Updated
7/12/2007
Payment Types
This
list shows all the different payment or adjustment types used in the Billing
Module. The Memo field describes how that payment type
affects the amount entered in the payment section on the Charge,
Payments or Admin screens.
Any record with a "X" in the
checkbox below the L (locked) column cannot have its Pay Type Description altered.
The Patient Resp Pay Type
The most confusing PayType is 1 Patient Resp. This selection
is meant to be a temporary selection ONLY that moves a specific
amount
from the insurance side of an invoice to the patient side so that all
monies are accounted for and so that an invoice can be considered on
both insurance and
patient ARs.
When a patient finally pays for
part of the insurance side of the invoice (such as a COPAY or
DEDUCTIBLE), this PT is either
brought up and changed or
deleted before the real payment is posted! There are examples of this in the Billing
Examples Section.
Insurance vs Payment Side of an Invoice
Keep
in mind that because PracticeMaker® allows both patient
charges
and insurance charges on the same invoice, there are specific payment
types
to tell you exactly what each payment was for, such as copay,
deductible,
etc., as well as adjustments, credits or refunds.
- If a
locked description has "Ins" in it, such as "Adjust-Ins" this only
means
that the "insurance side" of the invoice is being affected and not that
the
source is FROM an insurance.
- Another
example is "Refund-Ins". This PT tells you that monies are
being refunded that were paid originally against the insurance side of
the invoice, whether it was from the patient, such as too much
copayment, or the insurance, such as being paid twice (that's a rare
one!).
Charge/Payments
Column
This column has three selections
each with its own checkbox. Use the checkboxes here to limit the choice
of codes the user has on either Charge, Payment
or Administrator screen! For example, there is no need to
have Pay Type 2.1 through 2.9 on the Charges screen,
but these choices should be available, if used, on the Administrator
screen.
Different Pay Types
There are payment types that have an effect only on the patient side
of an invoice or the insurance side of any invoice. Generally, Pay
Types 7 through 8 are payments received from the patient
for charges originally assigned to the patient and never the
insurance.
- Pay Types 3, 4, 5 and 6 are specifically for
patient payments to used used towards paying charges that were
originally sent to insurance but are now partially or fully being paid
by the patient.
- Many of the Pay Types can have their
descriptions edited but the effect is unchanged. Use these to
further segregate your payments. This way you can run a specific report
telling you exactly what you want to know.
Credits and Refunds
Please keep the following in mind. Medical practices are not banks and
we are NOT supposed to hold money or "credit" for patients. Once it is
determined that a patient or insurance company is due a refund it
should be sent to the
the correct party and not held "on account". This ruling comes down
from the Office of the Inspector General (OIG). There are specific Pay
Types
to deal with this.
- 10 Credit-Ins means that you are applying a
payment to an invoice based on money originally applied elsewhere. This
PT will subtract the amount entered as an adjustment but
does not consider it a true payment.
- 13 Credit-Pat is similar to 10 but refers
to payment originally posted to the patient side of the invoice
- 18 Refund-Ins simply means you are refunding
money paid against insurance charges, whether being paid back to the
patient or insurance. Do NOT get fooled just because "Ins" is part of
the description. If the patient over-paid the copay, when you refund
the overpayment use THIS code and NOT the next one!
- 19 Refund-Pat means that the patient paid you too
much for something they purchased and you are refunding money back.
