Category: G5

Generating Patient Statements

Posted on | by SOS Blog

Most organizations generate patient statements monthly, but you can do them any time you please, with many filter options and other options to customize the accounts and specifics included in the output. SOS offers three very different kinds of statements:

  • The Standard Statement is similar to bank and credit card statements in that it includes an itemized listing of the activity (charges and credits) on an account during a specified date range.
  • The Open Item Statement is quite different in that it is not restricted to a date range and lists only items that still have an open balance, that is, those account charges that have not been fully paid or resolved by applying adjustments of some sort. The date of the charge entry is irrelevant.
  • The Alternate Statement By Charge is similar to the Open Item statement, but you can specify a date range and the output includes all charge entries within the range, whether there is a remaining balance or not.

If you are not already familiar with these statement options from previous versions of SOS, it is a good idea to run a sample of each one using your own data so that you can compare the types and select the one you think would work best for your organization.

To run a statement, you start at the Statements section of the Navigation bar, in which you will find Create Statements.

From there, highlight the desired statement selection on the right and click Print Report in the toolbar at the top.

If you choose Standard Statement the options page that appears will offer numerous filter and content options as well as several Type of Statement variations (All payer summary, All payer details, Payer specific details). Each of the variations provides a different level of detail. SOS recommends that you run a sample of each one, using your own data, to compare the options. You should then be able to make the best choice for your organization.

The Open Item Statement has fewer filter and content options. You may want to run a sample, especially if you are still not altogether clear about the difference between Standard and Open Item billing.

The setup for Alternate Statement By Charge is similar to that of the Open Item type, with the addition of the date range.

Note that all statement approaches allow you to include a section that prints the account aging information. Aging tells the payer exactly how much is still owed on charges that were due 30, 60, 90, or 120 days before the current billing was generated. Among the options available in each case is one to recalculate aging to be sure that it matches the dates covered by the statement.

Standard Statement Options. Adjust the options as desired, then click OK to continue.
Open Item Statement Options. Adjust options as desired, then click OK to continue.
Alternate Statement By Charge Options. Adjust options as desired, then click OK to continue.

Next, you will see your statement batch appear in the report preview window. From here you can scroll through or use the Search feature to locate a particular statement you may want to examine. Once satisfied, you can print or export the results. If you export, some of the formats (such as PDF) will offer you yet more options.

Open Item batch shown in the report preview window.

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

Posted on | by SOS Blog

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.

Managing Patient Insurance Payers (Policies)

Posted on | by SOS Blog

To add a new patient insurance policy, or to view the details of an existing policy:

  1. Find the desired patient in the Patient List.
  2. Double-click the row to open the Patient detail view.
  3. Click the Payers tab.
  4. If the Insurance Policies tab is not currently selected, click that tab to see the list.
  5. To add a new policy, you can do any of the following:
    • Press <CTRL><N> on the keyboard.
    • Click the first icon in the toolbar for this tab.
    • Right-click the list and select New from the pop-up menu.
  6. To view the details of an existing policy, just double-click the desired policy row in the list.

PatientPoliciesList.png

The Patient Insurance Policy detail view looks like this:

Policy DV.png

Notice that there are several tabs on this form:

  • Main has fields for the basics, such as the Insurance Plan, coverage dates, type of services being billed, type of policy, and over-rides for co-pay settings inherited from the policy’s Insurance Plan. On this tab you also can see current aging and balance data.
  • Managed Care Auths lists any authorizations. You can add new authorizations here, and view or edit the details of previously defined authorizations. For more information about Managed Care Authorizations see Adding and Changing Managed Care Authorizations.
  • Claim Form contains fields that are needed to submit a claim, ranging from the Insured’s ID Number (Subscriber Number) to “Accept Assignment”. These are fields that you will probably recognize immediately from the CMS 1500 form.
  • Patient Insurance Policy Attachments is a list of other documents associated with this policy. The most commonly attached document is a scanned copy of the patient’s insurance card, but there is no restriction or limit to the documents you can attach from this screen.
  • User Defined Fields
  • Change Log

