Cycle Billing

Cycle billing is a feature that can increase the cash flow to the office. Using cycle billing allows an office to send statements out more than once a month without sending multiple statements for the same transactions. This feature is most useful in offices that do not require frequent, regular visits for their patients. To use cycle billing, take the following steps: (Note: Steps 1-3 are only required for initial setup of cycle billing. Once these steps are completed, you can begin the process of billing starting with step 4.)

  1. Open the Program Options screen to the Billing tab.


  1. You will see a section of the screen labeled Statements. In this section, there are two fields that must be configured in order to use Cycle Billing. Place a check mark in the field labeled Use Cycle Billing. You will also need to specify the length of your cycle. This is done in the field labeled Cycle Billing Days. This field should usually have 30 entered in it. With this number we are specifying the number of days that must elapse before a statement is printed again.


  1. After setting these values, click the Save button.


  2. Open Statement Management by clicking the Activities menu and Statement Management.
  3. There are certain fields that are useful when doing cycle billing. These fields do not default into your grid display within Statement Management. You will need to add these fields to the grid. Click the small black dot to modify the grid.


  1. The Grid Columns window will open. Click Add Fields.



  2. While holding the [CTRL] button down, click on the fields labeled Last Billing Date and Next Statement Date. This will select both of the fields. Click OK.


  3. You will see those two fields added to the Grid Columns window. Click OK.
  4. You will now see columns in Statement Management labeled Last Billing Date and Next Statement Date.
  5. If you follow the steps outlined above for billing your statements, you will see these fields populated. As long as you are using cycle billing, the transactions attached to statements will not appear on another statement until the date listed in the Next Statement Date field.


As previously stated, Cycle Billing is not a tool that all offices would find useful. If patients have multiple visits during a particular month, it is possible that they could get multiple statements during that month. If patients are only seen few times each year, cycle billing will allow them to send statements as often as they would like, without sending multiple statements to the same patients/guarantors.

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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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Editing a Patient Statement

Once your statements are created, you can view and edit those statements from within Statement Management. To edit a statement, simply double-click the statement you wish to print. The following screen will appear.

The upper portion of the screen will be available regardless of which tab you have selected. This section of the screen will tell you the statement number, who the guarantor is, the remainder balance, and the date the statement was created.

General

On the general tab, you will see general information regarding this statement.

Status:  The Status field tells you where in the billing process this statement is.  When a statement is first created, it has a status of Ready to Send.  When a statement is first billed the status is changed to Sent.  Once the balance of all transactions on the statement reaches 0, the status is changed to Done.  The other status fields are used for your own purposes.  If you wish to use these other codes, you must manually set the statements to these status codes.

Billing Method:  The Billing Method field lets you specify whether you want to print out a paper statement or whether you want to send the statement electronically.

Type:  The Type field specifies whether the statement is a standard or remainder statement.  As you can see, this field is not one you can modify.  If you need to change this for any reason, you MUST delete the statement and recreate it.

Tips and Tricks:If you create standard statements and wish to change them to remainder statements, you will not be able to create statements for all of the patients originally listed in statement management.  This is because standard statements look for any charge with a balance, while remainder statements only look for charges making up the patient’s remainder balance.

 

Initial Billing Date:  This field specifies the first date the transactions attached to this statement were actually billed on a statement.

Batch:  The batch number is updated the first time a statement is printed or sent.  All statements billed at the same time will be assigned the same batch number.

Submission Count:  The Submission Count field tracks how many times the transactions attached to this statement have been billed to the guarantor

Billing Date:  The Billing Date field will tell you the last time these transactions were billed to the guarantor.

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Statement Management

There are two methods for actually printing your patient statements. The first method we will discuss is Statement Management. Statement Management handles statements in a similar manner to the way Claim Management handles claims.

Statement Management
allows you to integrate your statements into your collections module (Collection List). Additionally you will be able to utilize the cycle billing feature.

This section will examine the different processes you will use within Statement Management to effectively bill your patients.

To open Statement Management click the Activities menu and Statement Management.

Statement management is ONLY available in Medisoft Advanced and Medisoft Network Professional.

Creating Statements

In order for a transaction to print on a patient statement, that transaction must be created on a statement. In order to create statements, take the following steps from within Statement Management:

  1. Click the Create Statements button.


  2. The following window will appear. Here you will be have the ability to filter which transactions are created on statements. Leaving these filters blank will look for any ELIGIBLE transactions that have not been placed on a previous statement, and place them on a new statement.


