responsible for the particular charges, or the type of transaction.

Quick Receipt: If you click the Quick Receipt button, Medisoft will print out the walkout receipt format that is selected on the Billing tab of the Program Options screen under the Receipt field. This receipt is usually given to the patient on their way out of the office. The receipt details what procedures and payments were entered during that visit.

Print Receipt: Clicking the Print Receipt button will allow you to select a walkout receipt format for printing. These receipts will have the same properties as the receipt printed under the Quick Receipt button.

Tips and Tricks:

Walkout receipts will never contain insurance payments. These receipts are only designed to show which transactions were entered on the day of the visit. Insurance payments are not received in advance.

Print Claim: The Print Claim button will look at the transactions listed on the screen, and print claims for the transactions that have insurance carriers listed as eligible, responsible payors, AND have not previously been placed on a claim. This process will create a claim or claims in claim management for these transactions.

View eStatements: Select this button to open the BillFlash eView page for the guarantor associated with the case. See the BillFlash section of the eStatements chapter of the EDI documentation for more details.

Close: Clicking Close will close the Transaction Entry screen. You will need to apply any payments before clicking this button. If you have not saved your transactions before clicking this button, you will be prompted to do so.

Save Transactions: This button is used to save any new or edited transactions.

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