See also: Understanding Insurance Carriers, Plans, and Policies

Selecting the Best Payroll Calculation Method for Your Organization

Posted on | by SOS Blog

Many organizations pay their providers based on production. SOS G5 includes calculation of production-based payroll using either of the following approaches:

  • Net Fees (total fees charged, less adjustments).
    Example: Provider renders a service with a fee of $100, but the fee is reduced by patient discounts and/or insurance contract amounting to $30. The payroll calculation will be based on $70. The amount paid has no effect on the payroll calculation when you use the Net Fees calculation method.
  • Payments applied to services rendered by the provider.
    Example: Provider renders a service with a fee of $100. At the time of the payroll calculation, a total of $50 has been received and applied to this service. The payroll calculation will be based on $50. Later payments against this service will be included in future payroll calculations. If another $30 is received before the next payroll run, that $30 will be included in the next payroll calculation.Note that only APPLIED payments are included in payroll calculations. If a payment has been received, but has not yet been applied to a specific service, it will NOT be included in the calculation! If it is later applied, it will be included in the next payroll.

Typically, the total of the net fees or the total of the payments will be multiplied by the Payroll Multiplier specified for the Provider Billing Profile on each service entry.  If a multiplier is not specified on the Provider Billing Profile, then the default Payroll Multiplier on the main Provider screen is used.

Using the Net Fees method example above, this provider would receive $42 ($70 multiplied by 60%).

Using the Payments method example above, this provider would receive $30 ($50 multiplied by 60%) in the first payroll, and another $18 ($30 multiplied by 60%) in the second payroll.

See also:
Running Provider Payroll

Printing a Deposit Reconciliation Report

Posted on | by SOS Blog | 1 Comment on Printing a Deposit Reconciliation Report

SOS recommends that you reconcile your actual cash and checks with the receipts entered in the system prior to creating your bank deposit slip and making your deposit. Doing so is a simple matter. The system keeps a running list of your payment vouchers as you enter them, whether or not they are actually applied to outstanding patient account balances. View them by navigating to Billing > Deposit.

Notice that the Deposit list shows only physical payments (cash and checks) that you would include on a bank deposit slip.

  • First, keep in mind that the Deposit screen is a list like most others in SOS, so you can easily filter the list by specifying values in one or more columns at the top of the list. For example, you can specify a particular Payer name at the top of the Payer column, a particular date or date range at the top of the Date column, or a particular payment type at the top of the Type column. Doing so will immediately hide all rows that do not match your filter conditions. You can then selectively highlight the desired payments using the following techniques.
  • If you want to print or post everything in the Deposit list, use the Tag All button (third button of the four shown in the image above).
    If you want to print or post a group of consecutive payments, click the first one to highlight that one, then hold down the <SHIFT> key and click the last one in the group to highlight everything in between.
    If you want to print or post more than half of the payments, first highlight the whole list using the Tag All icon, then hold down the <CTRL> key and click each of the rows you want to un-tag.
    If you want to print or post less than half the list, you can reverse the above technique. Start by using the Un-tag All button (button four) then hold down the <CTRL> key and click the payments you want to tag.

Preview and print the Deposit

Once you have the desired payments tagged, SOS suggests that you preview and optionally print a hard copy or generate a PDF of the Deposit before posting. Click the Print Deposit button (the second of the Deposit buttons on the toolbar).

(Replace with Screenshot)

Posting the Deposit

Once you have checked over your Deposit preview and printed a hard copy or saved a copy as a PDF to a secure location (remember that this report may contain HIPAA protected data), you are ready to post the Deposit, archiving the tagged payments and removing them from the list. You might even want to wait until you have confirmation that the bank deposit has actually been made.

To post, simply click the Post Deposit button on the toolbar. The tagged rows will disappear from the Deposit list. They then can be viewed and modified if necessary from the individual patient ledgers.