  3. In the Statement Type section you have the option to create either Standard or Remainder
    Statements. If you select Standard, you will create statements for all eligible transactions regardless of the party that is currently responsible for the remaining balance. If you select Remainder, you will create statements for all eligible transactions with balances that are currently part of the Patient Remainder Balance.
Tips and Tricks:

When creating statements, each transaction can only be placed on one statement. If you create a standard statement, you will not be able to create a remainder statement for the same transaction unless you delete the original standard statement.

We suggest that you select one type of statement and ALWAYS create statements using that type.

 

  1. Once you have made your selections, click Create.


  2. If the following screen appears, no eligible transactions were found within the parameters set.


  3. If eligible transactions were found, you will see new statements created on the main statement management screens. These statements will have a Status of Ready to Send and a Batch number
    of 0.
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Family Billing


Medisoft Patient Accounting prints one statement per guarantor. A guarantor is the person listed as financially responsible for charges on a patient account. The guarantor is set on a case by case basis on the Personal tab of the case screen.

If a guarantor has multiple patients with balances eligible to print on a statement, all of those patients and charges will appear on one statement sent to the Guarantor.

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11. You will now see the payment listed on the main screen of the deposit list.

12. Highlight the payment and click Apply.


  1. The following screen will appear.


  1. You will see various fields that are grayed out. These fields do not apply to patient payments.
  2. By default, the only charges you will see are charges that have a remainder balance (meaning charges that have been paid by all responsible insurance carriers). If you would like to see charges with balances, regardless of remainder status, uncheck the box labeled Show Remainder Only.


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Patient Payments

To enter a patient payment, 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. Change it to Patient. You will see the window display change.


  5. When selecting the Payment Method, you will have the option to select Check, Cash, Credit Card, or Electronic. Make your selection according to the method the patient used when making the payment.

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  1. The fields labeled Payment Code, Adjustment Code, Withhold Code, Deductible Code, and Takeback Code. These codes represent the 5 types of transactions that can be entered into a patient’s ledger through the deposit list. These codes MUST be entered prior to applying the payment. You can set up default codes to be used for payments from each insurance carrier. This is done on the Options and Codes tab of the insurance carrier setup screen.


  2. Click Save. At this point you have updated the mwdep.adt table, but have not yet updated the mwtrn.adt or mwpax.adt tables.
  3. You will now see the payment listed on the main page of the deposit list. Highlight it and click Apply.


Tips and Tricks:

If you see EOB Only in the amount column, that indicates that there was not an actual payment made, and that the EOB indicates the reason payment was not made.

  1. You will see the following screen. In the For field enter the chart number for the first patient listed on your EOB. Any charges that have not yet been paid by that insurance carrier will be displayed. If there are charges on the patient ledger that do not appear on this screen, you may want to try unchecking the field labeled Show Unpaid Only.


  1. The first step is to locate the charges that were paid and to which you need to apply the payment. The EOB should list the date of service, the procedure code, and the amount billed. These fields are available to you on the left side of the window. You will need to find the charges using these fields. Additionally, you will see the balance remaining on each charge in the column labeled Remainder.


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Transaction Entry

During the recent blog posts discussing the Transaction Entry interface, we discussed the process used for entering payments and adjustments through the Transaction Entry screen. This process must be followed for entering insurance EOBs as well.

It is important to note that when entering payments through transaction entry, you will only have access to one patient and case at a time. This means that you will need to break out the EOB into multiple payments in order to apply it to each patient. Additionally, you will need to manually create each type of necessary adjustment.

If you are using Medisoft Original, you have no choice but to enter your payments through Transaction Entry.

Quick Ledger

(Please Note: The Quick Ledger is a feature only available in Medisoft Advanced and Medisoft Network Professional.)

Medisoft has the ability to change the current responsibility for a charge through the Quick Ledger. When doing this, you can only use the Quick Ledger to move the responsibility to a subsequent party. An example of this would be to move the responsibility from the primary insurance carrier to the guarantor. When using this feature, the program will automatically enter a payment with a 0 amount and mark it complete. This will effectively move the balance to the designated party.

This is done by simply right-clicking on a charge, clicking Responsibility, and then selecting the party you want to make responsible for a charge.

Tips and Tricks:

Insurance carriers will not be listed as the responsible party until a claim has been billed to them. Until the primary carrier has been billed, the responsibility will be listed as Patient Responsible.

If you want to undo this process, you will not be able to simply right-click and change it back.

The only way to undo this process is to open Transaction Entry to the screen including the payment that was created. You should then highlight the payment and click Apply. You will then have the opportunity to remove the Complete checkmark. This will take the responsibility back for that payor. If you have multiple 0 payments that were created, you will need to repeat this process for each carrier’s payment. If you wish, you can then delete the 0 payments. It is IMPERATIVE that you uncheck the Complete box PRIOR to deleting the payment.

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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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