Using Payment Vouchers

Every payment, whether cash, check, credit card, electronic funds transfer (EFT), or “Other”, must be associated with a Voucher. The Voucher includes:

  • The date of the payment.
  • The amount of the payment.
  • The identity of the payer, be it an insurance company, the patient herself, or some other non-insurance payer.
  • A description of the payment.
  • A list of specific patient credits made from the payment. (A voucher could be for a large payment that you then split among any number of patient accounts.)
  • A list of any portions of the payment that were refunded to the payer.
  • [Checks only] Check number.
  • [EFT only] EFT Number.

For your convenience, when you enter a new Credit to the Daysheet, you can add a new Voucher on the fly, or you can apply an amount from a previously entered Voucher. If there are existing Vouchers that have not been fully distributed, you will see a reminder on the Credit screen as soon as you select the Payer. Just select the desired Credit Type to view and select an undistributed Voucher to apply. You can, of course, apply any amount up to the entire undistributed amount shown on the Voucher.

This notification was displayed as soon as the payer was selected. In this (unlikely) example, there are Vouchers with undistributed amounts among the payer’s checks, cash payments, credit card payments, and EFT’s and even Other Vouchers. (You would have to click in the notification field and scroll right to see them all.)
In this example, we have selected Credit Card as the Credit Type, then we clicked in the Credit Card Voucher field to show available Vouchers. We can now select an existing Voucher, or click the New button in the lower right to create a new Credit Card Voucher.

Viewing Existing Vouchers

If you should want to review existing Vouchers, remember that Vouchers belong to Payers, not Patients. The most direct way to access them is to start from the Payer that owns them. From the main navigation panel, open Billing Lookups, then the appropriate Payer List: Insurance Carriers, Patient (Self) Payers, or Private Payers (that is, Payers that are neither Insurance Carriers nor Patient Payers.

Select the desired Payer from the list. At the top of the Payer detail screen, you will see tabs that include the various types of Vouchers:

Just click the type in which you are interested to see a list of specific Vouchers. Below is shown a list of existing Check Vouchers for Patient Payer Donna Bailey. Double-click one to view or edit :

Note that you cannot change the amount of a voucher to less than the amount that has already been applied. For example, if you have a voucher of amount $100, and you have already applied $75, you cannot change the amount of the voucher to less than $75.

How to Refresh the Payer List on a Charge Entry

If new payers are added to a patient, or details such as insurance policy coverage dates are added or changed, the payers listed on a charge may not automatically update to reflect those changes. In that event, you can force an update to the Charge payer list by clicking the Refresh Splits icon in the toolbar above the Charge window.

After clicking the Refresh Splits icon, the list of two payers gains a third payer.

See related article:

How to Correct Payroll Errors

Once the payroll has been processed, you cannot undo it. If you notice an error afterwards, however, you can fix any credits that caused a problem and SOS will create correcting entries in the current payroll report.

Let’s say, for example, that a $50 payment from patient Jimmy Johnson is applied to a service rendered by Dr. Smith. The credit entry is saved, the daysheet is posted, and a line indicating a payment for Dr. Smith appears in the pending payroll list. At the end of the payroll period, the payroll is processed and checks are distributed to the providers in accordance with the report.

In reviewing the payroll report, Dr. Jones notices that it does not include a payment from Jimmy Johnson, even though he is sure that one was made. The front office investigates and finds that the $50 payment was applied in error to Dr. Smith’s service rather than to Dr. Jones’ service.

The correction is pretty straightforward:

  1. Open the credit in which Jimmy’s payment was recorded, and located the split at the bottom showing that it was applied to the service by Dr. Smith.
  2. Modify that split, changing the amount paid in the split from $50 to $0 and save it. The credit will now show that $50 now shows as unapplied.
  3. Find the appropriate service by Dr. Jones among the outstanding charges, and apply the now available $50 to it.
  4. Save the credit entry.

After making and saving the change, take a look at the pending payroll list. You will see a line subtracting a payment from Dr. Smith, and another line adding a payment for Dr. Jones. When the payroll is run and checks are generated at the end of the period, Dr. Smith will receive less in his check to make up for the previous over-payment, and Dr. Jones will receive the back pay owed to him.

The bottom line is that you can just go ahead and fix errors in the patient ledgers and SOS will automatically create the appropriate payroll adjustments in the current pending payroll list.

How to Record a Refund

You may refund undistributed amounts to any payer.

Start by checking to see if the amount you want to refund is available in the system as undistributed funds — that is, funds that have not been distributed to specific patient accounts in the form of a credit entry and have not been applied to any specific charges. If the amount that you want to refund has already been applied, you can reverse the payment to convert the amount to undistributed, making it refundable. See How to Reverse a Credit Entry, Bounced Check, or Over-Payment for the details.

