Last updated 9/20/04

Billing Information Screen
This screen breaks down billing information into three logical steps, as outlined below. There is on screen help available for each section by clicking the Help me! button.

Guarantor Information


GREAT NEWS!! In PracticeMaker® the patient is assumed to be his or her own guarantor. If the patient is NOT responsible for any balance, then create a guarantor record for the other party that is responsible. This party will be mailed all statements.  Patients who would need a guarantor are:

• Children 21 or younger
• Full-time students 23 or younger
• Patients who have given another party Power of Attorney.

If the patient is the guarantor for OTHERS than you can click the Pat -> Guar button.  This will create a record using the patient’s information and assign a guarantor Code that can then be linked to other family members!

To review the patient’s guarantor record click Review Guar.

To learn more about entering guarantors click here.

If a patient is under 21 but is on their own and does not need a guarantor, change Guarantor Override to "Yes". This will eliminate messages reminding of the need for a guarantor!

If the patient’s Guarantor is currently a patient and is the guarantor for other patient’s in the practice, the name may appear in the pop-up list associated with the Code field.  If so, just select the person (the list is in Alphabetic order).

If the patient’s Guarantor is currently a patient but has not been assigned a guarantor’s code, here is what you do:

1. Find the patient’s record who will be the guarantor.
2. Click the Pat -->Guar button and confirm your action at the dialog box.
3. This patient has been assigned a guarantor’s number and appears on the pop-up list.
4. Return to the original patient’s record and select the guarantor from the list.

If the patient’s Guarantor is currently NOT a patient you will need to create a guarantor’s record.  Click the New Record button and confirm your action at the dialog box.

The Guarantor field links all related patient’s together and calculates the total balance do by those family members which ultimately must be paid by the guarantor!

Insurance Information


A patient can have unlimited insurance records. These records are stored in the Coverages module.  It is NOT necessary to ever delete a patient’s past insurance information.  Insurance information no longer used is assigned a Billing Priority of "99".

• To create a new record click the Add Insurance button and complete the record. You can read more about this in the Coverages Module chapter.
• To edit a current insurance record for a patient click the Edit button. You will be warned if there is any outstanding insurance balance as a warning that you should not play!
• If you need to fix an incorrect Subscriber ID or Group No simply click in one of the approproate fields.
• To see the insurance company's record in the Insurance Module click directly on the insurance code in the  Code field!
  

Assigned Benefits and Signature on file
This field defaults to Yes with Signature on file defaulting to B, or “block 12 & 13 signed on file”, which means the patient has assigned all medical benefits to the office.  The codes and descriptions used are for electronic claim transmission.

Release Signed and Date
This field defaults to Yes, which means the patient has signed the standard release.  The Date signed is made to be the creation date of the patient’s record.  If this information is different, it should be changed!

Billing Information
Before you start an invoice, you will need to complete the information in this section. However, if you are creating an invoice that does not involve insurance you can click Create Patient Invoice.


If you will be submitting an invoice to insurance, the fields in this section will need to be completed are needed for that invoice.

• For Bill First select that either the Patient or first listed Insurance will be billed! This can easily be changed at the invoice level!
• In Auth Needed select if a referral is or is not needed for this patient to be seen (the choices are No,
  Yes, Today's exam is routine). For patients with managed care, you need to determine under what circumstances a referral is needed.
• In Prior Auth No. enter the current referral number.
• In Auth Allows you can enter what the referral specifically allows. This is informational only.
  
• Auth. Date is the date on the referral. If you click the calendar icon today's date is entered.
• In Auth. Expires enter the expiration date of the referral (usually 60 to 90 days from the date on the referral).  To use the built in date calculator click the calculator icon and follow the on screen instructions. If no referral is entered for a patient that needs one, or no visits remain or the referral is expired, you cannot make an invoice!
• In the field #Start goes how many visits were initially on the referral. The next field, Remain fills in with the same number if initially blank, and is debited each time the referral is used.
  
• In Patient Type select from your own editable list. This is for your information only.
• If there is a Copay$, even if the patient isn’t under managed care, select an amount from the pop-up list!  The software will constantly remind you to collect the copay if you list one!  If a copay is never to be collected select “0” from the Copay$ pop-up list. 
• Some patient’s have a copay based on a percentage.  In this case make a selection from the Copay% field.  This field is informational only but may be used in the future to help calculate expected patient copayments.
• If you use our Specialty database (set up for Dental and Vision), the label for the next field is created. If this patient’s current insurance has some sort of coverage for your services, select Yes. This is informational only!
• If the patient is to receive a Discount (on discountable items only, of course...see Procedures chapter) from your current price, select an amount from the pop-up list or enter a different amount. For a 20% Discount enter 20. This will be applied to each charge line created.
• In PostOp Ends is the date you either entered, or the software calculated, when the current post operative period ends.  This is used to remind you to use specific modifiers for NEW invoice created before this date! In the Procedures module you predetermine the number of post-op days on your procedures.
• There is a combined field with check boxes.
• Check Courtesy if the patient should NOT receive statements related to insurance claims.
• Check No FCs if a patient is not to ever get Finance Charges. If you do not apply finance charges to begin with, ignor this selection!
• If the patient’s insurance never pays for Office Visits check No OVs.
• The remaining checks, Custom1 to 3, are for your personnel use and will not be used for billing purposes. To edit the values of this field go to the Dates screen.
  
  
• The Billing Notes field is for additional information. Clicking the Stamp button start a new entry on the  top of the field with a Date-Time stamp (just like with the Notes field on the Summary screen).
• Additional Information is a multi-purpose field. If you are using an electronic medical records program, this field may be filled with a reminder message about any unprocessed claims.
• The bottom section contains information about a credit card this patient may use on a frequent basis.
• In Card select the type of card from the pop-up list.
• Enter the Numbers without dashes or spaces. Once the numbers are entered, youwill be informed about the validity of the numbers entered.
• In Expires enter the full date (01/02 should be entered as 1/31/2004)
• Enter the exact Card Holder name as it appears on the card. The associated arrow icon fills in the patient's name.
• If needed by your credit merchant, enter the Bank Name and Phone. Some are now outting the three digit security code into the Bank Name field instead.

To learn how to start a new invoice click here.