4. The Insurance Charge Selection Screen
Once you have found a patient or claim, a list of unpaid insurance charges for the patient appears on the Charge Selection screen.
The Charge Selection screen shows the date, provider, procedure code, procedure name, primary diagnosis name, amount charged, and amount due for every outstanding charge with some amount pending an insurance company.
Use the Page Up or Page Down keys if there are more outstanding charges than can fit on one screen. The oldest charges will be sorted to the top of the screen for easy selection.
Selecting Charges for Payment: When you wish to post payments and adjustments, enter item numbers for the appropriate charges. When selecting charges, you can enter more than one number. Separate item numbers by spaces or commas, or use ranges, such as "1-4". Once you've indicated the items to be paid, press Enter and you will see the Payment and Adjustment Screen.
4.1. Find Missing Insurance Charges
The Charge Selection screen shows only pending charges on the patient's current guarantor account. If you are missing a charge that you expected to see here, consider the following possibilities:
You have selected the wrong patient or claim. Double check that the patient is not entered in your system twice, and use the function keys to verify that the charges in question were actually posted for this patient.
The charge is no longer pending an insurance carrier. Press [F6 -- Correct Mistakes] to review or change the pending status of any charge on the account.
The charge is the responsibility of some other guarantor account. Perhaps the patient was recently moved from one guarantor to another. Press [F2 -- Other Guarantor] to view pending charges for this patient that exist on different accounts. Note that this key will not be available unless such charges exist.
The charge was already paid off. Press [F8 -- Family Editor] and then [F3 -- Collection Report] or [F8 -- Account History] to research account activity and outstanding charges.
The charge was deleted. If none of the above explanations help you find the missing charge, it may have been deleted completely. How can you know for sure? A good first step is to review the Day Sheet (daysheet) report for the dates in question. For a family-specific record of activity, you can run the Daysheet History report (dsscan) for the guarantor account in question.
If you still have trouble finding charges or would like to learn more about the issues described above, give PCC support a call at 1-800-722-1082.
4.2. Function Keys on the Insurance Charges Selection Screen
Function keys on the Charge Selection screen will help you perform a variety of other billing-related activities.
- [F1 -- Next Patient]
Press F1 to clear this patient and find a different one.
- [F2 -- Other Guarantor]
Press F2 to see insurance charges for this patient which are attached to an account other than their current guarantor. This key only appears if the patient has pending charges on other guarantor accounts.
- [F3 -- Batch Claim] or H
Press F3 and then enter item numbers to create tags for later claim generation. You can then create the claim later using the hcfa or preptags and ECS programs.
- [F4 -- Print TOS Claim] or T
Press F4 and then enter item numbers to immediately print a HCFA 1500 claim form.
- [F5 -- Print A Bill]
Press [F5 -- Print A Bill] to jump to the bills program for this specific account. You could use this function to generate a personal bill immediately after posting an insurance payment.
- [F6 -- Correct Mistakes] or O
Press F6 to run the oops program for the patient's guarantor account. In oops, you can change the pending status of charges, unlink and relink payments, resubmit claims, correct errors, and more.
- [F7 -- Family Editor]
Press F7 to run the Family Editor (fame) for the patient's guarantor account. In fame, you can update demographic information, view a collection or account history report, print form letters, and more. After dealing with a difficult billing situation, you could add an account note in fame.
- [F8 -- Post A Refund]
Press F8 to run the refund program. In refund, you can refund personal credits and post other account corrections that add a charge or offset a payment.
- P
Press P to run the Post Regular Payments program (pam). In pam, you can record personal payments and post account corrections that reduce the account's balance or offset a charge.
- I
Press I to open the patient's Insurance Policy screen. In policy, you can review the patient's plan history, add or remove policies, or make other adjustments.