  1. In the Navigation Bar on the left side of the screen, click the type of payer (Insurance Carrier, Private Payer, or Patient (Self) Payer) you want to review. Look for non-zero amounts in the Total Undistributed Amount column. (Tip: Use the filter row just beneath the Undistributed column heading to change the column filter to “>”, then and type in a zero. Remember to clear the filter when you are done, using the same drop list.)

  2. When you find the desired payer in the appropriate Payer list, confirm that the undistributed amount is at least as much as you intend to refund.

  3. Open the Payer by double-clicking or by selecting the row and clicking the Edit (pencil) button on the tool bar.
  4. Now look through the various Voucher tabs to locate the undistributed amount(s) that you want to refund.

  5. To do the refund, open the detail view (Edit) the Voucher, and select the Refunds tab in the list box at the bottom.

  6. Click the New button to record the amount to be refunded and the date, then save and exit on this screen as well as on the Voucher.

  7. Notice that the undistributed amount on the Voucher and the Payer will now be reduced by the amount of your refund.
  • Start by checking to see if the amount you want to refund is available in the system as undistributed funds — that is, funds that have not been distributed to specific patient accounts in the form of a credit entry and have not been applied to any specific charges.
    • In the Navigation Bar on the left side of the screen, click the type of payer (Insurance Carrier, Private Payer, or Patient (Self) Payer) you want to review. Look for non-zero amounts in the Undistributed column. (Tip: Use the filter row just beneath the Undistributed column heading to change the column filter to “>”, then and type in a zero. Remember to clear the filter when you are done.)

How to Move a Payment from One of a Payer’s Patients to Another

Both insurance payers and non-insurance payers may be shared among two or more patient accounts. In fact, when it comes to insurance payers, that is the typical situation. The same large insurance payer, such as Medicare or United Healthcare, may well appear on the payer lists of many of your patients. Likewise, you might create a non-insurance payer for one of the parents in a family in which several family members, each with their own SOS account, are receiving treatment. Yet another example would be a forensic practice that receives payment from a law firm for several different client accounts.

When payments are received from one of these multi-patient payers, the payment can be attributed to one or more of the patient accounts that list that payer. There are several reasons why you might want to move a payment, or part of a payment, that was credited to one account to a different account:

  • There might have been a clerical error in which an amount was credited to the wrong account.
  • An insurance payer might issue a “take back”, in which an amount paid originally is reduced, and you are instructed to apply the difference to a service rendered to a different account.
  • A prepaid amount will not be needed on one account and the payer has requested that it be applied to a different account.

If you want to understand the procedure for moving payments from one patient account to another, you must first understand the difference between undistributed payments, unapplied payments, and applied payments. If you are fuzzy on the distinction, please review the article entitled What is the Difference Between Unapplied and Undistributed Payments? In general, moving the payment requires that you convert an applied or unapplied payment on the first patient’s credit back to an undistributed payment for the payer. Once the payment status is reverted to undistributed, it can be used as a credit for any other patient linked to the payer.  Remember that in each of these scenarios, it is essential that both patient accounts share the same payer.

If the amount to be moved is unapplied…

If the amount to be moved is available as an unapplied payment in a credit entry for Patient One, then:

  1. Open a Patient One credit that has an unapplied amount. That is, the credit amount is more than the total of what has been applied to charges in the credit splits.
  2. Confirm that the unapplied amount matches or is greater than the amount you want to move to Patient Two.
  3. Reduce the amount of the credit entry by the amount you want to move, but the new Credit Amount must be the same or more than the amount applied in the credit splits. If you make the credit amount too low, the Amount Unapplied will show a negative amount and you won’t be able to save the modified credit entry.
  4. Note the description of the voucher, for example, the check number of the payment.
  5. Save the credit. As the credit with its new, lower amount is saved, the unapplied payment amount on the Patient One credit will be reduced or eliminated and the undistributed amount of the payer’s voucher will increase by the same amount.
  6. Now create a new credit entry for Patient Two.
  7. Select the voucher noted in step 4 above as the payment source and adjust the amount of the credit as desired. It can be any amount up to the available undistributed amount available on the voucher.
  8. Apply the payment to Patient Two services or simply save the amount as an unapplied payment for Patient Two.

If the amount to be moved is already applied…

If the amount you want to move is more than the unapplied amount of the credit, or there isn’t any unapplied amount, then you must reduce the amounts of one or more credit splits you have already applied to services in order to proceed:

  1. Double-click one of the Credit Splits appearing in the list box at the bottom of the Credit Entry form. This list sits BELOW the Charge Splits list.
  2. Double-click a credit split you would like to reduce, change the amount, and save. Do the same for other credit splits if appropriate.
  3. As you save the change to each credit split and return to the Credit window, you will notice that the Amount Unapplied will increase by the same amount.
  4. Now decrease the Credit Amount by that amount. When you save changes you have made to the credit, the payer’s payment voucher (in this example, the voucher for check number 54325432543) will reflect that the amount is now undistributed.
  5. You can now enter a new credit for Patient Two, selecting the payer’s check number 54325432543 as the payment source.